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What is fat pad impingement?

In the knee, a fat pad lies between the kneecap and the underlying leg bone. Fat pad impingement, also known as Hoffa’s syndrome, is where this fat pad is pinched between the kneecap and the underlying bone. Physiotherapy is a very effective treatment for fat pad impingement.

How does fat pad impingement happen?

Impingement can occur in two ways:
  • Forcible straightening of the knee. This can occur when kicking or landing from a jump, and causes the bottom of the kneecap to dig into the fat pad.
  • Repetitive minor pinching. This can occur if the fat pad is enlarged or swollen it can cause bulging around the bottom of the kneecap making it more susceptible to being pinched. This type of impingement is often experienced if the fat pad is damaged during arthroscopic surgery.

What are the symptoms of fat pad impingement?

Fat pad impingement causes pain just below the kneecap. This pain is normally felt when the knee is straightened as far as possible. If the impingement is caused by repetitive trauma then the tissue below the kneecap may bulge out and may be firmer than on the other knee. This is due to the formation of scar tissue.

What should I do if I have fat pad impingement?

If you suspect that you have a fat pad impingement, you should arrange a physiotherapy appointment. In the meantime, you should avoid activities that make your pain worse. Icing should be applied to the front of your knee using a bag of frozen peas or crushed ice wrapped in a moist cloth for 15–20 minutes every 1–2 hours.

What shouldn’t I do if I have fat pad impingement?

If you suspect you have fat pad impingement, you should not ignore the problem. If you ignore the problem, the amount of inflammation and scar tissue may increase and cause more pain.

Physiotherapy treatment for fat pad impingement.

Physiotherapy is important in the treatment of fat pad impingement. At the initial assessment, your physiotherapist will be able to diagnose your problem and establish its severity. Following this your physiotherapist will design a progressive treatment plan for you. Treatment may include:

Could there be any long-term effects from fat pad impingement?

If properly diagnosed and treated, fat pad impingement does not produce any long-term effects. Without appropriate treatment, it can lead to prolonged pain in the region just below the kneecap and prolonged lay-off from normal activity or sport.

Please call Physio.co.uk on 0330 088 7800 to arrange an appointment or book online.

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