Fat Pad Syndrome

Fatty tissue plays an important role in the body. It serves as an energy store, and also functions as a cushion in many parts of the body for your organs and other tissues. The knee has a wedge-shaped fat pad that sits in the front of the knee, and is called Hoffa’s fat pad (named after Albert Hoffa, an orthopaedic physician who first discovered it and related it to knee pain), and prevents the bones from bumping into each other, and also cushions the knee from outside forces (e.g., when kneeling).

When this fat pad becomes irritated due to trauma or overuse, you can end up with fat pad syndrome. Hoffa’s fat pad has a high number of blood vessels and nerve endings within it; which means that this area is sensitive and easy to irritate.

What does fat pad syndrome feel like?

If you have fat pad syndrome, you may notice the following:

• Warm to the touch
• Swelling
• Tender to touch or painful
• Pain or discomfort during or after activity
• Sensations of pressure/fullness in the knee

The following activities may be irritable or painful:

• Deep bending of the knee (e.g., deep squats)
• Going up or down stairs
• Kneeling
• Running
• Jumping
• Walking for long periods
• Completely straightening the knee

How does fat pad syndrome start?

Most of the time, fat pad syndrome starts because the fat pad is being compressed between the knee joint and the knee cap. This may be the result of direct trauma to the knee, hyperextension (“over-straightening” the knee beyond normal ranges of motion), prolonged kneeling, or repeated and excessive loading of the knee joint beyond the tolerance of the tissue.

You may be at increased risk of developing this condition if your kneecap is in a higher position. This is known as patella alta. If the kneecap is positioned higher, it is easier for the fat pad to be pinched between the kneecap and the surface of the bone, resulting in aggravation of the tissue. 

How can Solutions help?

In order to address fat pad syndrome, we will need to go through a number of steps:

1. Identify activities and movements that aggravate your symptoms
2. Modify your activities to prevent aggravating your symptoms
3. Identify non-irritating exercises that help you maintain your strength and fitness
4. Maintaining physical activity and exercise as much as possible

How long will recovery take?

Most people recover well from fat pad syndrome within six to twelve weeks but may take up to six months in some cases. The most important part of managing fat pad syndrome is making sure that irritating activities are identified and managed to prevent further irritation of the fat pad.

Other factors can also influence recovery from this condition:

• How irritable the knee is (How sensitive is it? How much does it affect your function?)
• Getting enough sleep
• Age (older adults may take longer to recover)
• Whether you smoke (smoking delays recovery from many conditions)
• Metabolic health (conditions such as diabetes can delay recovery)

All the above factors influence your ability to recover and heal; taking care of other aspects of your health can help you recover more quickly!

I think I have fat pad syndrome – what should I do?

Fat pad syndrome can be highly irritating and limit your ability to work or participate in sport. A thorough assessment with a physiotherapist can help identify what activities contribute to your pain and can help inform a treatment plan to help your recovery. Call us now on 1300 738 609 or book online to see one of our physiotherapists! Let us help you find your Solution.