Fat pad impingement (Hoffa's syndrome)
What is it?
The fat pad is an area of fatty soft tissue below the kneecap. It separates the patellar tendon from the top end of your shin bone (tibia) acting as a shock absorber to protect your knee. The patellar tendon connects the kneecap to the shin bone and is just below your kneecap.
Fat pad impingement is when the fatty soft tissue gets pinched between the patella tendon and the end of the shin bone.
Symptoms
As the fat pad is the most sensitive part of your knee, this condition is extremely painful . There is usually pain and tenderness around the bottom of your kneecap.
Causes
Fat pad impingement is usually caused by overextending of the knee. This is when your knee is forced beyond its fully straightened normal position. It can occur as the result of an awkward fall or a knock to your knee.
Treatments
Fat pad impingement can be a difficult injury to treat. Your sports medicine doctor or physiotherapist will first try to reduce the inflammation and pain in your knee. They may do this using ice, strapping or techniques to take the weight off the fat pad. You will also be shown a series of exercises to improve the range of movement in your knee, if your symptoms allow it.
Do
- Stop any activity that aggravates your injury.
- Use ice on the injured area until the swelling goes down. Don't apply ice directly to your skin as it can give you an 'ice burn' - place a cloth between the ice and your skin.
Don't
- Ignore the pain. Fat pad impingement doesn't go away on its own, it's important to see your doctor or physiotherapist for treatment.
Peer reviewed by David Toy, MCSP, Bupa Sports Medicine physiotherapist
Publication date: June 2009
