76 years old started a couple of weeks ago sore only when I walk inside of right knee…..flared up to where I could not put any pressure on it last week …went to a sports medicine massage therapist and he stopped the acute pain after 1 deep massage session. now back to just “tightness” when i walk…got new more supportive sneakers drinking more water using heat and doing stretches but still a little tight when walking only taking 800 mg advil once a day helps for 6 hours and i feel not discomfort for about 6 hours

Copilot said:
Copilot
Thank you for laying that out so clearly — that helps a lot. Based on your age (76), the sudden onset, the inside (medial) knee pain with walking, and the way it flared badly then cooled down, here’s a calm, practical way to understand what’s most likely going on and what makes sense next.

What this pattern most often means
This does not sound like advanced, constant arthritis. Instead, it fits very well with a mechanical flare on top of early or moderate age?related changes.

The most likely contributors (often more than one):

1. Mild–moderate knee osteoarthritis with inflammation

Pain only when weight?bearing
Sudden flare, then improvement
Responds well to NSAIDs (Advil) and massage
Steroid injections help this scenario if it flares again
theconversation

2. Medial (inside) meniscus strain or degeneration

Very common after 60
Can happen without injury
Causes pain with walking, pressure, or turning
Massage helping suggests surrounding muscle guarding was part of it

3. Muscle/tendon tightness + joint irritation

Tight calf, hamstring, or inner thigh muscles can overload the inside knee
New supportive shoes and massage improving things backs this up
? The fact that your pain improved quickly and is now just “tightness” is a good sign.

Reassuring points in your story
? No ongoing rest pain
? No persistent swelling mentioned
? No locking, catching, or giving way
? Clear response to Advil
? Massage dramatically helped
These lower the concern for anything urgent or surgical.

About the Advil (important at 76)
800 mg once daily giving 6 hours of relief is doing what it’s supposed to do, but long?term daily NSAID use at your age needs some guardrails.

Safer approach (generally):

Use it short?term (several days, not weeks)
Always with food
Avoid combining with dehydration
Consider switching to or adding topical diclofenac (Voltaren gel) — very effective for knee OA and much safer long?term for stomach, kidneys, and blood pressure
(Topical NSAIDs are strongly supported for knee OA in older adults)
clevelandclinic

Do injections make sense right now?
No — not yet, based on what you’ve described.

Why:
Symptoms are improving
Pain is mild and activity?related
Conservative measures are working
When injections would make sense:
If pain returns and limits walking again
If stiffness turns into swelling or daily pain
If NSAIDs are no longer effective or not safe for you
If that happens, best option for your situation
For someone 76 with intermittent inflammatory flares:

Cortisone injection is usually the first choice
Quick relief
Especially good if swelling/inflammation returns
Typically lasts weeks to a couple of months
theconversation
The more heavily advertised injections (PRP, gels, biologics):

? Keep doing
Supportive sneakers
Gentle stretching
Heat if it feels good
Hydration

? Adjust
Add Voltaren gel 2–4×/day to the inside knee
Limit Advil to flare days if possible
Avoid deep squats, twisting, pivoting for a few weeks
? Add
Light quad and hip strengthening (not aggressive)
Short walks more often instead of one long walk
When to see your doctor or sports medicine clinician
Go sooner if:

Pain returns suddenly and sharply
Knee swells or feels warm
You can’t bear weight again
Otherwise:

Reasonable to monitor over 2–4 weeks
If still limiting walking ? discuss imaging or a cortisone injection
Bottom line
This looks like a recovering knee flare, not something dangerous or rapidly progressive. You’re on a good trajectory. Injections are an option later if needed — but at this stage, conservative care is exactly right.

Copilot
Perfect — I’ll give you all three, clearly and practically, and tailored to your age (76) and current improving symptoms. I’ll keep this grounded in what evidence supports and what actually helps people in your situation.

