JOSPT Insights

Osteoarthritis is common, and there's no cure for it. Clinicians working in musculoskeletal rehabilitation are likely to see people who are at risk of, or who have developed, osteoarthritis. In place of a cure, your focus might shift to strategies to reduce the risk of joint trauma—which could be the trigger for developing osteoarthritis years later—or to strategies that aim to slow the progression of the disease. Dr Tarcisio de Campos—physiotherapist and Clinical Postdoctoral Research Fellow (Institute of Musculoskeletal Health, University of Sydney and Sydney Local Health District)—tackles the questions of which strategies should you choose and how effective are they? ------------------------------ RESOURCES Interventions for preventing knee osteoarthritis: systematic review OPTIKNEE 2022 consensus recommendations for improving knee health and preventing osteoarthritis

Does the ACL have the capacity to heal following injury? And if it does, what might that mean for how clinicians approach ACL rehabilitation? The prevailing assumption has been that a ruptured ACL has limited capacity to heal and restore structural continuity without reconstruction. Now, a growing body of research is challenging that assumption. In today's episode, Professor Joanna Kvist (Linköping University, Sweden) discusses new findings from the NACOX cohort examining how ACL structure changes on MRI during the first 2 years following acute ACL injury. Dr Kvist and her team found that ACL structure and fiber continuity improved over time in many participants managed without ACL reconstruction, and greater ACL continuity was associated with less knee laxity on objective measurement. Dr Kvist explains what the ACL looked like on MRI over those 2 years, the changes in ligament thickness and fiber continuity, how those structural findings related to clinical outcomes, and what clinicians should (and shouldn't) take from these findings when discussing rehabilitation and treatment options with patients. ------------------------------ RESOURCES Structural changes of the ACL, evaluated by MRI, and their relation to clinical outcomes within 2 years after ACL injury

The RESTORE trial, published in 2023, put cognitive functional therapy (CFT) on the map as an effective approach for managing chronic, disabling low back pain. Since then, there has been more research supporting CFT, including a large network meta-analysis published in JOSPT in early 2026. In today's episode, we explore the results of the CONFeTTI trial, which tested the CFT+ intervention - combined care delivered by a physiotherapist and a psychologist in an interdisciplinary pain clinic. Dr Henrik Bjarke Vægter led the CONFeTTI trial. He is an experienced physiotherapist and head of the interdisciplinary Pain Centre at Odense University Hospital in Denmark. Dr Bjarke Vægter is Professor of Physiotherapy and Pain Treatment at the University of Southern Denmark's Department of Clinical Research. ------------------------------ RESOURCES CONFeTTI trial Tailored exercise therapy with or without psychological interventions: systematic review with network meta-analysis RESTORE trial

How many patients describe receiving what sounds like inadequate care for osteoarthritis before they reached your clinic? Osteoarthritis is one of the most common chronic musculoskeletal conditions. When there are many trustworthy, international clinical guidelines that clearly outline what best-practice osteoarthritis care should entail, why are so many patients missing out on high-value care? Today's guest, Dr Jodi Young, discusses her team's analysis of data from nearly 25,000 patients who received osteoarthritis care in the United States, and what these data say about osteoarthritis care. Dr Young is the Director of Research for the Doctor of Science in Physical Therapy program at Bellin College in Green Bay, Wisconsin. She is also a fellow of the American Academy of Orthopaedic Manual Physical Therapists. ------------------------------ RESOURCES Real-world use of exercise and manual therapy for managing knee osteoarthritis: https://www.jospt.org/doi/10.2519/josptopen.2026.0221 Opioid prescribing to active duty US military personnel: https://pubmed.ncbi.nlm.nih.gov/37507224/ Opioid vs. non-opioid medications for people with chronic back pain or hip or knee OA (SPACE Trial): https://pubmed.ncbi.nlm.nih.gov/29509867/ Opioid use patterns among active duty service members and civilians: https://pubmed.ncbi.nlm.nih.gov/29514335/ JOSPT Insights episode 257 - Reflecting on contemporary manual therapy: https://pod.link/1522929437/episode/NzM4ZjYwY2EtMzNhYi00OTI5LWE5OTAtZmUwY2ZkM2QxMDA0

There's plenty of debate in the musculoskeletal rehabilitation community about how to clearly communicate with patients about a diagnosis. Clinicians are trying to balance being clear about what the likely cause of the symptoms is without inducing unnecessary worry. How much should you—or even can you—accurately describe the pathology and anatomy of the problem? On the flip side, others have strongly argued that pathoanatomic labels do more harm than good. Today, experienced musculoskeletal physiotherapist and researcher (Laval University, Canada), Marc Perron makes the case that clinicians should not hide the pathology and anatomy—it's how you talk with patients about their diagnosis that matters most. ------------------------------ RESOURCES Physical therapists diagnosing musculoskeletal conditions: don't hide what matters - just say it the right way: https://www.jospt.org/doi/10.2519/jospt.2026.14197

