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Age-related changes in skeletal muscle, bone, and other connective tissues appear to place the older adult at greater risk of injury or a painful inflammatory event during exercise. To reduce the possibility of injury or painful episode, flexibility and strength should be maximized, particularly at the joints used for the sport activity. Findings for adults 55–97 years of age indicate that injury during exercise is unlikely to occur, but the incidence of painful inflammatory events ranges from 27% to 63%. The higher incidence of painful episodes is associated with higher intensity of physical activity. Painful inflammatory events respond to traditional conservative treatment, including exercise modification, rest, application of ice, elastic wrapping, massage, and nonsteroidal medication. The overwhelmingly positive benefits of exercise lend strong support to the recommendation for physical activity as part of the lifestyle of older adults even if an injury or painful episode should occur. Although a high proportion of exercising older adults will probably experience a painful episode, conservative measures are likely to be highly successful in resolving them.