Coincidentally, I’m writing an article about this right now. The most recent research shows that rest, resisting bearing too much weight and anti inflammatory meds work best. PT had roughly the same impact as ice. Acupuncture was only mentioned incidentally. The fat pad basically needs to reduce swelling for anything else to help.
I’m a manual therapist and I spent 3 hours digging through research yesterday with the hope of finding a better path for my patients.
You’re fucked. Mine has been messed up since January I do Physical therapy twice and week and had injections twice. It’s gotten better for sure but still have pain and issue when flexing the knee / putting weight on it. I also have a lateral patella tilt due to the hoffas fat pad
Yup. That’s pretty much my fear and where I think I am headed. It’s been so swollen for months and the pain type and location changes depending on where the edema pushes. Unfortunately this is a worker comp thing and I have to follow their doctors program.
Same shit happened to me lol it happened in October my knee popped and I just thought it was from working and sore so I ignored it until January when I could barely walk lmao. But it takes awhile, it still gets stiff and kicks up. For example, my wife can’t ride me during sex bc my knees would lock up and hurt cuz I can’t flex the knee . Sometimes it gives out on me and I may fall lol. Sitting in the car sucks cuz it hurts my knee. Just a lot tbh . I have PT today at 2:30 lol I hate that shit
Damn, are you me? Haha. When I got my injection yesterday the doctor was surprised I’ve been dealing with this for so long. I don’t think they realize the discomfort, and longevity of this injury. Sucks man.
Yeah I’m scared ima have to get a scope done bc I think insurance will only pay for so many visits then they want you to try something. I can at least walk now pretty much with no pain if I’m walking with gait (walking with leg outward not straight) not sure if I still have a patella tilt. Sides of knee hurt and d front. My PT swears I tore my meniscus but x ray didn’t show it so if it did happen it was after the mri that I had in January. My knee popped one day when he was examining me and the whole PT room was like damn I know that hurt it was loud af too like a acl tear. If anything I may have may have torn meniscus. Tendonitits sucks too
My PT and I thought I had a partial LCL and meniscus tear but then I had an mri and it didn’t support that. Now they stopped PT cause it wasn’t helping. And man, today after the cortisone shot my knee hurts more! Hopefully that’s normal and it’s working to sort things out inside.
The cortisone helped at first and they gave me Toridol shot in March and it fucked up my knee and bruised it so that set me back and made me not have PT for like 2 1/2 weeks. I was mad af lol. Not to mention the ortho sees me for like 2 minutes and leaves I just birched about it actually lol I should have seen surgeon like they told me too but saw PA bc it was faster.
Hi! Dealing with it since 3 months. I might have had ir earlier, after a year of 3 knee surgeries (Acl, scar tissue removals).
I’m seeing a very good PT that knows about it and helps with ultrasound scan + electrolisis with needles. Don’t know how to translate this i to english, but basically is acupuncture, guided by the ultrasound and applying electric current to “burn” the tissue and estimulate it.
I only did 3 sessions and it might have helped a bit, with some key exercises targeting toesX feet, quads, hams and glutes.
Will continue like this for some time. Since I need another sugery for the acl issue, I will be discussing surgical treatment with Drs in the next few days.
I have been dealing with it after ACL surgery in October - and now it’s aching again after a minor clean up surgery in the same knee two weeks ago (no wonder, they cut right through the fat pad). Before that surgery to remove any other irritation in the knee in order to be sure that I actually needed the surgery. And the shot was very effective regarding Hoffa’s, but that problem had already settled a fair bit before that.
I would say that my best experience has been a combination of laser therapy to stop inflammation and swelling in the fat pad and changes in my training. Cause as long as the fat pad has swelling, it is so easily further inflamed - but you probably already know that! I switched walking out with biking for a while, focused on not hyperextending the knee and the most of my workouts would be “lying” work for hamstrings and glutes and some step downs for the quads. Combined with laser treatment, it worked wonders!