Psychological factors like a person's thoughts, beliefs and emotions can exert a strong influence on rehabilitation outcomes for people with chronic musculoskeletal conditions. When a person has pain, they might feel scared to move or convinced that moving in a certain way will damage their body. Today's discussion focuses on how a person's thoughts about shoulder pain can change over an 8-week exercise-based rehabilitation program, and the implications for how musculoskeletal rehabilitation clinicians approach discussions about fear and moving with the patients you work with. Dr Courtney Mears and Dr Matthew Heindel discuss their recent JOSPT publication (linked below). Dr Mears is a physical therapist at the University of Southern California, and a researcher in the Clinical Biomechanics Orthopedic and Sports Outcomes Research Lab. Her research focuses on understanding the relationship between psychosocial factors, shoulder pain, and functional outcomes. Dr Heindel is a physical therapist, and a postdoctoral associate at Duke University’s School of Medicine, where he studies the neuroimmune mechanisms of chronic musculoskeletal pain. Dr Heindel completed his PhD on the mechanics of pain and muscle dysfunction in rotator cuff tendinopathy in 2025 at the Clinical Biomechanics Orthopedic and Sports Outcomes Research Lab at the University of Southern California. ------------------------------ RESOURCES Changes in pain-related fear: https://www.jospt.org/doi/10.2519/jospt.2026.13563 OSPRO yellow flag assessment tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487

Does hip crepitus make a difference to the health of the joint? Does crepitus indicate damage, harm or progression of osteoarthritis? How should clinicians explain hip crepitus and its implications to patients? Today's guest addresses those questions and more in a deep dive on hip crepitus. Dr Danilo De Oliveira Silva (La Trobe University) discusses his JOSPT article, Self-Reported Hip Crepitus Is Prevalent in Football Players With Hip/Groin Pain, but Is It Associated With Early Hip Osteoarthritis Structural Features? A Longitudinal Study, with Dan and Marquis. ------------------------------ RESOURCES Self-reported hip crepitus - longitudinal study: https://www.jospt.org/doi/10.2519/jospt.2025.13474 Beliefs and attitudes about hip crepitus: https://pubmed.ncbi.nlm.nih.gov/41056730/

Hip morphology and hip injuries have been receiving increasing attention, which is a good thing given their prevalence and impact on athletes' health and performance. Today's guests combine the hip and groin field, with the attention that female athletes deserve to their health and performance. Dr Pim van Klij, who works with Dutch football/soccer powerhouse, Ajax, and Pirette Claes, who is starting her career in sports medicine, discuss the PROFE study. We focus on the work they have been leading to quantify the relationship between groin symptoms, and pubic symphysis radiological findings and skeletal maturity. Dr van Klij is sports medicine physician and Assistant Professor at Amsterdam University Medical Centre, Department of Orthopaedic Surgery and Sports Medicine. Pirette Claes is a medical intern at Leiden University Medical Centre, and an early-career researcher. ------------------------------ RESOURCES Prevalence of symphyseal radiographic findings and relationship to groin symptoms (PROFE study): https://www.jospt.org/doi/10.2519/jospt.2026.13580 JOSPT focused issue on hip and groin research (July 2026): https://www.jospt.org/toc/jospt/56/7

Tendinopathy will show up regularly in the clinic for many JOSPT Insights listeners. In a person-centred care model, it's important to understand the person with tendinopathy, where they're coming from and what they're experiencing. Today's guest has been studying patients' experience of different types of lower limb tendinopathies. The results might surprise you, in just how complex and variable people's experiences are. Max Hopes is an osteopath and researcher (University of Technology Sydney) studying lower limb tendinopathy. Today Max shares some of the early results of his PhD work, and we explore what it means for musculoskeletal practice. ------------------------------ RESOURCES Lived experiences of people with tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2026.13666

In last week's episode, Dermot Simpson and Simon Wallace explained the hamstring and rectus femoris rehabilitation pathways that they and their colleagues at the Aspetar Orthopaedic & Sports Medicine Hospital have developed to guide daily practice. In using the rehabilitation pathways, Dermot and Simon, and the team have discovered some clinical pearls that help them help the athletes they're working with. Today, Dermot and Simon are sharing those clinical tips. These are the things that you can do in practice tomorrow to give you and the athlete the best chance of rehabilitation success. Dermot Simpson and Simon Wallace are sports physiotherapists working at the Aspetar Hospital in Doha, Qatar. Between them, they have more than 2 decades of experience in elite sport, especially in rugby and football/soccer. ------------------------------ RESOURCES Aspetar Hamstring Injury Rehabilitation Pathway: https://www.jospt.org/doi/10.2519/josptopen.2026.0213 Aspetar Rectus Femoris Injury Rehabilitation Pathway: https://www.jospt.org/doi/10.2519/josptopen.2026.0212 Longer muscle length resistance training (systematic review): https://pubmed.ncbi.nlm.nih.gov/41646176/ Nordic hamstring exercise vs. lengthened state eccentric training: https://pubmed.ncbi.nlm.nih.gov/38857522/

