Fat pad irritation of the knee can be caused by the pinching of the thigh bone and the knee cap. It could be due to direct impact or from incorrect movement patterns. The fat pad of the knee is positioned at the bottom end of the knee cap and its main purpose is shock absorption during activities involving the knee. As the knee bends the fat pad moves back and as it straightens it moves forward to maintain its position in relation to the knee cap.
The knee joint is made of the femur gliding on the tibia and the fat pad allows this motion to be smooth. Due to changes in the hip, changes in knee or ankle movements during activity can occur at the knee joint. This may increase the force on the fat pad making it change shape or position and alter the pressure upon it.
The fat pad space-saving properties and pain sensors can create increased sensitivity and severe pain when injured. This leads to the expansion of blood vessels resulting in swelling around the area. When it expands it creates a pinching of the knee cap on the fat pad and results in decreased blood flow to the area.
All the joints and tendons involved in this area would need to be assessed in order to improve the control, strength and endurance of muscles.
How can Physiotherapy help fat pad irritation?
Treatment for knee injuries like this would include unloading the inflamed structures by using different taping techniques. Improving the mechanical movements of the hip, knee and ankle by loosening joints and relaxing the muscles surrounding them will lead to better alignment of the knee cap.
In addition, strengthening the buttock muscles around the hip will help prevent the hip from rolling inward, which in turn puts more pressure on the fat pad. Stretching the muscles on the front of the thigh will also reduce the force placed on the fat pad.
It is important to create a balance between the muscles behind and in front of the knee. This not only prevents the knee from straightening too far back but may also reduce the force placed on the fat pad.
As walking is an everyday task, your physio may need to re-educate you about your walking pattern, which is an important consideration to prevent any extra strain from being placed on the knee cap during normal walking motion.
- Evaluation and treatment of disorders of infrapatellar Fat Pad, Jason Dragoo, Christina Johnston, Jenny McConnell. Sports Medicine 42(1):51-67 November 2012.
- Evaluation, treatment and rehabilitation implications of infrapatellar Fat Pad Joseph Hannon, Sean Bardenett, Steven Singleton and J.Craig Garrison. March 2016,8(2): 167-171.