Knee pain is a common problem, and it can come from a number of different sources. If your knees hurt, it may be difficult to do the things you enjoy and you may experience a lower quality of life.
One possible source of knee pain is Hoffa’s fat pad. The Hoffa’s fat pad is a cushion of fatty tissue located right under your kneecap. When that fat pad gets pinched or inflamed, it’s called fat pad impingement (or Hoffa’s Syndrome), and it can cause pain in the front of your knee.
Understanding Fat Pad Impingement
Fat pad impingement, also known as Hoffa’s syndrome or infrapatellar fat pad syndrome, is a condition affecting the cushion of fatty tissue that sits just under your kneecap. That pad of fat plays an important role in cushioning the knee joint and reducing friction as you move.
Causes and risk factors
Fat pad impingement can occur for a number of reasons:
- Tight quadriceps muscles
- Anterior pelvic tilt
- Direct impact or injury to the knee
- Knee hyperextension
- Scarring in the knee
- Osteoarthritis
Some people are more prone to fat pad impingement than others. These include athletes who play hockey, participate in martial arts, or play football. People with ACL injuries, a history of knee hyperextension, IT band syndrome, or flat feet are also at higher risk.
What are the symptoms?
The primary symptom of fat pad impingement is pain in the front and sides of your knee. You may notice the pain gets worse when you extend your knee.
Activities that can trigger pain include walking, kicking, squatting, and standing in hyperextension (locking your knee backwards).
Other symptoms you may experience include:
- Inflammation and swelling
- Occasional sharp pain
- Pain while climbing stairs
- Pain while sitting
How is fat pad impingement diagnosed?
If you think you have fat pad impingement, it’s important to get a diagnosis from a doctor. You’ll likely need to see an orthopedist, sports medicine specialist, or physical therapist.
To diagnose the condition, the doctor will perform a physical exam. This will likely include a “Hoffa’s test,” in which the doctor presses on the fat pad while extending your leg. The doctor will also want to discuss your medical history.
In some cases, you may need an MRI to rule out other possible causes of your pain and confirm the diagnosis.
Treatment and Management Strategies
Most cases of fat pad impingement respond well to conservative treatment options. In rare instances, surgery may be needed.
Conservative Treatment Options
- Rest and activity modification: Avoiding activities that aggravate the pain is key.
- Cold therapy: Applying ice to the affected area can help reduce pain and inflammation. Wrap the ice pack in a towel to protect your skin.
- Physical therapy: Exercises to strengthen and stretch the muscles around the knee can provide support and stability. Your physical therapist may also use electrotherapy, such as TENS or ultrasound.
- Anti-inflammatory medications: NSAIDs, like ibuprofen or naproxen, can help manage pain and inflammation, but should be taken as prescribed by your doctor.
- Taping: Kinesiology tape can provide support to the knee and create more space for the fat pad.
- Anti-inflammatory injections: In some cases, your doctor may recommend a cortisone injection to reduce inflammation.
Surgical Intervention (Rare Cases)
Surgery is rarely necessary for fat pad impingement. However, in severe cases where conservative treatments have failed, surgery to remove a portion of the inflamed fat pad may be considered.
In Summary
To prevent fat pad impingement, stretch and strengthen the muscles in your hips, knees, and ankles. It’s also a good idea to avoid wearing high heels and maintain a healthy weight.
With proper treatment, it usually takes two to four weeks to recover from fat pad impingement. It’s important to follow your treatment plan carefully.
For the best results, work closely with your physical therapist and doctor. If you think you might have fat pad impingement, seek treatment as soon as possible. Early diagnosis and treatment can improve your outcome and prevent chronic pain.