Physical therapy management of knee osteoarthritis in the middle-aged athlete.

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.