麹町駅すぐの整形外科 Oneクリニック



膝の痛みに対するリハビリを深掘りする(膝蓋下脂肪体炎)  ~Deeper look at the Rehabilitatios for knee pain (sub patellar adipositis)~

東京都千代田区 麹町駅と半蔵門駅の間 新宿通り沿いのビル2階にある整形外科クリニック“One Clinic 麹町(ワンクリニック麹町)”院長の栗本です。





1. 診断
• 膝の痛みの場所、時期、時間帯、強さ、誘因など➡スポーツや階段昇降を繰り返す仕事などが原因となり得ます
• スポーツ歴、過去の怪我➡膝に外傷歴がある方は症状が出やすい印象があります
• 日常生活での制限➡屈伸がしづらい場合には脂肪体に炎症が起きている可能性があります
• 膝の腫れ、変形、皮膚の赤みを伴う事もあります
• 膝蓋下脂肪体の圧痛を確認します
• 膝の可動域制限を確認します
• エコー検査:脂肪体の腫れや炎症を確認できます
• MRI検査:骨や軟骨の状態も確認できます

2. 治療 
• 炎症を抑えるための薬物療法・アイシングに加えてサポーターなどによるコンプレッションを加えることもあります。

3. リハビリ

• アイシング:1回15分、1日3回程度を目安に行います
• コンプレッション:膝を圧迫・固定してくれるサポーターを着用しましょう
• 挙上:寝る際に膝の下に枕などを置くことで膝を心臓よりも高い位置に置き、腫脹軽減を図ります
• ストレッチ:膝周りの筋肉を緩める
• 軽い有酸素運動:水泳など膝の負担を減らしながら行える運動を選択します。

• 筋力トレーニング:膝周りの筋肉を鍛えましょう。膝周りだけでなく、殿筋群も鍛えていくことが大事です。
• 運動強度を上げる:ジョギング、サイクリングなど膝に負担がかからないよう注意しながら少しずつ強度を上げましょう

• 再発予防のためのストレッチや筋力トレーニング・スポーツ復帰後のコンディショニングを行いましょう

4. 経過と予後
• 適切な治療とリハビリを行えば、多くの症例は改善します。
• 早期発見・早期治療が重要ですが、再発のリスクもあるため予防策を続けることが大切です。

5. 注意点
• 痛みが強い場合は無理せず当院までご相談ください
• マッサージやリハビリは医師や理学療法士・作業療法士等国家資格保持者と相談しながら行うのが良いでしょう
• 患部の状態に合わせて運動強度を調整することが大事です

6. まとめ





Hello everyone(^^)/

I am Dr. Kurimoto, the director of “One Clinic Kojimachi,” an orthopedic clinic located on the second floor of a building along Shinjuku-dori between Kojimachi and Hanzomon Stations in Chiyoda-ku, Tokyo.

The weather has been unstable since the start of the consecutive holidays, how are you doing?

Today, I would like to delve deeper into rehabilitation again.

When it comes to joints that are prone to pain in daily life, the “knee joint” is one that comes to mind, but just because you feel pain does not necessarily mean that there is something wrong with your knee on x-rays.

In this article, I would like to write about “sub patellar adipocele” among knee joint pains that cannot be detected by X-rays.

What is Sub patellar adipositis?

Sub patellar adipositis is knee pain caused by inflammation of the fatty tissue located under the patella, behind the patellar ligament. Pain often occurs with exercise such as running, jumping, or going up and down stairs, and the knee may become difficult to bend and extend smoothly.

1. diagnosis


– Location, timing, time of day, intensity, and triggers of knee pain ➡Possible causes include sports and jobs that involve repetitive stair climbing and descending

– Sports history and past injuries ➡People with a history of trauma to the knee seem to be more prone to symptoms.

– Limitations in daily life ➡If you have difficulty in bending and extending, there is a possibility of inflammation of the fat body.


– Swelling of the knee, deformity, and redness of the skin may accompany the symptoms.


– Check for tenderness of the infrapatellar fat body

– Check for limitation of knee range of motion


– Echography: can confirm swelling and inflammation of the fat body

– MRI scan: to check bone and cartilage condition. 2.

2. treatment 

Basically, conservative treatment is the first choice.

– In addition to medication and icing to reduce inflammation, compression with a supporter may be applied.

When the pain has decreased, exercise therapy (rehabilitation) will be used, and at this point, a brace such as a supporter may also be used. The details are described below.

In addition, hyaluronic acid injections and steroid injections may also be used.


After the inflammation has subsided (after the pain has lessened), rehabilitation is performed to gradually increase the amount of exercise,

Stretching and strength training

Taping, shoes, etc. to prevent recurrence are also important. The following are examples of rehabilitation

Initial stage (period of high pain)

– Icing: 15 minutes per session, 3 times a day

– Compression: Wear a supporter that compresses and holds the knee in place.

– Elevation: Place a pillow or other object under the knee when sleeping to elevate the knee above the heart and reduce swelling

– Stretching: relax the muscles around the knee

– Light aerobic exercise: Select exercises that can be done while reducing the burden on the knee, such as swimming.

Mid-term phase (when pain improves)

– Strength training: Strengthen the muscles around the knee. It is important to strengthen not only the knee area but also the gluteus maximus muscle group.

– Increase the intensity of exercise: gradually increase the intensity of jogging, cycling, etc., taking care not to stress the knee.

If there are no problems, gradually increase the load in preparation for returning to work or sports.

Late stage (when pain improves)

– Perform stretching, strength training, and conditioning after returning to sports to prevent recurrence.

After symptoms improve, “prevention” as described above is necessary.

4. progress and prognosis

– With appropriate treatment and rehabilitation, many cases will improve.

– Early detection and early treatment are important, but it is also important to continue preventive measures because of the risk of recurrence.

5. points to keep in mind

– If pain is severe, please do not overdo it and consult our clinic.

– Massage and rehabilitation should be done in consultation with a doctor, physical therapist, occupational therapist, or other nationally certified therapist

– It is important to adjust the intensity of exercise according to the condition of the affected area.

6. summary

Sub patellar adipositis can be improved with proper treatment and rehabilitation.

It is important to receive treatment tailored to the symptoms and to perform rehabilitation well. In addition, to prevent recurrence, care should be taken to avoid straining in daily life:)