Don’t let that niggling Fat pad prevent you from completing the race you’ve trained so hard for.

Is it touch and go as to whether you will be able to complete the race you’ve trained so hard for due a sudden onset of knee pain.

If so, don’t panic. Platinum Physio may just be able to get you to that start line and possibly over the finish line.

If it is unfortunately too late for the women’s mini marathon or the cork marathon don’t worry, we promise will have you back on track well before your next challenge.

A Most Common Complaint.

On a weekly basis people attend our clinic’s here in Platinum Physio and say they have pain under knee cap which is aggravated when they run long distances, when they kneel, or if straighten their knee when they go down the stairs. They have often at that stage thrown in the towel in their attempt to complete the event which they had been training for.

If you are one of these people that couldn’t take part or perform as planned for the mini marathon on Sunday, don’t panic there may be a solution. Often with patients who present with these types of symptoms the solution is relatively easy but does require persistence and hard work. Here are our five top tips to help resole your symptoms and most importantly, to give you a chance of completing your next racing event without seriously injuring your knee.

Step 1.

Don’t panic, it’s not necessarily too late to get you to a point where you can complete the race if you have a race coming up in the next few week’s. If you have some or all of the above symptoms and your pain is located directly beneath your patella (Knee cap) you may in fact have Fat Pad impingement of the infrapatellar fat pad. This fat pad is a shock absorber or buffer between the end of the patella and its tendon and the underlying bony structures. It is Highly innervated with nerve endings and can be very painful if impinged or aggravated by with a direct blow to the knee. There is a certain subtype of people who are more predisposed to Fat pad impingement. These subtypes include people who hyper extend their knee, have generic joint hypermobility and people who begin training for running events without any guidance on how to prepare for such events or prehab.

Step 2. 

Try to off load the fat pad by placing a line of tape around the upper calf and underneath the knee cap. View the attached video footage to learn how to apply the tape correctly. Please do not apply the tape too tightly as it may reduce the circulation to the foot and lower calf causing your foot to become numb making it difficult to complete the race. If the taping does not reduce your discomfort significantly you certainly require a physiotherapy assessment and subsequent treatment. You can watch a video here.

Step 3.

If the tape reduces your pain significantly and you wish to go ahead and complete your next race. Make sure you begin some of the exercises attached below to help improve your form and function when running:

  • Stretch your hip flexors and quads as tightness in these structures may cause compression at the front of the knee cap/patella when running.
  • Strengthen the surrounding musculature – with knee cap symptoms research supports practicing single leg squatting exercises keeping the hip in line with knee cap and the knee cap in line with second toe. This can be performed ideally in reformer Pilates without aggravating the knee in both double and single leg exercises. You should only progress to single leg if your biomechanical control is adequate.
  • Calf heel raises are also important to alleviate any muscle imbalance when running. Ideally you should be able to perform single leg heel raises pain free with good biomechanical control and awareness. This exercise can also be perfectly executed on the reformer.
  • Glute strengthening is a must to help alleviate any biomechanical overloading whilst running. The exact exercise that would be most beneficial is dependant on the area of weakness but exercises such as crab walking are a safe bet when preparing for an event such as the Women’s mini marathon.

Step 4.

However, if you have managed to complete the mini marathon or cork marathon with resultant pain it is certainly very important to have a physio assessment and subsequent treatment to help alleviate your ongoing symptoms. Tapping is short term benefit as we must train the musculature to adapt and develop to prevent this continuous overloading into the knee joint. There is a multitude of different reasons as to why someone may develop fat pad impingement such as biomechanical overload, weakness, genetic disposition due to generic joint laxity and previous injuries to the knee. A specialist physio assessment in Platinum physio can help determine which of these dysfunctions is responsible for your onset of knee pain. If you haven’t made the starting line due to pain remember this simple piece of advice. Prehab is more important than rehab. Thus, when you decide to register for your next run or event pop into platinum Physio and we can perform and assessment which will prevent the onset of such dysfunctions prior to the event.

Step 5.

If you are already a Platinum Pilates client intensify your reformer Pilates sessions. If you have never tried Reformer Pilates before, sign up and give it a go. From beginner to advanced level classes we focus on all the areas which are most likely to be weak and cause excessive over loading to the knee and thus resultant injury. Therefore, you will be performing the necessary prehab exercises in your reformer class before you attend your physio for a prehab or rehab session.

Don’t let Fat pad impingement become your excuse for not completing the running event that you have trained so hard for this year or next. Pop in for a specialist physio assessment and for some of our amazing reformer classes here in Platinum. If you follow the steps above the one thing I can promise is fat pad impingement will not prevent you from completing your next event.

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