Why did Rafa Nadal make such a quick exit from Wimbledon?

This article is by the chiropractor in London at the Angel Chiropractic Clinic in Islington.

I am old enough to remember The X-Files and at the end of the credits up on the screen would pop the tag line “The truth is out there”.

Well, after lots of guessing and rumours about what exactly is wrong with Rafa’s knee over the years it appears to be Hoffa’s Syndrome. In the past it has been reported as infra patellar tendonitis or as infrapatella tendonopathy or even infrapatella tendonosis, which is what we thought it was and wrote about in an article last year.


So what is Hoffa’s syndrome?

This is also known as fat pad impingement syndrome where the sensitive fat pad under the femur and under the knee-cap gets inflamed.

What does the fat pad do?

The fat pad helps to cushion the knee-cap and allows the knee cap to ‘float’ up and down the femoral groove when the quads contract and relax.

Why does the fat pad get inflamed?

Repetitive flexion and extension, particularly hyperextension of the knee can irritate the fat pad. It was telling that listening to the commentary yesterday by John McEnroe, he was saying that Rafa wasn’t flexing his knee enough to get to the lower bounce on the grass court as compared to the clay at the French open.

This biomechanical irritation to the fat pad is increased if the pelvis is anteriorly rotated squishing the pad. This is often a repetitive injury and the cycle of irritation, inflammation and swelling can lead to a nasty impingement and plenty of pain.


•Swelling management using ice and ultrasound.

•Taping to lift the bottom of the knee-cap whilst pulling the middle and outside of the knee cap diagonally upwards.

•Stretching to loosen the quads and to relax the patella tendon.

•Strengthening the quads and coordination exercises to help the patella tracking and to reduce hyperextension of the knee.

If you are in London and have a knee problem and you want treatment with our chiropractor, click below to make an appointment.

By Brian on 25th Jun 2013   Share |

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