Fat pad impingement occurs when the infrapatellar of the knee becomes irritated or impinged.

The fat pad is well innervated, and therefore a sensitive structure

The infrapatellar fat pad lies beneath the patellar tendon, behind the patella, and in front of the distal end of the femur.

Also known as ‘Hoffa’s disease’

Signs & Symptoms

  • Pain below the patella

  • Tenderness on squeezing either side of the patellar tendon

  • Patella is tilted inferiorly

What Causes It?

  • Excessive hyperextension of the knees in standing

  • Increased anterior pelvic tilt

  • Repeated hyper extension of the knee

How to Self Manage

  • R.I.C.E. protocol

  • Monitor stance and sporting technique to see if hyperextension is a contributing factor

  • Improve your posture and core stability with a Pilates program


  • Conservative management should be enough to manage mild to moderate arthritis

  • Once pain becomes constant and severe, and life activities are significantly impeded then specialist intervention may be required

How Physio Helps

  • Assess your knee to confirm that the fat pad is impinged

  • Assess the patella for inferior tilt

  • Trial taping technique to offload the irritated fat pad

  • Correct postural contributing factors (lumbar lordosis, pelvis tilt, degree of hyperextension in standing and in sport)

  • Assess and correct muscular imbalances

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Sammy Margo Physiotherapy

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Email: physiophysio@hotmail.com

Tel: ​020 7435 4910​​​
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Web: sammymargophysiotherapy.com


Disclaimer: Information made available by AskPhysio (Sammy Margo Physiotherapy) is provided for guidance only and should not be considered as medical recommendations or advice.  AskPhysio is not responsible for errors or omissions in the information. Please consider what the best options for your healthcare are, based on the urgency of your condition and nature of your condition. Please consult a GP or Healthcare Specialist to discuss any specific concerns that exist prior to using the information provided.