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I spend roughly one hour a day 5 days a week exercising. Lately I have noticed on the medial (inner) side of both knees pain that has continues during my day. I have had this for a few months now and am wondering what it could possiblly be and how to treat.


I'm not an Orthopedist, but I am a physician and have been running regularly for over 30 years.

Sounds like Patello-Femoral pain syndrome. That's really a fancy term for what could be a number of possibilities. At your age, having run for many years, there is certainly the risk of wear and tear on the underlying joints and soft tissues, so that there is a good possibility of uneven stresses to the area that could cause degenerative joint disease, bruising to the underlying bone (which could cause subperiosteal bleeding), a stress fracture, or even a small tear in your medial meniscus, the cartilage in the medial portion of our knees that becomes progressively less vascularized with blood flow as we age.

Did you bear any trauma to the knee or twist/turn it during running lately? You would have to think about meniscal (or other cartilaginous injuries) if you did. If not, it could just be an 'overuse' injury along the lines of what I've mentioned above, and that won't likely get better without a perod of rest to the knee. You might want to consider not running for a good week or two to see if the pain improves/resolves. If not, you'd need to consider seeing an Orthopedic Surgeon and maybe getting an MRI (assuming that plain X-Rays are negative). If the pain does not improve with rest, I'd be more concerned about a cartilaginous tear.

As I said, I have been a long distance runner for many years with no history of injury. I then decided I would play in an over 50 basketball league because I missed 'banging bodies' on the court. The result was a painful medical meniscus tear that necessitated arthroscopic knee surgery and a wide excision of the torn portion. The good news is that I was back running up to 8 miles per day after only 4 weeks, albeit with a less than enthusiastic response by my surgeon at that point. Good luck.

Regards,
Roc
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