I am a 71 year old male and I still like to hike, shoot hoops and play pickleball. When I was 65 years old I had some knee pain which was getting quite painful. I had an x-ray which showed very minor arthritis and was given a cortisone shot in both knees. The pain was resolved for about another year. I have been having 1 and sometimes 2 shots a year. The last cortisone shot I had was in June of 2017. The doctor moved and I went to another doctor (a doctor of physical medicine this time.) I told him I wanted a shot of cortisone and that it had worked in the past. He ordered another x-ray with the same results-mild arthritis. He talked me into having a set of 3 shots of synsvic (probably spelled it wrong). I had the first shot on June 5 and the last one on June 26. He told me to take it easy and not do any serious hiking until after the shots and then to start mildly. I did some easy walking on level pavement during the last month. Yesterday I tried my first serious hike in the mountains. I noticed that there was some tenderness in the knees and that my balance wasn't as good-probably because of the tenderness. It was a 50 minute hike in and a 60 minute hike back out. I spend the better part of the day at the lake fishing. Some standing but mostly sitting. When I got home it was sore but I wasn't overly concerned. My knee continued to get worse during the night. This morning (and now) it is real sore and I can't stand much without a lot of pain and it is quite stiff. There doesn't appear to be any swelling. I'm wondering if this is normal after the synvisc shots? Can the shots in and of themselves cause any permanent damage. If it does not get better, how soon can I have a cortisone shot to get relief from the pain. If you could answer my questions I would greatly appreciate it. And if you could offer me any additional advice, I certainly would like to have it.