Fat Pad Impingement

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INJURY TITLE

Fat Pad Impingement

 

INJURY OVERVIEW

The fat pad is a prominent piece of tissue at the front of the knee in-between the kneecap and the femur.  A direct blow can pinch it or if certain biomechanics allow it to happen.  It can be very painful.  This is a prominent injury in kicking sports like football and rugby.  This is because as the leg straightens rapidly during the kick the fat pad can get pinched.

 

INJURY IN-DEPTH INFORMATION

The fat pad has a decent nerve supply and can be very tricky to deal with once injured/inflamed.  The problem being that when inflamed there is a proportional increase in size of the tissue so it is easy to keep on aggravating it buy just completing normal tasks.

 

The fat pad has been implicated in many different knee conditions.  Some people clinical diagnosed with patellofemoral problems have been shown to actually have fat pad inclusion.  Pain levels in osteoarthritis of the knee can be reduced by simple off loading of this structure.

 

COMMON SIGNS & SYMPTOMS

  • Pain on leg straightening activities
  • Pain on prolonged standing
  • Often seen with hyperextension of the knee.

 

HOW IS IT ASSESSED

  • Biomechanical assessment during functional tasks
  • Direct palpation during clinical tests
  • MRI imaging

 

 

 

GENERAL TREATMENT

  • Off loading the fat pad – use of taping to possibly address any kneecap positional issues.
  • Use of taping to prevent unwanted knee extension
  • Hamstring strengthening exercises in near extension to increase the proprioception of the knee.
  • Biomechanical intervention – use of orthotics
  • Acupuncture
  • Surgery has mixed results

 

Exercise Videos: i.e.

  • Rotator cuff strengthening
  • Pec stretch
  • etc

 

WHICH HEALTH PROFESSIONAL TO CONSULT

PHYSIO     X

MEDIC     X

PODIATRY     X

Put an ‘X’ next to each health professional that most commonly deals with this injury.

i.e. tennis elbow would be Physio and Medic as injections are common, whereas for muscular LBP it would be Physio and not Medic as they would just refer them to a Physio.

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