It is important to note that the infrapatella fat pad is oftentimes called as Hoffa’s pad. This is a soft tissue that is situated under the kneecap that can become impinged, resulting to knee pain.
The symptoms of fat pad impingement typically include tenderness around the base and beneath the kneecap. The individual might have a history of being able to over straighten the knee which is called as knee hyperextension.
In some circumstances, the base of the kneecap might be tilted outwards due to the swelling beneath it. The doctor usually performs Hoffa’s test to diagnose the injury.
What is Hoffa’s test?
The individual is in a lying position with the knee bent. The doctor will press both thumbs along either side of the patellar tendon, just beneath the patella. The individual is then asked to straighten out the leg. If there is pain or apprehension, it is considered as a positive sign of fat pad impingement.
A close look on fat pad impingement
The infrapatella fat pad is the soft tissue that lies beneath the patella which separates it from the femoral condyle. In scenarios where a force is directed at the patella, it functions as a shock absorber, thus providing protection to the underlying structures.
In case of a forceful direct impact on the kneecap, the fat pad can end up impinged between the femoral condyle and the patella. Since the fat pad is one of the highly sensitive structures in the knee, this injury is known to cause severe pain. The condition is usually long-standing since it is worsened by straightening or extension of the knee joint. It simply means that the fat pad is under constant irritation and can even become significantly inflamed.
The treatment for fat pad impingement includes conservative measures. The individual must be encouraged to rest and avoid engaging in aggravating activities. You can apply an ice pack to minimize pain and inflammation. An ice pack can be applied at 10 minutes every hour and steadily reducing as the symptoms improve. Avoid using an ice pack directly over the skin since it will cause further injury. Make sure that the ice pack used is wrapped in a clean towel or cloth. If you want to learn more on how to effectively provide cold therapy, enroll in a first aid class. (Read here for more information on classes offered).
The doctor might utilize electrotherapy such as TENS and ultrasound. Muscle strengthening exercises should be performed to maintain the strength and fitness of the surrounding muscle groups as long as the pain allows.
Patella taping can be effective in treating fat pad impingement. A commonly used method involves taping of the upper area of the patella in order to allow additional room for the structures under the inferior surfaces, thus putting them under reduced stress. In case conservative measures do not work, surgery might be required which involves partial or full removal of the fat pad.