If you work with athletes who play any of the football codes, or any field-based sport that involves high-speed running or kicking, you'll surely have hamstring and rectus femoris injuries at the front of your mind. Even if you're not in field-based sports, today's first episode in a 2-part series is a terrific opportunity to review your approach to managing thigh muscle injuries. We're taking a deep dive into best practice in rehabilitation planning. Part 1 explores the components of rehabilitation; part 2 covers the clinical pearls to help you design and deliver the most effective rehabilitation plans possible. Our guides are experienced Irish sports physiotherapists, Dermot Simpson and Simon Wallace, of the Aspetar Orthopaedic & Sports Medicine Hospital in Doha, Qatar. Dermot has spent over 10 years at Aspetar, working with athletes from a range of sports. His clinical and research work is in thigh muscle and groin injuries. Simon applies his expertise to complex thigh muscle injuries, also calf and foot & ankle injuries. Before joining Aspetar, Simon worked for a decade in professional rugby. To learn more from Dermot and Simon, check out their new Reload-Ed platform. ------------------------------ RESOURCES Aspetar Hamstring Injury Rehabilitation Pathway: https://www.jospt.org/doi/10.2519/josptopen.2026.0213 Aspetar Rectus Femoris Injury Rehabilitation Pathway: https://www.jospt.org/doi/10.2519/josptopen.2026.0212

JOSPT Insights episodes often explore what well-functioning teams look like and how they function. Why? Well there's at least 2 important reasons: Effective athlete centred care depends on the sports medicine, rehabilitation and performance team all co-ordinating to help the athlete get the best out of themselves. Working in teams and leading those teams well is not about telling people what to do - it's about shaping the path and working together to achieve goals. Effective leaders shape the path and bring people along with them - they don't make it all about themselves. Today's guest embodies those leadership qualities. Agnes Makowski is a registered International Sport Physiotherapist and has served as Chief Physiotherapy Advisor for Skate Canada since 2014. Agnes has extensive experience working in interdisciplinary teams and supporting athletes from the recreational level all the way to the pinnacle of Olympic performance. Today, Agnes shares her experiences and approaches to working in interdisciplinary teams. ------------------------------ RESOURCES Why screening tests to predict sport injury do not work: https://pubmed.ncbi.nlm.nih.gov/27095747/ 2022 Bern consensus on shoulder injury prevention, rehabilitation and return to sport: https://www.jospt.org/doi/10.2519/jospt.2022.10952

The biopsychosocial model of health has been around since the late 1970s. In musculoskeletal rehabilitation, the biopsychosocial model is prominent in clinical practice guidelines for a variety of different conditions, with different approaches advocated for how to provide rehabilitation within the model. Today, Dr Kate Jochimsen guides JOSPT Insights listeners through psychologically-informed rehabilitation practice - taking principles that have become quite prominent in the chronic low back pain field and seeing how they might apply to young, active people with chronic hip pain. Dr Jochimsen is an Assistant Professor in the Department of Psychiatry at Harvard Medical School, a researcher at the Center for Health Outcomes and Interdisciplinary Research at Massachusetts General Hospital (MGH), and a member of the Physical Therapy Residency Faculty at the MGH Institute for Health Professions. Her work bridges the gap between sports medicine and psychology, with a primary focus on chronic pain and hip injuries. ------------------------------ RESOURCES OSPRO yellow flags tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487 Screening for yellow flags - clinical framework: https://www.jospt.org/doi/10.2519/jospt.2021.10570 Pain Catastrophizing Scale: https://www.sralab.org/rehabilitation-measures/pain-catastrophizing-scale Association between pain and function in people with hip pain - systematic review: https://pubmed.ncbi.nlm.nih.gov/41020468/ JOSPT's July 2026 hip-focused issue (10 hip articles): https://www.jospt.org/toc/jospt/56/7 Association for Applied Sport Psychology mental wellness resource center: https://appliedsportpsych.org/resources/mental-wellness-resource-center/ Why things hurt - TEDx with Professor Lorimer Moseley: https://www.youtube.com/watch?v=gwd-wLdIHjs Psychologically informed practice in low back pain (case report): https://www.jospt.org/doi/10.2519/josptcases.2025.0177 Psychologically informed physical therapy for musculoskeletal conditions (APTA paid course): https://www.orthopt.org/course/33-3-psychologically-informed-physical-therapy-for-musculoskeletal-disorders Managing persistent pain (APTA paid course): https://learningcenter.apta.org/products/persistent-pain-management-certificate-a-comprehensive-learning-series

