Fat Pad Syndrome
Article by John Miller
Fat Pad Syndrome
(aka Fat Pad Impingement, Hoffa's Syndrome)
image source: http://www.uwhealth.org/sports-medicine/clinic/fat-pad-impingement/10106
What is Your Fat Pad?
The knee fat pad, or infrapatellar fat pad, is a soft tissue structure which lies just below and under the kneecap (patella). The fat pad is also enclosed by the thigh bone and the shin bone. Because the fat pad is richly innervated it is considered one of the most sensitive structures in the knee.
If irritated, your fat pad can be a great source of knee pain and discomfort. Since the fat sits just below the knee cap, if there are problems with the kneecap alignment it can cause pinching or “impingement” on the fat pad. Fat pad syndrome is also known as Hoffa's Syndrome.
What Causes Fat Pad Syndrome?
What are the Symptoms of Fat Pad Syndrome?
Fat Pad Impingement, also called Hoffa’s Syndrome can include some or all of the following symptoms:
These symptoms can also be characteristic of several other knee conditions including patellar tendonitis and patellofemoral joint pain syndrome, so it is best to contact your physiotherapist for a thorough assessment and proper diagnosis.
How is Fat Pad Syndrome Diagnosed?
On examination, your physiotherapist or sports doctor will look for signs of the symptoms mentioned above. In addition, they will perform a clinical test called Hoffa’s test which involves moving the kneecap after you contract your quadriceps muscles.
An MRI may also be used to diagnose fat pad inflammation but it is not very accurate for diagnosing fat pad impingement. A thorough assessment from your physiotherapist or sports doctor is usually able to provide you with a more definitive diagnosis.
What is the Treatment for Fat Pad Syndrome?
Physiotherapy treatment will hasten your recovery. Your physiotherapist will aim to:
We suggest that you discuss your knee injury after a thorough examination and accurate diagnosis from your knee injuries clinician such as your sports physiotherapist, sports doctor or knee surgeon.
If knee pain and symptoms continue to persist fat pad surgery may be an option. Surgical treatment of fat pad impingement may involve arthroscopic debridement or partial removal of the fat pad.
How to Prevent Fat Pad Syndrome?
The best way to prevent occurrence or recurrence of fat pad impingement is to optimise the strength and flexibility of the muscles around the knee, hip and ankle. Your physiotherapist is an expert at guiding you towards the best exercises to correct for any deficits in these areas.
If you have previously battled fat pad impingement it is best to avoid potentially aggravating activities such as kneeling, squatting and kicking for prolonged periods. For females, it is best to avoid or limit walking in high heels.
For more advice, please consult with your physiotherapist.
Fat Pad Syndrome Treatment Options
FAQs about Fat Pad Syndrome
Helpful Products for Fat Pad Syndrome
Excellent for stretching your tight thigh structures: ITB, quadriceps and hamstrings.
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