Infrapatellar Fat Pad Syndrome [Hoffa’s Disease]
Infrapatellar fat pad is located in the front part of the knee. In this syndrome the fat pad becomes impinged between kneecap, patellar tendon and thigh bone, it is a sensitive area as it has rich supply of nerves resulting in pain in the anterior part of the knee.
Functions of infrapatellar fat pad:
- It acts as knee bone cushioning shock absorber.
- It reduces the friction between kneecap and bony structure of knee.
- Primary causes – obesity, micro trauma, major trauma post surgical scaring, and biomechanical abnormality like hyperextension of knee.
- Secondary causes – Osteoarthritis, meniscal injury, ligamentous tear.
- Swelling of knee
- Anterior knee pain i.e. front and lower part of knee.
- Pain aggravates during kicking movements, squatting motions, jumping and running.
- Pain on prolonged standing, walking
- Infrapatellar crepitus might be present.
- MRI – To diagnose source of inflammation.
- Hoffa’s test – special test performed by physical therapist.
- Use of NSAID’s
- Steroid injections
- Physiotherapy treatment:
It is a very effective therapy for Infrapatellar fat pad syndrome.
- To decrease pain
- .To improve joint range of motion
- To improve strength of the surrounding muscles
- To improve proprioception.
- Rest – Stop activities which are provocation till the symptoms subside.
- Done for 10-15 minutes every 3-4 hours once .It helps in reducing swelling.
- Ultrasound therapy and Laser
- Helps in reducing swelling.
- Helps in tissue healing by increasing blood flow.
- Taping is done to support the area and also unloads the inflammation area.
- Manual therapy [joint mobilization]
- Done to improve the joint mobility.
- Muscle Stretching
- To improve the infrapatellar fat pad restrictions symptoms and flexibility of muscles.
- Muscle strengthening exercises
- Exercises to the muscles nearer to the joint, done to avoid future re injury.
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