For the second time in a week, Pope Francis cancelled his scheduled appointments on Tuesday, April 26.

“Due to pain in his knee, and on medical advice, Pope Francis has interrupted his activities planned for today,” the Vatican press office announced. The Pontiff has been increasingly troubled by knee pain, which has been attributed to strained ligaments.

Pope Francis has been scheduled to meet with the Council of Cardinals. The Pontiff did not attend that meeting—although he presumably would have been able to sit throughout the session.