Infrapatellar Fat Pad and Pain

The infrapatellar fat pad is located between the patella tendon and the tibiofemoral joint synovium, (tissue that encases the knee) at the inferior (bottom) of the patella (knee cap).

It’s shown in the diagram in yellow. The fat pad is richly innervated (filled with neurons) and vascular (filled with blood vessels), leading to strong pain when impinged or pathological.

The fat pad is a mobile structure that helps stabilise the patella and decrease pinching of the synovial membrane. Trauma to the fat pad can lead to its hyperplasia (growing in size), scar tissue and even calcification (boney deposits).

Aggravating activities may include walking up stairs (as you push up) or wearing heels (knee extension). Once diagnosed clinically, treatment may involve postural education initially, such as reducing how much someone locks their knees in standing, icing for pain relief or strapping the patella.

There is usually a case for progressive exercises such as quadricep (front thigh) and hip strengthing, plus motor control. There may be a case for foot orthotics. Surgical fat pad resection may also be warranted, with post-op rehab.

Do you or someone you know have knee pain? All general enquiries are welcome.

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