Fat pad atrophy is a problem as we get older. There is a fat pad under the foot, especially the heel that can protect the foot from impacts and maybe from injury when running. With age, that protection decreases. There is really nothing that can be done to reverse fat pad atrophy except with the use of fat injections. The only other option is the use of soft tissue supplements (ie padding) in the shoes with materials like poron. This is also were a well cushioned maximal running shoe can be helpful, perhaps one of the Hoka’s. If the shoe and padding under the foot is adequate, then fat pad atrophy is not going to be a problem unless a lot of activity is done barefoot.