We're often asking or answering the question "why?" in clinical practice. Why does it hurt? Why does this treatment give me relief? Why is the problem not getting better? Sometimes it's easy to answer why, and sometimes it's not. In today's episode, Dr Damian Keter (US Department of Veterans Affairs) explores and explains musculoskeletal treatment mechanisms. Dr Keter suggests some ways to approach responding to the why question, even when the treatment mechanism isn't clear. He shares his perspectives on person-centered care and precision medicine. ------------------------------ RESOURCES Understanding musculoskeletal treatment mechanisms: https://www.jospt.org/doi/10.2519/jospt.2026.14486 Person-centered care and modern manual therapy: https://www.jospt.org/doi/10.2519/josptopen.2023.0812 The case for treatment pluralism: https://www.jospt.org/doi/10.2519/jospt.2026.13992 Sequenced care pathway vs. pain navigator pathway for veterans with low back pain: https://pubmed.ncbi.nlm.nih.gov/41926124/

Returning to sport after an ACL injury is often framed around a single construct: fear of reinjury. But what if fear doesn't tell the whole story? In today's episode, Chelsea and Marquis speak with Cobie Starcevich about her team's qualitative evidence synthesis exploring how athletes experience and interpret reinjury concerns after ACL injury. The team's findings suggest that what clinicians commonly label as "fear of reinjury" is actually a much broader, nuanced experience encompassing altered beliefs, assessments of threat, behavioral and cognitive coping strategies, physiological sensations, and concerns about the future. Cobie explains what the findings mean for clinicians, and how clinicians can move beyond fear and into exploring the multidimensional experiences of injury with patients. ------------------------------ RESOURCES Qualitative evidence synthesis of athletes' experience and interpretation of reinjury concerns after ACL injury: https://www.jospt.org/doi/10.2519/jospt.2026.13852

A patient might ask the clinician: "How long will it take me to get back to sport?" or "How long until I'm feeling back to myself again?". These questions ask the clinician to make a prognosis - to predict the future. Often we rely on our clinical experience or intuition to answer with a prognosis. Sometimes we might know some prognostic factors, which can give us some big-picture ideas, but they're rarely enough to give the full picture. Today physiotherapists and researchers Daniel Feller and Dr Alessandro Chiarotto (Erasmus Medical Centre, Rotterdam, The Netherlands) explain prognostic prediction models: what they are, how they might help in practice, and what to look for when you're deciding whether a tool like the STarT Back is suitable for your practice. ------------------------------ RESOURCES When is a prognostic prediction model ready for clinical use?: https://www.jospt.org/doi/10.2519/jospt.2026.13868

Today we're talking about one very important milestone in rehabilitation after an ACL reconstruction: return to running. It's a milestone that sometimes gets overshadowed by its more flamboyant sibling, return to sport. Brendan Butler joins JOSPT Insights to explore best practice in return to running. Brendan an Irish sports physiotherapist, who is currently working at the Aspetar Orthopaedic & Sports Medicine Hospital in Doha, Qatar. He's a member of the Aspetar ACL team, where he applies skills honed in Gaelic football, rugby, soccer and athletics. ------------------------------ RESOURCES Simple clinical measures that quantify knee loading symmetry during running: https://pubmed.ncbi.nlm.nih.gov/41110241/ Clinician choices for return to running criteria: https://www.jospt.org/doi/10.2519/josptopen.2026.0195 Lower medial hamstring activity during running: https://pubmed.ncbi.nlm.nih.gov/33782638/

All the data point to a growing burden of chronic musculoskeletal pain for populations around the world. Clearly, there is a need to innovate in the way that musculoskeletal care is delivered. In today's episode, Dr Luc Hébert shares his wealth of experience in musculoskeletal rehabilitation care - as a clinician and as a researcher leading clinical trials of different care models. We explore new models of care and the data supporting them. Dr Hébert is Professor at Laval University in Quebec City, Canada, and researcher at the Interdisciplinary Research Centre on Rehabilitation and Social Integration. ------------------------------ RESOURCES Group-based rehabilitation vs. individual programs: https://www.jospt.org/doi/10.2519/jospt.2024.12342 Benefits of primary contact emergency department physical therapy: https://www.jospt.org/doi/10.2519/jospt.2025.13429

There are many outstanding leaders in the sports medicine and musculoskeletal rehabilitation world. How did they get there? What decisions did they make that have got them to where they are today? In today's episode, Dr Amber Donaldson shares what she is looking for in the next generation of sports medicine leaders, how she has approached developing her own career, and her advice for early-career clinicians looking to establish themselves in elite sports medicine. Dr Donaldson is the Vice President - Sports Medicine at the United States Olympic and Paralympic Committee.

