This is an interesting BJSM editorial published last year on the above topic.
Published online: 28 Nov 2016
“Is it merely a curiosity that fat pads are found adjacent to the area of tendon affected by tendinopathy? We propose that fat pads share an anatomical and functional relationship with their adjacent tendons and may therefore contribute to the pathogenesis of tendinopathy. Fat pads and tendons have a shared blood supply, and cytokines produced in the fat pad have only a short distance to travel in order to affect the tendon.
Fat pads lubricate, insulate, protect and provide structural support for tendons. However, the functional significance of the fat pad is often overlooked. In an early study of fat pad function, the distal tip of Kager’s fat pad migrated into the retrocalcaneal bursa during ankle movement in healthy individuals, but not in an individual with a hindfoot disorder. This ‘variable plunger’ mechanism minimises pressure changes within the bursa during ankle movement. …”
Unfortunately I do not have access to this article. It is a very interesting topic and I would love to learn more about this. Please click here to access the article if you have access.