VP asks: I am a 43-year-old male with right sided knee pain. I have pain in the front of the knee. It hurts when I run on the treadmill. My shin hurts as well every time I run. It is better when I stop running.

Dr. Patel writes: Dear VP, it seems that you may actually two different things going on with your knee. The knee pain in the front of the knee could be due to weakness in the quadriceps tendon.

If the quadriceps tendon is weak, this can cause the kneecap to have higher pressures when the knee bends. This in turn can cause pain in the front of the knee and can cause cartilage problems on the surface of the kneecap called chondromalacia of the patella.

Strengthening the quadriceps muscle can help resolve this pain. Instead of running, you may want to try a stationary bike or an elliptical machine to help with your quadriceps muscle.

The second pain related to your shin sounds like you may have shin splints. Shin splints occur when there are stresses across the front of the tibia, which then causes either a stress fracture or inflammation of the soft tissue lining.

A lot of the pain can be alleviates with rest from running for a couple of weeks and then gradually getting back into the exercise routine. Some times anti-inflammatory medicine can help with the pain. Also, avoid running on any hard surfaces.

One of the best exercises that I have found to help the lower extremities and get a good cardio workout is spinning. I personally go to spinning class and found it to be very beneficial for the quadriceps and hamstrings. I also get a great cardio workout.

Dr. Manish Patel has extensive training in treating shoulder, elbow and knee injuries, and performing arthroscopic surgery. He is the principal medical practitioner in the offices of Southampton Orthopaedic and Sports Medicine Center, on the campus of Southampton Memorial Hospital. Submit questions about sports medicine, injuries and treatment for this column to sports@tidewaternews.com, or call Patel at 562-7301.