How often do you think about the air quality in the clinic or outside when you're exercising? Perhaps you live and work in a part of the world where you're fortunate to have good air quality most of the time. For many people though, that's not the case. Air pollution from wildfires in increasing, and it has serious implications for everyone's health. Today, Dr Débora Petry Moecke (Centre for Heart Lung Innovation, University of British Columbia) explains how to support clean air in the clinic to protect patients' health. ------------------------------ RESOURCES Wildfire smoke and its impact on physical therapy practice: https://www.jospt.org/doi/10.2519/jospt.2025.13546 IQAir (real-time air quality data from around the world): www.iqair.com

Today, Dr Federico Pozzi (University of Florida), walks Dan and Marquis through his recent paper titled “Addressing Shoulder Weakness in Individuals With Rotator Cuff–Related Shoulder Pain: A Systematic Review With Meta-analysis” In this discussion, Dr Pozzi, Dan & Marquis look at the research regarding rotator cuff-related shoulder pain, asking the question: what type of strengthening interventions help best? Dr Pozzi shares his advice for clinicians on how to design and implement effective shoulder rehabilitation programs. ------------------------------ RESOURCES Addressing shoulder weakness systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13445

Rugby is seeing consistent growth in popularity and participation. It's also no secret that women's sport is also growing rapidly. Put those together and you enter the exciting and rapidly developing area of women's and girl's rugby. Today, Dr Isla Shill (University of Victoria) discusses her research work in preventing injuries (including concussion) in girl's rugby. She shares the key components, and what it takes to implement an effective injury prevention program. ------------------------------ RESOURCES Effects of neuromuscular training warm-up for preventing injury and concussion in girl's rugby: https://www.jospt.org/doi/10.2519/jospt.2026.13373 SHRED injuries neuromuscular training warm-up programs: https://www.ucalgary.ca/shred-injuries Tips for supporting athletes to return to sport after concussion, with Dr Kathryn Schneider: https://pod.link/1522929437/episode/YTA0ZWY0NDgtYzNmZi00ODlmLTg5ZWQtMTAyMDE3ZTUxNjhk Female, woman, and/or girl Athlete Injury pRevention: https://fairconsensus.com/ FAIR practical recommendations: https://pubmed.ncbi.nlm.nih.gov/41330629/

Today’s guest—Dr Thomas Ibounig—who led the paper, “Rotator Cuff Imaging Abnormalities in Asymptomatic Shoulders: A systematic review” explores how prevalent abnormal MRI findings are in asymptomatic shoulders, and how the prevalence changes by population. The systematic review is an exemplar of what musculoskeletal rehabilitation clinicians can learn from accepting what we don’t know! Chelsea and Marquis wrap up the chat by thinking about how physical therapists can take the systematic review findings into account when educating and referring patients with shoulder pain. ------------------------------ RESOURCES Rotator cuff imaging abnormalities in asymptomatic shoulders systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13611 More on the SCRUTINY (Systematic Review of Shoulder Imaging Abnormalities in Asymptomatic Adults) project: https://www.ficebo.com/project/scrutiny

Psychological factors can be prominent for people with tendinopathy–so how do you pick up on them? How might psychological factors guide your plan of care? Today, physiotherapist Jack Mest (University of Canberra), is your guide to understanding how best to screen for important psychological factors, and how to address them in the clinic. Jack Mest is a PhD candidate, studying psychological factors associated with persistent tendinopathy and psychologically informed approaches in Achilles tendinopathy rehabilitation. ------------------------------ RESOURCES Psychological factors in people with and without persistent tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2025.13307 Scoping review of psychological factors in tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2022.11005 JOSPT Insights ep 255: what if clinicians trusted people in pain? With Joletta Belton & Ben Darlow: https://pod.link/1522929437/episode/ZjcwNTljYzMtMjI5Ny00NWI2LWJjNzMtYzlkZTA3ZjVhODcz

The Covid pandemic was an inflection point for many aspects of health care, including turbocharging uptake of virtual models of care. Telerehabilitation was around before Covid, of course, but the past few years has seen it in a far more prominent place in health care systems. There's also increasing research evaluating different telerehabilitation interventions. Dr Bruno Saragiotto (University of Technology Sydney) studies telehealth for chronic pain conditions, artificial intelligence and implementing digital solutions in health care. Today he joins JOSPT Insights to discuss the present and future of technology for improving outcomes in musculoskeletal rehabilitation. ------------------------------ RESOURCES Internet-based self-management for chronic pain (ReabilitaDOR Trial): https://www.jospt.org/doi/10.2519/jospt.2025.13418 Effectiveness of activity trackers and smartphone apps for increasing physical activity: https://www.jospt.org/doi/10.2519/jospt.2026.13825 Physiotherapy Evidence Database (PEDro): https://pedro.org.au/

In episode 258, Drs Ruth Chang and JP Caneiro explain the results of trials testing cognitive functional therapy (CFT). They explored what CFT is and how it might help people in pain. In today's episode, Dr Caneiro (Curtin University; Evoolve Pain Care Academy) joins the JOSPT Insights community again to explain what is involved in learning the patient-centred CFT approach. ------------------------------ RESOURCES Evoolve Pain Care Academy: https://evoolvepaincare.academy/ Videos, infographics and written resources for clinicians: https://evoolvepaincare.academy/clinician-resources