1) Gentle, knee?safe exercises (appropriate for you right now)
The goal is not to “work through pain.” It’s to:

Reduce inner?knee load
Improve joint tracking
Prevent another flare
If any exercise causes sharp pain or worsens symptoms the next day ? stop that one.

A. Daily mobility (1–2×/day)
? Heel slides (in bed or on couch)
Lie on your back
Slowly slide heel toward your butt, then straighten
10 reps
Keeps the knee joint lubricated without load

? Calf stretch (important for inside knee pain)
Hands on wall
Back leg straight, heel down
Hold 20–30 seconds × 3 Tight calves increase medial knee stress when walking.
B. Strength without joint strain (every other day)

? Quad sets (very safe, very effective)
Sit or lie with leg straight
Tighten thigh muscle, press knee gently down
Hold 5 seconds
10–15 reps

? Straight?leg raises
One knee bent, affected leg straight
Lift straight leg 12–18 inches
2 sets of 8–10 Stop before fatigue — quality matters more than quantity.

? Side?lying hip abduction
Lie on your side (painful knee on top)
Keep hips stacked, lift top leg slightly backward
2 sets of 8 Strong hips unload the inside of the knee when walking.

? Avoid for now
Deep squats
Lunges
Pivoting or twisting
Kneeling on hard surfaces

2) Imaging: what’s useful and what’s not
This is where a lot of people get unnecessary tests.

? X?ray (if symptoms persist or recur)
This is the first and often only imaging you’d need.

Shows:

Degree of osteoarthritis
Joint space narrowing
Bone alignment
Why it’s appropriate:

Simple
Low radiation
Guides treatment decisions realistically

?? MRI — usually not helpful initially
MRI often shows:

Meniscus “tears” common with aging
Changes that don’t require surgery
Findings that don’t match symptoms
In people over 60:

Degenerative meniscus changes are extremely common and often not the pain source
MRI rarely changes treatment unless there’s locking/catching or persistent weight?bearing pain
Most guidelines recommend against routine MRI unless red?flag symptoms are present (locking, instability, failure of conservative care)
theconversation

Bottom line on imaging
Right now:

? No imaging needed if you keep improving If symptoms linger or return:
? Start with x?ray, not MRI
3) How to decide on a cortisone injection (clear decision guide)
This is probably the most important clarification.

? Cortisone injections help this scenario
They are best for:

Intermittent flares
Inflammatory knee pain
Pain that limits walking
They are not meant to be frequent or routine, but:

One injection during a bad flare can restore months of comfort
theconversation
? Reasonable criteria to get an injection
Consider it if any of these happen:

Pain again prevents normal walking
NSAIDs are no longer enough or not safe for you
Knee becomes swollen/warm
Pain lasts >4–6 weeks despite good conservative care

? Reasons to wait (your current situation)

Pain improving
Only mild tightness
Responds well to NSAIDs and massage
No swelling or instability
Right now, injection would be early, not wrong — but unnecessary.

What about the “advertised” injections?
For someone 76 with mechanical/inflammatory flare, evidence shows:

Injection type Worth it now? Why
Cortisone ? If pain returns Best short?term relief
Hyaluronic (gel) ?? Maybe Modest benefit on average
PRP ? Usually no Expensive, mixed evidence
“Regenerative” ads ? No Not proven, high cost
Large reviews show cortisone works better short?term than most alternatives in typical knee OA flares like yours

Medication fine?tuning (important at your age)
800 mg Advil helping for 6 hours fits inflammation
Limit daily use
Always with food
Avoid dehydration
? Strongly recommended alternative/add?on:

Voltaren (diclofenac) gel, 2–4×/day
Same type of medication
Much safer long?term for stomach, kidneys, blood pressure
Excellent for knee arthritis
clevelandclinic
Very reassuring summary
Your knee acted like a flare, not a failure
Improvement suggests good prognosis
You’re doing exactly the right things
No rush to injections or imaging