The heel pad, with its specially organized elastic adipose tissue, and the importance of heel pad shock absorption loss (soft heel pads) in the pathophysiology of achillodynia (particularly in heel strikers) is described and illustrated by case histories of three athletes. All had unusual, soft, flattened heel pads; all were heelstrikers; and all were successfully treated with added external heel shock absorption. A diagnostic method to evaluate the shock absorbing ability of the heel pad is the "visual compressibility index" calculated on the basis of x-ray films of the heel, loaded and unloaded by body weight.