All clinicians know the challenge and opportunity that comes with tailoring clinical decisions to the person in front of you. While it's helpful to have clinical practice guidelines to give you a starting point and to reduce unwarranted variation in practice, of course every patient is different! Today, Dr Trevor Lentz (Duke University) explains the concept of clinical phenotyping, which is another way of identifying patterns in your clinical practice, and guiding your clinical decisions. Clinical phenotyping has been suggested as a way of tailoring musculoskeletal care in practice, although its implementation in practice has been patchy - Dr Lentz explains some of the reasons why. ------------------------------ RESOURCES Psychological phenotyping in osteoarthritis: https://www.jospt.org/doi/10.2519/josptopen.2025.0177 OSPRO yellow flags tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487 Clinical framework for screening yellow flags: https://www.jospt.org/doi/10.2519/jospt.2021.10570 STarT MSK research programme review: https://pubmed.ncbi.nlm.nih.gov/37490570/

Last week we explored how people with pain move. Drs Ruth Chang and JP Caneiro explained cognitive functional therapy, or CFT, as an approach to helping people in pain explore their beliefs with curiosity. Today, we take the discussion further, exploring what CFT could do for your practice. Dr Chang is a postdoctoral research fellow at Curtin University in Perth, Australia, and a specialist musculoskeletal physiotherapist. Dr Caneiro is a specialist physiotherapist, Adjunct Senior Clinical Researcher at Curtin University, and Director and Educator at Evoolve Pain Care Academy. ------------------------------ RESOURCES RESTORE trial: https://pubmed.ncbi.nlm.nih.gov/37146623/ Patterns of change in forward bending, and pain self-efficacy during CFT: https://www.jospt.org/doi/10.2519/jospt.2025.13114 Relationship between forward bending and improvement in pain and disability during CFT: https://www.jospt.org/doi/10.2519/jospt.2024.12727 Network meta-analysis of tailored exercise therapies with or without psychological interventions: https://www.jospt.org/doi/10.2519/jospt.2025.13281

If cognitive functional therapy hasn't been on your radar, it's likely only a matter of time. There's an increasing number of trials studying the effects of cognitive functional therapy. In a network meta-analysis published in January 2026 in JOSPT, the authors found that cognitive functional therapy topped a list of 27 different interventions for reducing disability in people with chronic non-specific low back pain. Today, Dr Ruth Chang (Curtin University, Australia) and Dr JP Caneiro (Curtin University; Evoolve Pain Care Academy) explain how cognitive functional therapy works and how to incorporate it into your practice. ------------------------------ RESOURCES RESTORE trial: https://pubmed.ncbi.nlm.nih.gov/37146623/ Patterns of change in forward bending, and pain self-efficacy during CFT: https://www.jospt.org/doi/10.2519/jospt.2025.13114 Relationship between forward bending and improvement in pain and disability during CFT: https://www.jospt.org/doi/10.2519/jospt.2024.12727 Network meta-analysis of tailored exercise therapies with or without psychological interventions: https://www.jospt.org/doi/10.2519/jospt.2025.13281

Manual therapy is one of those topics that seems to quickly descend to polarised debates in musculoskeletal rehabilitation. Today, we're talking about what manual therapy looks like and does in the 2020s. Dr Jodi Young explains the mechanisms of manual therapy, the typical effects and why you might think about adding manual therapy as another tool in your physical therapy toolkit. Dr Young is the Director of Research for the Doctor of Science in Physical Therapy program at Bellin College in Green Bay, Wisconsin, where she mentors doctoral clinicians and helps turn clinical and educational research questions into meaningful, publishable research. She is also a fellow of the American Academy of Orthopaedic Manual Physical Therapists. ------------------------------ RESOURCES Modern definition and description of manual therapy: https://pubmed.ncbi.nlm.nih.gov/38457654/ Modern way to teach and practice manual therapy: https://pubmed.ncbi.nlm.nih.gov/38773515/ Living review of manual therapy mechanisms: https://pubmed.ncbi.nlm.nih.gov/40100908/ Unravelling the mechanisms of manual therapy: https://www.jospt.org/doi/10.2519/jospt.2018.7476 Developing manual therapy frameworks: https://www.jospt.org/doi/10.2519/josptopen.2023.0002 Integrating person-centred concepts and modern manual therapy: https://www.jospt.org/doi/full/10.2519/josptopen.2023.0812 How do patients believe manual therapy works? https://www.jospt.org/doi/10.2519/josptopen.2025.0149 Does it matter how you apply spinal manipulation? JOSPT Insights ep 221: https://pod.link/1522929437/episode/NmM0MTg4OGMtODMwMi00ZTA3LTg1NzUtYjY2ZjBiMThiZGUy

