Fat Pad Impingement
Typical Symptoms
Fat pad impingement causes an intense sharp pain at the front of the knee with extension, which is typically worse with loading. It it usually quite localised and replicable by the patient.
What causes it?
Swelling or scarring to the fat pad from previous trauma, surgery or even abnormal mechanics of the knee can cause the fat pad to be pinched and cause pain symptoms. In some situations, there may be notable swelling compared to the opposite side.
How can I help myself?
Perhaps consider when the symptoms started and what triggered it off. Was it due to a change in running style, footwear, load etc? If related to something in particular, try reverting back to what you did before and see if things improve.
Sometimes working with a coach or personal trainer can help improve your form and reduce symptoms or a sports therapist can help with tightness. Simple measures such as PRICE can help to reduce swelling in the knee and pain can also be improved with oral pain-killers.
When to seek help?
If you have attempted to improve the symptoms but are having ongoing or increasing pain, or if it is significantly affecting your running, it may be useful to have the knee assessed as soon as possible.
What are the treatment options?
Once your clinician assesses you with a thorough history and examination, they may organise a weight-bearing X-ray of your knee to see if the patella (knee cap) is abnormally positioned or if there are any degenerative (wear and tear) changes in the front of the knee.
You may be referred for rehabilitation with a physiotherapist or a gait analysis with a podiatrist and in some situations, an ultrasound guided cortisone injection may help alleviate inflammation and pain symptoms. An MRI is not usually needed for this, unless another concurrent injury is suspected.
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