In young age (18 - 40 years), bilateral knee pain following prolonged activity is due to ligament instability and strains. In old age, bilateral knee pain after prolonged activity might be due to ligament imbalance, strains, or osteoarthritis.
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It is recommended that all individuals see a Family Doctor for a full medical examination annually. Adults should get their blood pressure checked (US Preventive Task Force), a flu vaccine (CDC) and more each year.