After Lindsey Vonn's sad early exit due to injury from the Milano-Cortina 2026 Winter Olympics, it feels like an apt time to revisit the latest consensus on managing knee injury, and supporting return to sport after complex meniscus injury and surgery. Today, we continue the conversation on the latest consensus for managing acute and degenerative meniscus tears. We jump into non-surgical treatment, and all the return to sport considerations for athletes and active people with meniscus injury. Dr Arielle Giordano (University of Delaware) shares the results of the EU-US Meniscus Rehabilitation Consensus. ------------------------------ RESOURCES EU-US Meniscus Rehabilitation Consensus on prevention, non-operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539 DREAM trial primary report: https://pubmed.ncbi.nlm.nih.gov/38319181/ Should symptoms guide treatment choice in young patients? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/ Early surgery vs exercise therapy + education for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245 Ep 224: Saving the meniscus: https://pod.link/1522929437/episode/NTg3YTgzZWUtYTZjZC00ZDYwLWI2OTAtYTczMzAzNTEyNzgz Ep 192: DREAMing of better care for meniscus tears: https://pod.link/1522929437/episode/Yzk2YzkyOWItMDk1MS00YWZkLWI2MjQtNmRlYjIwZGJmOTg0

Trust is integral to the therapeutic relationship between patients and clinicians in musculoskeletal rehabilitation. But does that trust go both ways? If you do a deep dive into the literature on trust, you'll find that it almost always talks about whether patients trust clinicians, not if clinicians trust patients. There's also an inherent bias built into the biomedical environment where so called 'objective' tests - the imaging, the bloodwork, the physical performance tests that clinicians administer - are prioritised over patients' lived experience and expertise, which is derided as 'subjective' and somehow less trustworthy. Today's guests today invite you to join a revolution of starting from a place of trusting people with pain, and acknowledging the patient's expertise. Joletta Belton is an author, advocate and patient engagement in research specialist, who makes sense of pain through science and stories. Dr Ben Darlow is a physiotherapy specialist and Professor of Primary Health Care at The University of Otago in Aotearoa/New Zealand. ------------------------------ RESOURCES Do we trust patients in pain viewpoint: https://www.jospt.org/doi/10.2519/jospt.2025.13725 Jo's substack (MyCuppaJo): https://mycuppajo.substack.com/ Framework for establishing connections in physiotherapy practice: https://pubmed.ncbi.nlm.nih.gov/29432058/

Need a refresher on youth sport-related concussion? Today's episode is a rapid review of the epidemiology and best practice for managing youth concussion. Lisbeth Lund Pedersen (University of Southern Denmark & Danish Society for Sports Physiotherapy) shares the results of the HAAPY study, which involved more than 900 young Danish handball players prospectively recording handball exposure and injuries. We discuss why female athletes might have a greater concussion risk, and what clinicians can do to promote you athletes' brain health. ------------------------------ RESOURCES <>Health And Performance Promotion in Youth Sport (HAPPY) study of concussion: https://www.jospt.org/doi/10.2519/jospt.2025.13399 Female, woman and/or girl Athlete Injury pRevention (FAIR) practical recommendations: https://pubmed.ncbi.nlm.nih.gov/41330629/ Consensus statement on concussion in sport: https://pubmed.ncbi.nlm.nih.gov/37316210/

The updated clinical practice guideline for managing hip osteoarthritis landed in late 2025. Today, Dan and Marquis speak with lead author Dr Thomas Koc Jr. to highlight what's new, what's changed and what’s currently considered best practice for hip osteoarthritis. Dr Koc shares the upgraded evidence for dry needling, downgraded evidence for ultrasound, and everything in between. ------------------------------ RESOURCES Read the CPG yourself here: https://www.jospt.org/doi/10.2519/jospt.2025.0301

Sleep: we all know it's essential for function in everyday life, and plays an important role in recovery and managing musculoskeletal pain. How much did you learn about assessing and managing sleep dysfunction in your musculoskeletal degree program? Today, Dr Mark Shepherd (Bellin College) shares practical tips to help you assess sleep, identify common sleep disorders, and incorporate behavioural strategies into your musculoskeletal rehabilitation practice. ------------------------------ RESOURCES Clinician's guide to assessing and addressing sleep dysfunction in people with musculoskeletal pain: https://www.jospt.org/doi/10.2519/josptopen.2025.0198 Spine pain and sleep study: https://pubmed.ncbi.nlm.nih.gov/35642567/ UK Biobank study on predictors of persistent pain: https://pubmed.ncbi.nlm.nih.gov/37414898/ Systematic review on lack of sleep measures: https://pubmed.ncbi.nlm.nih.gov/37259893/ APTA position paper on the PT’s role in sleep health: https://www.apta.org/apta-and-you/leadership-and-governance/policies/role-pt-apta-sleep-health DPT students and sleep behaviours: https://pubmed.ncbi.nlm.nih.gov/39425093/

