Conservative Management and Rehabilitation in the Older Runner with Knee Osteoarthritis: An Evidence-Based Review

Osteoarthritis (OA) is an age-related condition that commonly affects the middle-aged and elderly population including individuals who continue to pursue an active and athletic lifestyle. Running is an easily accessible activity with many health benefits; thus, it is becoming a popular form of exercise, even in older individuals. Studies evaluating the correlation between running and OA show conflicting results; however, most studies show an increased risk of OA in runners with a combination of modifiable and non-modifiable risk factors. This study reviews the current literature to provide an overview of conservative (non-pharmacological and pharmacological) management strategies including patient education, therapeutic modalities and exercises, mechanical measures, dietary factors, oral and injectable pharmacotherapies, and orthobiologics. Rehabilitation considerations and return-to-sport guidelines are discussed, emphasizing the notion that a return to running activity requires reduction in mileage and formulation of a structured exercise program that includes strengthening, flexibility, and stability exercises, as well as modifications in the running technique. *Corresponding Author: William Micheo, MD, Professor and Chair, Sports Medicine Fellowship Director, Physical Medicine, Rehabilitation and Sports Medicine Department, University of Puerto Rico, School of Medicine, PO Box 365067, San Juan, PR 00936-5067. E-mail: william.micheo@upr.edu, wmicheo@usa.net. Telephone: 787-751-9625. Fax: 787-754-1478 ** The authors received no specific funding for this work ***Authors have no conflicts of interest to disclose for this work Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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