Other contributing factors to be considered would be any past trauma to the knee, hip or back.
attachments to the talus which is the bone that resides within the ankle mortise and as a result the stability of this joint complex is based on bony architecture and surrounding ligamentous support. Clearly exercise is critical for good health to include cardiovascular, musculoskeletal and even mental but we must be cautious and understand the limits of our body and appreciate the activity and its pressure that it is exerting through the skeletal system. I have frequently advised patients with notably
higher BMI to begin with appropriate dietary restriction under physician guidance and begin weight loss in this fashion prior to engaging in high intensity activities in an effort to further lose weight through caloric burn. Alternative exercises that do not put excessive pressure on the lower extremity joints to include use of a stationary bike, aquatic exercise are a great initial means to do this. As body mass improves with weight loss then increased exertional activities such as higher intensity walking and running can be initiated with reduced risk of injury.