If pain is present at the front of the knee, around the bottom of the kneecap and is exacerbated when the knee is fully extended the infrapatellar fat pad might be the source of discomfort.
The infrapatellar fat pad, also known as the Hoffa’s fat pad sits behind and just below the kneecap. The anatomical location (seen in blue in the picture) is thought to expose this fat pad it to mechanical load, especially during end of range knee extension (straightening), according to Larbi et al. (2014).
The mechanical load during knee extension – in symptomatic cases – causes the fat pad to become impinged, hence the reason why some clinicians refer will refer to this condition as infrapatellar fat pad impingement syndrome. The fat pad also has a rich supply of nerves which contribute to level of discomfort often experienced with this condition.
Seeking advice from a musculoskeletal specialist is recommended. At Pure Physiotherapy, our clinicians complete a thorough assessment which facilitates in making an accurate working diagnosis and the subsequent development of an individualised condition specific rehabilitation protocol.
Most commonly this condition is thought to develop gradually over time following repetitive overextension of the knee. Some individuals may be more susceptible to developing this injury if they have a perpetuity towards knee hyperextension, Larbi et al. (2014) give the example of jumping sports and those with ligamentous laxity as potential contributing factors. In other instances, this condition can start following a direct blow to the knee.
Initial treatment should focus on reducing pain and inflammation. Thus, after speaking with an appropriate healthcare professional, you might want to consider simple pharmacotherapy such as Ibuprofen which is a non-steroidal anti-inflammatory. We recommend that you always read the patient information that comes with your medicine, and if you have any questions ask your pharmacist for advice.
It is advised that aggravating tasks are limited or in some instances, dependent upon severity ceased. This will be dependent upon the individual but might include: not standing for too long, remaining vigilant in not over-extending the knee, and avoiding sports that exacerbate symptoms.
Further treatment should include condition specific strengthening exercises and potential certain taping techniques. Please find the patient resources section of our website where we have created a series of recommended exercise programmes to increase knee strength and stability. To access these, please contact us to obtain the password. We advise consulting with your Physiotherapist prior to trying any of these exercises.
If your symptoms do not improve to the point where you feel you are able to self-manage then our clinicians are ideally positioned to treat this condition.
Larbi, A., Cyteval, C., Hamoui, M., Dallaudiere, B., Zarqane, H., Viala, P. & Ruyer, A. (2014). Hoffa’s disease: A report on 5 cases. Diagnostic and Interventional Imaging. 95(11), pp. 1079-1084.