Pain in the heel frequently occurs and there are many different reasons for this. Plantar fasciitis is by far the most common problem and is typically simple to diagnose. However, there are many other reasons that are not as common and are more difficult to diagnose. Among the less common conditions is a ailment known as heel fat pad atrophy. There is a layer of fat beneath the heel which provides a cushion and shock absorber when we are walking or running. Generally there's sufficient fat there to provide that cushioning, however in some people it atrophies or wastes away and it might no longer protect the heel with that shock reduction. Precisely why it occurs isn't completely obvious, but there is some atrophy of that fat pad with growing older and some just appear to atrophy more than others quicker. The main signs of fat pad atrophy are increasing pain with weight bearing underneath the heel. It is also crucial that you eliminate other conditions because they may exist concurrently.

The main approach to take care of heel pad atrophy is to replace the fat that has wasted away. The easiest way is to use padding in the footwear to cushion the heel. This is usually made from a silicone gel which has the same consistency as the natural fat. This can act as a substitute for the fat that has atrophied. This commonly deals with almost all cases of this and that is all that has to be done. The only issue with this approach is you need to wear the pads and you can’t do that when barefoot or in sandals without difficulty. The only other choice is a surgical procedure called augmentation in which some fat is surgically implanted underneath the heel. The inserted fat may come from another part of the body or might be artificially made in the laboratory. The longer term results of this type of approach aren't yet known, however early results from the procedure appear excellent.

Cracked heels are a pretty common foot disorder, often referred to as heel fissures. Cracked heels are the result of dry skin and made more complicated should the skin surrounding the side of the heel is callused. They can be painful to weightbear on and also the cracks in the skin could bleed.

Some individuals tend to have a normally dry skin which makes your skin easy to split. The thicker dry skin (callus) surrounding the heel that could be more prone to tear is usually due to weightbearing variables which increase strains under the heel (eg the way you move).

Factors that might also be involved in the explanation for cracked heel skin include:

* continuous standing

* being obese

* open back on the shoes

* some medical conditions predispose to a dehydrated skin (for example all forms of diabetes)

* skin conditions (eg skin psoriasis)

Self management for cracked heels:

* Applying an oil based moisturizing lotion twice daily is very necessary to get on top of cracked heels. A pumice stone may be used to decrease the thickness of the hard skin. It is important to avoid open back footwear or thin sole shoes.

* It is best not to try and reduce the callused skin yourself using a blade or scissors. There's a risk of an infection occuring and taking way too much off.

Podiatrist treatment of cracked heels can include the following:

* looking into the cause of the cracked heels, so this can be addressed

* treatment of hard thick skin by debriding it (frequently the splits are not going to heal unless the skin is not taken off). This will have to be carried out consistently. Regular maintenance might be the easiest way to avoid the disorder.

* if very painful, taping are often used to 'hold' the cracks together while they get better (a upkeep plan after this to stop it happening again is very important).

* prescription as well as guidance about the most appropriate lotion or cream.

* advice about shoes and self-care of the cracked heels.

* insoles may be used to change the way you walk for preventing the thick skin from developing (these are typically indicated in situations of heel callus and aren't appropriate for all cases).

* a heel "cup" might be used to keep the fat pad from expanding laterally. This cup is worn inside of the shoe and might be very efficient at prevention when used frequently.

* on rare instances a number of Podiatric doctors along with Dermatologists have tried a skin glue to retain the sides of the epidermis together, so the cracks can mend.

Cracks in the skin at the back of the heel are unattractive and can be painful. They are reasonably common, especially in those people who are predisposed to them. These splits in the skin about the heel occur when the skin is thicker and dry. As the fat beneath the heel expands out sideways when walking puts strain on the skin that it may not take, so the skin just tears or splits. The wearing of open back shoes also contributes to the problem. Various medical conditions can also contribute to the dryness of the skin and a numerous biomechanical issues contribute to the thickening of the skin and the subsequent cracked heels.

After a crack happens, it does need to be dealt with as it may act as a entrance for an infection to get in. Firstly, an antiseptic needs to be used to avoid that if the split is open. It is then necessary to get rid of the thick callus around the peripheray of the heel. This can be done by a experienced podiatrist if you have access to one. Otherwise, then you need to use something such as a foot file, pumice stone or emery board and get to work on reducing it. This may take a lots of effort. As soon as that thickened skin is reduced, then it is important to use lotions and emollients to make the skin soft and flexible so it doesn't have the tendency to crack. Urea based creams are typically better for that. When this original condition is taken care of, then preventative approaches have to be put in place to continue with or else the condition will in all probability occur again. Occasional use of a foot file or similar is recommended to keep the callused skin down and frequent use of a urea based cream is crucial to make the skin resistant to splitting and stop the dryness. Keeping away from open back shoes is also advised to avoid cracked heels.