Sports clinic

I play football every weekend. I'm fine off my right foot, but a bit ropey off my left. How can I improve the strength of my weaker foot?
Peter Aston, by email

Basically it takes practice but two simple exercises will help you a lot. Either on a wall or in a goal put targets and try to hit them. Use a dead ball because that makes you put all the power on the ball and as you get more accurate, increase the power and the distance. Twenty minutes of this before every training session or kick-about will give noticeable improvement in a few weeks. The other exercise is to stand on the 18-yard line and keep chipping balls into the centre circle. Even better, have a partner there and he can chip them back allowing both of you to practice. Of course you can try and control the ball with the weaker foot as well.

I'm 19 years old. Four months ago I started jogging, and have started getting pain under my kneecaps. This hurts on the stairs, particularly going down stairs. I've had to stop jogging and even feel the pain walking. It also hurts if I sit with my knees bent for more than 10 minutes. There's never been any swelling. What can I do?
Julie Smithers, by email

Pain felt under the kneecap is called anterior knee pain, and is the most common knee injury seen in any sports clinic. It is normally related to a weak inner quadriceps (thigh muscle) relative to the outer quadriceps. This results in the kneecap being pulled outwards every time the knee is bent more than it is used to, and irritation of the under-surface. The shape of your leg may increase the angle of the pull of the outer quadriceps and make the problem worse. Any activities that contract the thigh muscles hard will cause the pain, which is why going down stairs hurts. The pain after sitting is also typical, and called "the cinema sign". Exercises will strengthen the outer quadriceps, but it will take several weeks of hard work to feel any effect. If you have a large angle of pull, then orthotics (insoles) to partially reverse this can be helpful. Surgery is not very successful, and should be reserved as a last resort.

I'm 27 and have been diagnosed as suffering from Chronic Fatigue Syndrome (I still call it ME) having been tired for the last year. My doctor says I should exercise, but this seems ridiculous, as every time I try I get really tired for several days. Is it safe?
Ray Unsworth, Chester

It's not only safe but beneficial. Two studies have shown exercise helps recovery from Chronic Fatigue Syndrome (CFS) when compared to simple stretching, but is less affective if any underlying depression is not treated. So don't ignore any depressive element, but get that treated too. There is a level of light exercise that everyone can manage without breaking down. Most effective in helping recovery is gentle aerobic exercise at a very low pulse rate of about 120 beats per minute. Find how much you can do on most days of the week without relapsing, then build that up very slowly, over many weeks. Reduce your exercise if there are other stresses at any time before carefully building up again. The only other proven help in CFS is a form of psychotherapy called cognitive behavioural therapy. There is no evidence for any benefit from supplements or drugs other than anti-depressants if you are depressed.

My 10-year-old has been playing a lot of tennis but has had to almost stop completely in the last few weeks because of a pain in his knee which has got worse over the last two months. Although it's making him limp, his knee seems completely normal, with no swelling, tenderness or pain when I move it around. So far I've put it down to growing pains. I don't want to fuss, but should I take him to the doctor?
Oliver Masterton, Camberley

Two months is too long to put it down to growing pains, so your son must see his doctor. He will probably say there is nothing wrong with your son's knee, but it's likely there's a problem with his hip. It's common for people with a hip to feel the pain in the knee rather than hip. If you gently rotate your son's hip you may find it makes his knee-pain worse. It may be just a strain, but if there is any doubt he should have an X-ray to exclude degeneration of the ball in the hip joint, which is called Perthe's disease. If this is the case then he should make an excellent recovery, but he will need careful monitoring and rest from all painful activities.

In this week's panel, alongside Dr Richard Budgett, medical director of the British Olympic Association, was Ipswich Town and Republic of Ireland midfield player Matt Holland

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