Loop Taping for Heel Fat Pad Syndrome: A Crossover Pilot Randomized Controlled Trial

OBJECTIVES: Heel fat pad syndrome (HFPS) is a common but under-investigated cause of plantar heel pain. No randomized controlled trials (RCTs) have evaluated targeted treatments. This study evaluated the immediate and short-term effects of novel loop taping on pain, function, and fat pad thickness in adults with HFPS. DESIGN: Two-period crossover pilot RCT. INTERVENTIONS: Participants completed two taping conditions (loop and control) in randomized order, separated by a 4-to-7-day washout, with each participant serving as their own control. OUTCOME MEASURES: The primary outcome was immediate change in heel pain during the most painful weightbearing activity [0-10 numeric pain rating scale (NPRS)]. Secondary outcomes at 3 days post-taping included changes in Foot Health Status Questionnaire (FHSQ) Pain and Function scores [0 (worst)-100 (best)] and in average 24-h heel pain (NPRS). Mechanistic outcomes included heel fat pad thickness and pressure pain threshold (PPT). Linear mixed effects models estimated between-condition differences. RESULTS: Among 16 paired observations, loop taping produced a small, non-significant between-condition difference in change in immediate activity-related pain (mean difference 0.8; 95% CI: -0.1 to 1.7; p = 0.10); 63% (loop) versus 25%-31% (control) met minimal clinically important difference (MCID) thresholds. Between-condition differences favored loop taping for FHSQ Pain (20.7 points; 95% CI: 4.5 to 36.8; p = 0.02) and Function (11.3 points; 95% CI: -1.0 to 23.6; p = 0.09), exceeding MCIDs of 12.4 and 6.4 points. Fat pad thickness increased by 1.7 mm (95% CI: 1.2 to 2.3; p < 0.001) and correlated with improvement in FHSQ Pain. PPT did not differ between conditions. CONCLUSIONS: Loop taping showed favorable trends for reducing pain and improving function and significantly increased heel fat pad thickness. Although underpowered for definitive conclusions, several outcomes exceeded MCIDs. Findings support the potential of loop taping and inform primary outcome selection and design considerations for future, larger trials of this low-cost, pathomechanics-based intervention. TRAIL REGISTRATION: This RCT was registered at Clinicaltrialabas.gov (NCT05385796).