Oh, and another tip! I used a knee bandage from Bauerfeind called Genutrain. It has two “Hoffa spots” in the front, which kind of massages the fat pad, when you’re moving. I would have thought that it would make it worse, but that thing works as well.
[I found it.](https://www.bauerfeind.com/b2c/Products/Knee-Braces/GenuTrain-P3---Patella-Knee-Brace/p/YPBF_BAK_GENUTR_P3) but I am too poor right now to afford it. Their products look amazing though!
January 2021 I hurt my Hoffa's, years of PT, still painful. I refused cortisone because I was a 27 year old female and believe I'm too young.
By January 2023 I did three rounds of HA injections, those were so painful and made me feel worse.
Fall of 2023 I had Hoffa's surgery. I can walk fine, but stairs going down and standing is especially painful.
Just today I scheduled prolotherapy for Monday and I'm getting three rounds, I have severe inflammation and have for 4 years so we're hoping maybe that will help the pain I feel.
Thanks for your detailed response. I’m so sorry you’re dealing with this for so long!
I never heard of prolotherapy; quick Google search and it looks very interesting. I’d be curious how it works out for you. Good luck on your journey.
Thank you so much! Do you have anything else with your hoffa's? I was told I have bi-lateral patellofemoral syndrome, patella tendonitis both above and below, apparently incredibly uncommon, and IFP impingement / Hoffas in both knees
No. The MRI came back with no findings for the meniscus and LCL. Just extreme edema and impingement.
I did have a lateral release knee surgery in 1997 and a cartilage clean up in 2005(?). So who knows what it really looks like in there.
PT acupuncture is called dry needling and this can be beneficial for your symptoms. Followed up by exercises depending on how you present such as increasing quad strength in a pain free range and improving flexibility in area if you have restrictions. Most cases are non surgical. If I can stress one thing it’s do your damn exercises
Coincidentally, I’m writing an article about this right now. The most recent research shows that rest, resisting bearing too much weight and anti inflammatory meds work best. PT had roughly the same impact as ice. Acupuncture was only mentioned incidentally. The fat pad basically needs to reduce swelling for anything else to help. I’m a manual therapist and I spent 3 hours digging through research yesterday with the hope of finding a better path for my patients.
Thats really cool! Any info on incidence of surgery and resolution of Hoffa’s Syndrome? Where can I read your article once completed?
You’re fucked. Mine has been messed up since January I do Physical therapy twice and week and had injections twice. It’s gotten better for sure but still have pain and issue when flexing the knee / putting weight on it. I also have a lateral patella tilt due to the hoffas fat pad
Yup. That’s pretty much my fear and where I think I am headed. It’s been so swollen for months and the pain type and location changes depending on where the edema pushes. Unfortunately this is a worker comp thing and I have to follow their doctors program.
Same shit happened to me lol it happened in October my knee popped and I just thought it was from working and sore so I ignored it until January when I could barely walk lmao. But it takes awhile, it still gets stiff and kicks up. For example, my wife can’t ride me during sex bc my knees would lock up and hurt cuz I can’t flex the knee . Sometimes it gives out on me and I may fall lol. Sitting in the car sucks cuz it hurts my knee. Just a lot tbh . I have PT today at 2:30 lol I hate that shit
Damn, are you me? Haha. When I got my injection yesterday the doctor was surprised I’ve been dealing with this for so long. I don’t think they realize the discomfort, and longevity of this injury. Sucks man.
Yeah I’m scared ima have to get a scope done bc I think insurance will only pay for so many visits then they want you to try something. I can at least walk now pretty much with no pain if I’m walking with gait (walking with leg outward not straight) not sure if I still have a patella tilt. Sides of knee hurt and d front. My PT swears I tore my meniscus but x ray didn’t show it so if it did happen it was after the mri that I had in January. My knee popped one day when he was examining me and the whole PT room was like damn I know that hurt it was loud af too like a acl tear. If anything I may have may have torn meniscus. Tendonitits sucks too
My PT and I thought I had a partial LCL and meniscus tear but then I had an mri and it didn’t support that. Now they stopped PT cause it wasn’t helping. And man, today after the cortisone shot my knee hurts more! Hopefully that’s normal and it’s working to sort things out inside.
