Skip to content
Call

Anterior Knee Pain

Anterior knee pain has many causes. Often medical professionals and patients are worried about ligaments, tendons, or patella tracking issues. While these are all related causes of anterior knee pain, there can be an underlying problem that goes unaddressed. One of the most commonly forgotten causes of anterior knee pain is the infrapatellar fat pad or Hoffa’s fat pad. Hoffa was the first person to describe this structure in literature.

While it has been proven that the infrapatellar fat pad has a large concentration of nerve endings and can be a generator of pain, clinicians can overlook this structure as the cause of other knee conditions. At times there can even be imaging performed that shows no structural damage inside the knee despite the patient’s reports of severe pain.

Typically, there is two mechanism of injury for the infrapatellar fat pad. The first is macro trauma where there is a direct blow either from a fall or other object to the knee. What a blow of this nature will lead to the infrapatellar fat pad is suspected as a cause of the symptoms. The second is microtrauma where the infrapatellar fat pad can be pinched between the patella and tibia. The repetitive small irritation can lead to large-scale problems. As the infrapatellar fat pad becomes inflamed, swelling can take place. The swelling can alter the way the patella tracks during movement.

There are several methods of treatment that can be used to address the pain from fat pad inflammation. However, the irritation typically comes from an underlying issue like muscle tightness, altered movement patterns, muscle weakness, or hypermobility. These causes are usually referred to as mechanical causes of pain. Other causes are often referred to as metabolic causes like obesity or osteoarthritis.
Regardless of the cause (mechanical or metabolic) or combination of causes in most of my patients, physical therapy is an effective and individualized treatment that can reduce pain and allow you to return to the activities you love. Setting up a consult with a physical therapist is quick and easy. If you have any questions, contact our office, and we would be happy to help.

Content provided by Evan Reinert, PT, DPT.

Schedule Now