Knee Impingement: What You Need to Know for Relief

What Is Knee Impingement?

Knee impingement, also known as Hoffa's disease, is a condition where the infrapatellar fat pad gets compressed or irritated, leading to pain and inflammation.

This fat pad, located beneath the kneecap, plays a critical role in cushioning the knee joint.

When it becomes impinged, it can cause significant discomfort and limit mobility. Knee impingement often results from trauma or previous knee surgery.

Causes of Knee Impingement

Several factors can contribute to knee impingement:

• Injury or Trauma: Direct blows to the knee or falls can compress the infrapatellar fat pad, causing inflammation and pain (NCBI Bookshelf).
• Repetitive Stress: Activities that involve frequent running, jumping, or squatting can lead to repetitive stress on the knee joint. This is common among athletes and active individuals like dancers, runners, and soccer players.
• Surgical Complications: Post-surgical fibrosis or hypertrophy of the fat pad can occur after procedures like arthroscopy, leading to chronic impingement.
• Hypermobility Syndrome: Individuals with hypermobility may be more prone to developing knee impingement due to increased joint movement leading to repetitive stress.

Common Symptoms

The symptoms of knee impingement can vary but typically include:

• Anterior Knee Pain: The most common symptom is pain in the front of the knee, often experienced below the kneecap.
• Swelling and Tenderness: You may notice localized swelling and tenderness around the affected area.
• Activity Aggravation: Pain usually worsens with specific activities such as squatting, walking downhill, or jumping.
• Difficulty Straightening the Knee: You might find it challenging to fully extend your knee due to the impingement.
• Localized Pain: The pain can also extend to the sides of the kneecap, making everyday activities difficult.

How Knee Impingement Is Diagnosed

Diagnosing knee impingement often involves:

• Physical Examination: A thorough examination of your knee by a healthcare professional to check for tenderness, swelling, and pain during movement.
• Medical History: Discussing your symptoms, activities, and any previous injuries or surgeries with your doctor.
• Imaging Tests: Techniques like MRI, ultrasound, or X-rays may be used to visualize the infrapatellar fat pad and confirm the diagnosis (Complete Physio).

Effective diagnosis is essential to developing an appropriate treatment plan, which may include activity modification and rest, physical therapy, or other therapies to alleviate symptoms and improve knee function.

For more on treating knee pain, visit our section on non-surgical treatment options.

Non-Surgical Treatment Options

These treatment options should be treated as a general guideline, always consult with a healthcare professional for personalized guidance on medication and treatment that is right for you.

Activity Modification and Rest

Managing knee impingement often begins with activity modification and rest.

Reducing activities that aggravate your knee pain can help mitigate symptoms and allow your knee to begin the healing process.

Ensure to take breaks, avoid high-impact exercises, and consider low-impact alternatives like swimming or cycling.

Physical Therapy and Strengthening

Physical therapy is the cornerstone of treatment for knee impingement, particularly Hoffa pad impingement syndrome.

The main goals include restoring patellar tracking mechanics, strengthening the quadriceps, and improving overall lower extremity mechanics.

Physical therapists may use a variety of methods, including targeted exercises, manual therapy, and modalities like ultrasound or electrical stimulation.

For specific exercises, you can refer to our guide on knee strengthening exercises.

Anti-Inflammatory Medications

Over-the-counter anti-inflammatory medications can help alleviate pain and reduce inflammation. For advice on medication, check out our detailed article on what is the best painkiller for knee pain.

Injections and Pain Management

In some cases where conservative management such as physical therapy and anti-inflammatory medications are not effective, injections can provide significant relief.

Ultrasound-guided injections with corticosteroids are commonly used for this purpose. These injections can reduce inflammation and provide pain relief.

Additional resources include our articles regenerative treatment for knee pain and degenerative knee joint treatment.

Seek RELIEF®

RELIEF® is a science-backed, targeted approach that targets dysfunctional fascia that surrounds the affected knee tendons.

