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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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