Conservative Management and Rehabilitation in the Older Runner With Knee Osteoarthritis

Abstract

Osteoarthritis 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 osteoarthritis show conflicting results; however, most studies show an increased risk of osteoarthritis in runners with a combination of modifiable and nonmodifiable risk factors. This study reviews the current literature to provide an overview of conservative (nonpharmacological 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.

Celastrol ameliorates endoplasmic stress-mediated apoptosis of osteoarthritis via regulating ATF-6/CHOP signalling pathway

“…The ACLT surgery model of osteoarthritis was performed as previously described. [ 17 ] Rats were deeply anaesthetized by 2–4% isoflurane at 1 l/min until cessation of all sensory reflexes. The left hindlimb was shaved and cleansed by ethanol, and the shin of knee cap at the medial side was incised about 2 cm to expose the patella and patellar tendon.…”

“…The rats were divided into five groups (10 rats each group), and rats were treated with intraperitoneal administration for 14 days: Control group, animals were injected with saline; OA group, animals were injected with saline; 4‐PBA + celastrol group, animals were injected with 50 mg/kg 4‐PBA and 1 mg/kg celastrol, and both were dissolved in 0.9% NaCl and 1% dimethylsulphoxide (DMSO) (InvivoGen, San Diego, CA, USA) immediately [ 17 ] ; 4‐PBA group, animals were injected intraperitoneally with 50 mg/kg 4‐PBA; celastrol group, animals were injected intraperitoneally with 1 mg/kg celastrol. [ 15 ] …”

Oral sodium hyaluronate relieves knee discomfort: A 12‑week double‑blinded, placebo‑controlled study

“…Furthermore, 250,000 have been reported to run full-length marathons at least once a year ( 10 ). However, numerous runners who are middle-aged and elderly experience issues centered around knee joints, such as gonarthrosis, due to physical decline from aging and overwork ( 11 ). To prevent the progression of running disorders, such as gonarthrosis, it is desirable to treat them as easily as possible at a relatively mild stage, such as when the affected individuals feel discomfort in the knees, before they become serious due to excessive training ( 12 ).…”