Q: I am a 23-year-old man.

I exercise intensively thrice a week, cycling and lifting weights. Recently, while exercising,

I found a tiny bump the size of a five-cent coin just below my right knee.

It feels hard like bone and seems to be part of my shin bone. There is slight pain when I press on it.

Is it a cause for concern and should I still exercise regularly?

A: For any newly discovered lump on the body, it is best to consult a doctor. This is to ensure the lump is not due to an infection or cancer.

From your description, the lump is located where the knee cap ligament (patella ligament) attaches to the leg bone (tibia).

It is normal to have a small elevation of the bone (tibial tuberosity) at that location and this can become more prominent during adolescence in some people.

At puberty, the bones are still growing, hence active adolescents can get injured from the strong pull of the patella ligament on the tibial tuberosity during physical exertion.

This occurs more often with activities like jumping or lunging. Younger patients usually complain of pain during exercise and may notice the bony lump.

This condition is self-limiting after one year and is relieved with rest, stretching and ultrasonic therapy. The lump will remain prominent and benign indefinitely.

Some people do not notice it until they are older, which is possibly what has happened in your case. It can be left alone once infection and cancer have been excluded.

This article was first published in Mind Your Body, The Straits Times.