Fat Pad Impingement Knee

Overview

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Fat pads are the wad of fat blobs which sit behind and on either side the patellar tendon in the front part of the knee. The fat pads are closely associated with the patellar tendon. Although they are not known to have any major function, they contain blood vessels that supply to the patellar tendon. Fat Pad impingement is one of the common causes of the knee pain. 

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Why & how does fat pad impingement happen?

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In runners and sportsman, the fat pads can get irritated along with patellar tendon. With patellar tendinopathy, the fat pad also gets irritated and inflamed. Once the fat pad gets irritated and swollen, it can get pinched between the femur (thigh bone) and tibia (leg bone). That leads to increased inflammation and further swelling. 

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Who gets fat pad impingement?

 

This is often seen in the age group between 30 and 50. It occurs not only in runners, but also in other sporting population such as footballers, basketball players, cricketers, badminton and so on. The reasons for the fat pad impingement are

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• Poor warm up

• Restarting playing / running after a long gap

• Sudden escalation in the intensity of the workouts

• Over use (not having gap days or rotation to help heal the stress injuries)

• Poor patellar tracking

• Patella Baha (low patella)

 

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Symptoms

 

• Pain when running and high intensity leg activities.

• Initially pain is not felt while doing workouts, when warmed up.

• Anterior knee pain – in and around the patella (knee cap).

 

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Natural History (Progression of disease in the absence of treatment)

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The inflammation of the fat pad may persist and are likely to keep stopping you from doing activities such as running. Natural resolution of symptoms may occur in some, but in majority the pain recurs on resuming the activities. The recurrent cycles of pain is likely to force one out of any further sporting /exercise based activities. 

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When to seek medical help?

 

If the pain is not getting relieved with heat therapy, analgesic gels and sprays and with basic warm up stretches, then it is necessary to see a Sports Orthopedics Surgeon. The diagnosis is based on the symptoms and clinical examination. If the symptoms are not improving with simple treatments an MRI scan may be necessary to assess the condition of the fat pads. 

 

 

What happens when I visit the Consultant?

 

You will be asked about your sporting history, symptoms further to that so far. Consultant will examine you and discuss the treatment modalities.

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What are the treatment modalities?

 

The treatment modalities vary from knee stretches to an injection to the fat pad to reduce the inflammation. In some, arthroscopic (key-hole) surgery and fat pad debridement would be necessary. 

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