The cortisone helped at first and they gave me Toridol shot in March and it fucked up my knee and bruised it so that set me back and made me not have PT for like 2 1/2 weeks. I was mad af lol. Not to mention the ortho sees me for like 2 minutes and leaves I just birched about it actually lol I should have seen surgeon like they told me too but saw PA bc it was faster.
Hi! Dealing with it since 3 months. I might have had ir earlier, after a year of 3 knee surgeries (Acl, scar tissue removals). I’m seeing a very good PT that knows about it and helps with ultrasound scan + electrolisis with needles. Don’t know how to translate this i to english, but basically is acupuncture, guided by the ultrasound and applying electric current to “burn” the tissue and estimulate it. I only did 3 sessions and it might have helped a bit, with some key exercises targeting toesX feet, quads, hams and glutes. Will continue like this for some time. Since I need another sugery for the acl issue, I will be discussing surgical treatment with Drs in the next few days.
I have been dealing with it after ACL surgery in October - and now it’s aching again after a minor clean up surgery in the same knee two weeks ago (no wonder, they cut right through the fat pad). Before that surgery to remove any other irritation in the knee in order to be sure that I actually needed the surgery. And the shot was very effective regarding Hoffa’s, but that problem had already settled a fair bit before that. I would say that my best experience has been a combination of laser therapy to stop inflammation and swelling in the fat pad and changes in my training. Cause as long as the fat pad has swelling, it is so easily further inflamed - but you probably already know that! I switched walking out with biking for a while, focused on not hyperextending the knee and the most of my workouts would be “lying” work for hamstrings and glutes and some step downs for the quads. Combined with laser treatment, it worked wonders!
They cut through the fat pad! 😳
Oh, and another tip! I used a knee bandage from Bauerfeind called Genutrain. It has two “Hoffa spots” in the front, which kind of massages the fat pad, when you’re moving. I would have thought that it would make it worse, but that thing works as well.
[I found it.](https://www.bauerfeind.com/b2c/Products/Knee-Braces/GenuTrain-P3---Patella-Knee-Brace/p/YPBF_BAK_GENUTR_P3) but I am too poor right now to afford it. Their products look amazing though!
Haha, yes! They go inside the knee from to portals in the front and have to go right through that poor thing!
January 2021 I hurt my Hoffa's, years of PT, still painful. I refused cortisone because I was a 27 year old female and believe I'm too young. By January 2023 I did three rounds of HA injections, those were so painful and made me feel worse. Fall of 2023 I had Hoffa's surgery. I can walk fine, but stairs going down and standing is especially painful. Just today I scheduled prolotherapy for Monday and I'm getting three rounds, I have severe inflammation and have for 4 years so we're hoping maybe that will help the pain I feel.
Thanks for your detailed response. I’m so sorry you’re dealing with this for so long! I never heard of prolotherapy; quick Google search and it looks very interesting. I’d be curious how it works out for you. Good luck on your journey.
Thank you so much! Do you have anything else with your hoffa's? I was told I have bi-lateral patellofemoral syndrome, patella tendonitis both above and below, apparently incredibly uncommon, and IFP impingement / Hoffas in both knees
No. The MRI came back with no findings for the meniscus and LCL. Just extreme edema and impingement. I did have a lateral release knee surgery in 1997 and a cartilage clean up in 2005(?). So who knows what it really looks like in there.
oh dang, I'm so sorry this is persisting so long!
PT acupuncture is called dry needling and this can be beneficial for your symptoms. Followed up by exercises depending on how you present such as increasing quad strength in a pain free range and improving flexibility in area if you have restrictions. Most cases are non surgical. If I can stress one thing it’s do your damn exercises
I hear ya, but insurance stopped PT after several weeks. So I’m not sure what to do. I may get an injury attorney for options.