Physical Therapy Management of Knee Osteoarthritis in the Middle-aged Athlete

Abstract

Osteoarthritis (OA) is prevalent in today's population, including the athletic and recreationally active "middle-aged" population. OA is a degenerative condition of the articular/hyaline cartilage of synovial joints and commonly affects the knee joint. In general, athletic participation does not specifically influence a higher incidence of knee OA in this population; however, traumatic injury to the knee joint poses a definitive risk in developing early-onset OA. The purpose of this article is to review evidence-based nonpharmacological interventions for the conservative management of knee OA. Manual therapy, therapeutic exercise, patient education, and weight management are strongly supported in the literature for conservative treatment of knee OA. Modalities [thermal, electrical stimulation (ES), and low-level laser therapy (LLLT)] and orthotic intervention are moderately supported in the literature as indicated management strategies for knee OA. While many strongly supported conservative interventions have been published, additional research is needed to determine the most effective approach in treating knee OA.

Effect of Laser Therapy on Chronic Osteoarthritis of the Knee in Older Subjects

“…41 Several studies have reported positive effects from LLLT including influences on fibroblast propagation, osteoblast production, and collagen synthesis as well as revascularization in wound healing. 10 In addition, it has a positive effect on modulation of inflammation 13,14,42 and stimulation of angiogenesis as well as in the reduction of fibrosis formation. 15 Improvements of physical joint function outcomes usually occur as a consequence of pain intensity reduction, as pain reduction is usually primarily responsible for improvements in muscle function.…”

“…LLLT is considered a safe and applicable modality for patients with knee OA. 12,17,18 Its usage is supported either in middle-aged subjects 10 or for particular older subjects 12,23 where the usage of drugs is more restricted. Effects of LLLT on knee OA has been studied, but the results are still in conflict.…”

“…8 Common targets of interventions are to alleviate pain, maintain physical function, and to prevent or postpone progression of adverse structural changes. 9 Non-pharmacological treatment includes patients' education and physical therapy such as exercise training, phonophoresis, ultrasound, electromagnetic therapy, and transcutaneous electrical nerve stimulation, 10,11 to relief pain and muscle spasm, reduce stiffness, and to strength weak muscles. 10 Many factors may influence the responsiveness of the knee OA to physical therapy, e.g.…”

The Effects of Tai Chi Chuan on Improving Mind‐Body Health for Knee Osteoarthritis Patients: A Systematic Review and Meta‐Analysis

“…Knee osteoarthritis symptoms include joint pain, inflammation, and swelling [2]. Joint discomfort can impede the ability of the older adults to engage in daily and functional activities [1].…”

“…Joint discomfort can impede the ability of the older adults to engage in daily and functional activities [1]. Conservative treatments for knee osteoarthritis often involve physical therapy, weight control, and therapeutic exercise [2]. Therapeutic exercise, a widely accepted treatment approach, increases the muscle strength of the thighs, thereby enhancing joint stability and reducing cartilage loss in the knee [3].…”