Runners' knee woes

My joints – particularly the knees and shoulders – started to 'crack' and 'creak' a few years ago, but they do not hurt. Is it safe for me to continue exercising (running, tennis)? What kind of preventive measures should I take so that I do not worsen my condition? I find that taking glucosamine doesn't help.

Creaking without pain is not uncommon and is not really a cause for concern. If there is pain associated with the creaking (also called crepitus), then it is a sign of underlying abnormality in the joint.You should then consult a doctor for a proper assessment.

There is no need to take joint supplements if you do not have pain.

I often experience pain in my right ankle a day or two after the run. I don't feel any problems during the run itself so it's hard for me to gauge when to stop. Why does the pain occur only after the run?

Pain in the ankle can be due to multiple causes. The most common cause is inflammation of the tendons (tendinitis). Other less common causes include cartilage injuries and stress fractures.

In many instances, you do not feel pain during the run because the adrenaline coursing through our body can numb the pain.

I experience knee pain after running long distances regularly, and the pain can persist for several hours after the run. Is there any form of DIY physiotherapy, stretching exercises, or any other kind of routines that I can do myself to alleviate the pain?

Before you embark on any DIY routines, it is probably wise to get your knee checked by an orthopaedic surgeon or sports physician to rule out any structural abnormalities such as mensical, cartilage or ligament injuries. These conditions might be worsened by unsupervised exercises and stretches.

Conditions such as iliotibial band syndrome and patella tendinitis can usually be treated conservatively with rest, activity modification and physiotherapy modalities such as ultrasound. Occasionally, they may benefit from injections of platelet rich plasma.

Q&As answered by Dr Kevin Lee, medical director of the Centre for Joint & Cartilage Surgery, a subsidiary of the Singapore Medical Group Limited. Dr Lee was awarded both the Singapore Orthopaedic Association Young Investigator Award and N Balachandran Award in 2005 and is the Principal Investigator for several active grants involving cartilage repair, stem cells, biomaterials and joint replacements.