The fat pad is a soft tissue structure that sits below the kneecap (patella) right behind the patellar tendon. The fat pad acts as a cushion, protecting the condyle of the femur from being hit by the patella in the case of a direct blow to the kneecap. The fat pad contains many nerves, and at the time of injury, one experiences extreme knee pain. A person’s hip and/or knee alignment can cause the fat pad to become irritated and impinged.
Fig 1. Image showing fat pad impingement
People who engage in sports or activities where a forceful blow to the knee is highly likely such as hockey, martial arts, football, soccer, and rugby.
People who have suffered from an anterior cruciate ligament (ACL) injury. An ACL injury decreases the stability of the knee, which makes the fat pad more prone to impingement.
People who have had a history of hyperextension in the knee area.
People suffering from Iliotibial Band Syndrome (overuse injury of the connective tissues that are located on the outer thigh and knee).
Runners who have flat feet (also known as excessive pronation) or have muscle weakness/imbalance around their hip muscles.
Knee pain treatment includes:
Use cold therapy or apply ice to the knee to reduce knee pain and inflammation. Application of the ice should not be directly on the skin to avoid skin burns. Instead, one should wrap the ice in a tea towel or use recommended knee wraps.
Rest and avoiding activities that may strain the knees is another way of treating the condition.
A physiotherapist may also use electrotherapy such as TENS and ultrasound to treat fat pad impingement.
A patient should also carry out exercises that strengthen the knee muscles. The exercises should not cause excessive strain to the knee. These will be prescribed to you by your physiotherapist.
Taking anti-inflammatory medications prescribed by the doctor.
Taping the kneecap is also an effective treatment for treating the condition since it helps create more space for the fat pad, therefore minimising the stress on it.
A steroid injection to the knee may be considered to help reduce inflammation and pain.
In some exceptional cases where conservative methods fail, then surgery may be advised. Surgery may involve complete or partial removal of the fat pad.
Fig 2. Image of a cold compression wrap used in treating fat pad impingement