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Fat pads adjacent to tendinopathy: more than a coincidence?
  1. Ella Rose Ward1,
  2. Gustav Andersson2,3,
  3. Ludvig J Backman2,
  4. Jamie E Gaida1,4
  1. 1Discipline of Physiotherapy, University of Canberra, Canberra, Australian Capital Territory, Australia
  2. 2Department of Integrative Medical Biology, Section for Anatomy, Umeå University, Umeå, Sweden
  3. 3Department of Surgical and Perioperative Science, Section for Hand and Plastic Surgery, Umeå University, Umeå, Sweden
  4. 4University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australian Capital Territory, Australia
  1. Correspondence to Dr Jamie E Gaida, Discipline of Physiotherapy, University of Canberra, University Drive, Bruce, ACT 2617, Australia; Jamie.Gaida{at}

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Is it merely a curiosity that fat pads are found adjacent to the area of tendon affected by tendinopathy? We propose that fat pads share an anatomical and functional relationship with their adjacent tendons and may therefore contribute to the pathogenesis of tendinopathy. Fat pads and tendons have a shared blood supply,1 and cytokines produced in the fat pad have only a short distance to travel in order to affect the tendon.2

Fat pads lubricate, insulate, protect and provide structural support for tendons. However, the functional significance of the fat pad is often overlooked. In an early study of fat pad function, the distal tip of Kager's fat pad migrated into the retrocalcaneal bursa during ankle movement in healthy individuals, but not in an individual with a hindfoot disorder.3 This ‘variable plunger’ mechanism minimises pressure changes within the bursa during ankle movement. …

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  • Twitter Follow Jamie Gaida at @tendonresearch

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.