Knee Fat Pad: Anterior Knee Pain Impingement | Hoffa's Fat Pad
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Knee Fat Pad: Anterior Knee Pain

Knee pain can be debilitating. One of the primary causes of knee pain on the front of your knee is fat pad impingement. There are a number of other conditions on the anterior knee that can be painful such as kneecap arthritis, Patellar tendonitis, housemaid’s knee, and patellofemoral pain syndrome. In this article, we will explore all about Knee Fat Pad Impingement.

What is a knee Fat Pad?

A fat pad is an anatomical structure that is made up of adipose tissue. There are three main fat pads within the knee joint, although the most important one is the Infrapatellar fat pad, located at the front of the knee just beneath the knee cap. The anterior location of the fat pad makes it one of the possible structures responsible for anterior knee pain.

What is the function of a knee fat pad?

The purpose of having a knee fat pad within the knee joint is to provide shock absorption and load distribution across the numerous structures around the knee joint, such as the menisci, tendons, cartilage, and ligaments.

Knee Fat Pad Impingement

What causes knee fat pad pain?

The fat pad anatomically sits between the knee cap and the lower part of the femur. Irritation of the fat pad can occur as a result of direct trauma to the knee such as a fall or as an overuse injury of the soft tissue around the knee due to repeated knee extension or flexion: this is generally known as fat pad impingement. It should be noted that the fat pad is a highly innervated structure, therefore high pain levels are quite common. Patients often describe their pain as a dull ache to sharp intense pain. 

Hoffa’s fat pad impingement

This is the name that is commonly given to infrapatellar fat pad syndrome, named after the first scientist to study this condition. An “impingement” is generally the result of an anatomical structure being compressed between two bony structures.

In this case, the highly innervated infrapatellar fat pad gets compressed between the knee cap and the lower end of the femur. This can come as a result of hyper-mobility (knee hyperextension can commonly cause fat pad impingement), prolonged static postures in knee flexion or knee extension, tight muscles (for example the quadriceps and the calf).

Fat Pad Impingement taping | Flawless Physio

Hoffa’s Fat Pad Impingement treatment?

After establishing the contributing factors for the Hoffa fat pad impingement, the goal is to off-load the area and settle down symptoms. Treatments include:

  • Icing (ice works well as an anti-inflammatory)
  • Taping (applied to relieve some pressure and reduce inflammation)
  • Stretching is an important part of treatment when fat pad impingement is resulting from tight calves or quadriceps muscles
  • Once the acute stage has resolved and pain has settled, exercise therapy becomes critical to load the surrounding tissues which may become de-conditioned as a result of pain and inhibition from a fat-pad impingement. Strengthening exercises generally involve hip and knee joints, although hip-dominant exercises are generally preferred.
  • Orthotics may also be beneficial if there are biomechanical abnormalities in your gait pattern which could provoke irritation to the fat pad.

Are there other treatment options?

Should a course of physiotherapy not fully resolve your symptoms, injections from a Sports Medicine Doctor may have also a role in reducing pain from a fat pad irritation. Normally, injections utilise a combination of corticosteroids and lidocaine. Should this not resolve your pain, a consultation with an orthopedic surgeon may be appropriate to consider surgical management.

If you are experiencing pain at the front of your knee and would like some advice on diagnosis and management, please get in touch.

We offer Private Physiotherapy via Online Appointments for £40 and Face-to-Face appointments for £70 in our clinics.

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