The fat pad in your knee sits just below your knee cap and provides cushioning and shock absorption between the bones of your knee joint. It is also known as Hoffa’s pad and is one of the most sensitive components of your knee joint. Pain is most often caused by the fat pad becoming pinched between the end of your thigh bone and your kneecap.

Symptoms of Fat Pad Impingement

A direct blow to your kneecap is usually the cause of impingement, which leads to the fat pad becoming trapped and inflamed 1. This condition is often referred to as Hoffa’s syndrome and, if you have it, you are likely to notice some swelling and/or tenderness around the bottom of your knee and find it painful to straighten your leg. You might also hear a cracking sound when straightening your knee, which is the fat pad popping out of the joint. A health professional will usually diagnose the condition by pressing firmly on the tendons under your kneecap and asking you to straighten your leg. If you find this painful -- or even resist performing the action altogether -- it’s a good sign you are suffering from Hoffa’s syndrome.

Treatment

Unfortunately, this condition can take a while to treat because the fat pad is aggravated every time you move your knee. The first step is to rest and apply ice to the area to reduce inflammation. Exercises to strength the muscles that support your knee can also help. Taping your knee cap is another effective treatment method. This gives the fat pad more room to move underneath, so that it is no longer trapped in the joint. Failure to treat the condition can lead to osteoarthritis, so see a health professional if you think you may have this condition.

Knee Strengthening Exercises

Your quadriceps and hamstrings are the main muscles that support your knee joint, so they are likely to be the focus of any strengthening exercises you are prescribed 2. It is important that you perform all knee exercises slowly and, while minor discomfort is normal, you should stop immediately if you feel any pain.

Hamstring Curl

Stand side-on to a wall with one hand against it for support. Make sure your feet are together and you are standing up straight then slowly bend your injured leg back, moving your heel towards your buttocks. Hold for a few seconds at the top then gently lower the foot back down to the ground. Use your hamstrings to perform both the lifting and lowering movements with control.

Quadriceps Contractions

Sit on the floor with your legs out in front of you and place a rolled-up towel under your injured knee, which should be slightly bent. Engage your vastus medialus muscle -- located above your knee cap on the inner side -- to straighten your leg and lift your heel a few inches off the ground. Lower your heel back down to the ground and repeat.