The treatment utilizes hydrodissection—a fluid-based technique that gently separates and releases adhered soft tissue layers and fascia, which may contribute to knee pain and degenerative joint symptoms.^{1,2,3,4,5,6,7}

RELIEF® is a minimally invasive alternative to traditional treatments—and requires no steroids, medication, surgery, anesthesia, or post-procedure immobilization.

Surgical Options for Severe Cases

When non-surgical treatments for knee impingement fail to provide relief, surgical options may be necessary.

Arthroscopic Debridement

Arthroscopic debridement is a minimally invasive procedure that involves the removal of damaged tissue or debris within the knee joint.

• Procedure: The surgeon makes small incisions around the knee to insert an arthroscope (a tiny camera) and surgical instruments to clean out the impinged area.
• Effectiveness: Partial arthroscopic resection has shown favorable results for patients who do not respond to physical therapy.

Realignment Procedures

Realignment procedures are often recommended to address knee impingement issues related to improper patellar tracking and alignment.

These procedures aim to correct the alignment of the knee structures, thus alleviating the pressure that causes impingement.

• Procedure: The specific technique depends on the type of misalignment but often involves adjusting the position of the kneecap (patella) or realigning the structures in the knee to ensure proper movement and reduced impingement.
• Effectiveness: These procedures can be highly effective when conservative treatments, such as physical therapy, fail. They often focus on restoring patellar tracking mechanics, strengthening the quadriceps, and improving lower extremity mechanics (NCBI Bookshelf).

Before considering surgery, it's important to exhaust all non-invasive options, such as activity modification and physical therapy.

For more information on the various non-surgical treatments available, you can check out our articles on non-surgical alternatives, exercise, and hydrodissection.

Remember to consult with an orthopedic specialist to determine the best course of action for your specific condition.

Preventing Knee Impingement

Preventing knee impingement involves understanding how to manage movement mechanics and load, along with maintaining proper mobility and flexibility.

This is crucial for anyone looking to relieve knee pain and avoid symptoms like sharp knee pain or swollen knee.

Movement Mechanics and Load Management

Engaging in physical activities that place repetitive stress on the knee joint can increase the risk of knee impingement.

Activities such as running, jumping, and squatting are common culprits..

To prevent knee impingement:

• Balance Activity and Rest: Alternating between activity and rest helps to prevent excessive stress on the knee joint. Avoid overloading your knees with continuous high-impact activities.
• Proper Technique: Maintain correct posture and movement mechanics during physical activities. This minimizes undue pressure on the knee. For instance, ensure your knees track over your toes during squats to reduce stress..
• Load Management: Gradually increase the intensity and duration of physical activities. Abrupt escalations in activity levels can lead to conditions such as patellar tendinitis.

Certain individuals, like those with ligament and joint laxity (e.g., hypermobility syndrome), are more susceptible to knee impingement. Special considerations should be taken to manage load effectively in these cases.

Mobility and Flexibility Work

Improving mobility and flexibility is another effective strategy to prevent knee impingement. This approach involves regular stretching and strength training to maintain knee health.

• Stretching Exercises: Incorporate daily stretching exercises targeting the quadriceps, hamstrings, and calves. This helps to maintain flexibility and reduce the risk of tight muscles pulling on the knee.
• Strengthening Exercises: Engage in exercises that build strength in the muscles surrounding the knee, such as knee strengthening exercises. Strong muscles support the joint and reduce the likelihood of knee injuries.
• Use of Braces or Taping: In some cases, taping or bracing the knee can provide additional support and reduce symptoms. Consult a healthcare professional to determine the best approach for your condition.

Regularly practicing mobility and flexibility exercises can help mitigate the risk of knee impingement, particularly in active individuals like runners, dancers, and athletes.

For more detailed exercises, refer to our article on stretches for knee pain.

‍Contact us today to schedule a consultation and learn more about how RELIEF® may help with your knee pain.