The JOSPT Insights team has been on a hiatus in December. We're very pleased to say we're back and recording new episodes to share with you in 2026. We're back in your feed with new episodes from mid-January. Until then, we're sharing a couple of our most impactful episodes of 2025. Enjoy! ------------------------------ Patellofemoral pain can affect anyone at any age, which mean you're likely to come across it in your clinical career. What is best practice in managing patellofemoral pain? Today, Dr Brad Neal (Queen Mary University of London) walks us through how to apply the best research to your practice. Dr Neal has worked for over a decade in elite sport, private and public health care settings as a specialist musculoskeletal physiotherapist. His PhD work in biomechanics has helped guide understanding of how to manage patellofemoral pain. ------------------------------ RESOURCES Best practice guide for patellofemoral pain: https://pubmed.ncbi.nlm.nih.gov/39401870/ Effects of treatment for patellofemoral pain - systematic review with meta-analysis: https://www.jospt.org/doi/full/10.2519/jospt.2022.11359 Patellofemoral pain 2019 clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2019.0302

The JOSPT Insights team has been on a hiatus in December. We're very pleased to say we're back and recording new episodes to share with you in 2026. We're back in your feed with new episodes from mid-January. Until then, we're sharing a couple of our most impactful episodes of 2025. Enjoy! ------------------------------ Tune in today for the latest consensus on rehabilitation approaches for people who have had meniscus surgery. Orthopaedic surgeons and physical therapists from Europe and the US debated the best research evidence, and brought extensive clinical experience to the table, ultimately producing a 2-part series of summary papers. Dr Arielle Giordano (University of Delaware) was one of the physical therapy leads on the project, and today she shares the most important messages from the consensus. ------------------------------ RESOURCES EU‐US Meniscus Rehabilitation 2024 Consensus - Rehabilitation after meniscus surgery: https://www.jospt.org/doi/10.2519/josptopen.2025.0162 EU-US Meniscus Rehabilitation 2024 Consensus - Prevention, non‐operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539

Calf strains are challenging for athletes and clinicians to manage—with uncertain return to play times and risks for reinjury if they're not managed well. Dr Brady Green (University of Notre Dame, Perth, Australia) shares his research and clinical expertise on muscle strains in elite and subelite athletes, including from his previous work in elite Australian football at the Essendon Football Club. Today's episode launches from Dr Green's latest study of the epidemiology of calf strains, and discusses how musculoskeletal rehabilitation specialists, including sports physical therapists, can use this information to guide their practice. ------------------------------ RESOURCES Gastrocnemius muscle strain injury epidemiology: https://www.jospt.org/doi/10.2519/jospt.2025.13526

Over the past decade, the term rotator cuff–related shoulder pain (RCRSP) has gained traction as a more accurate, patient-centered way to describe shoulder pain. In this episode, Dr Amy McDevitt (Physical Medicine and Rehabilitation Department, University of Colorado) joins Dan Chapman and Marquis Sanabrais to unpack why shifting from structural labels like impingement or tendinopathy toward RCRSP can improve both communication and care. They discuss how imaging often fails to match symptoms, why language matters for patient engagement, and how clinicians can explain shoulder pain without over-pathologizing. Take home messages: 1. RCRSP reflects the multifactorial nature of shoulder pain, biological, mechanical, and psychosocial. 2. Clear and non-anatomic terminology helps patients understand and buy into treatment. 3. Future research should clarify mechanisms behind exercise and refine subgroups within RCRSP. ------------------------------ RESOURCES The case for using "rotator cuff-related shoulder pain" in practice: https://www.jospt.org/doi/10.2519/jospt.2025.13405

Some of the most powerful drivers of change in musculoskeletal rehabilitation aren’t researchers or administrators—but clinicians working shoulder-to-shoulder with their peers. These so-called "local opinion leaders" often shape practice more effectively than top-down mandates or distant guidelines. And they're more than simply influencers or savvy social media marketers. In today's episode, Dr Seth Peterson explores how local opinion leaders—those trusted voices within clinical settings—can play a pivotal role in translating research into practice. Dr Peterson shares practical strategies for fostering cultures of learning and supporting clinicians to lead. Dr Peterson is a clinician-researcher based in Tucson, Arizona. He leads care at his clinic, The Motive, and teaches nationally with The Movement Brainery. ------------------------------ RESOURCES Empowering local opinion leaders in physical therapy systems: https://www.jospt.org/doi/10.2519/jospt.2025.13508 Why higher standards are needed in physical therapist professional development: https://www.jospt.org/doi/10.2519/jospt.2022.11377 2025 hip osteoarthritis clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2025.0301

Pain near the posteromedial tibia is common in running and jumping athletes. Laura Anderson, physiotherapist and PhD candidate, is challenging the diagnostic labels "shin splits" and "medial tibial stress syndrome", and suggesting a new term: "load-induced medial leg pain" (LIMP). In today's episode, Laura explores ways to improve how you diagnose and manage shin pain in athletes, including how you talk with athletes about their condition. She discusses loading, red flags and the role of running retraining. ------------------------------ RESOURCES Diagnosing medial tibial stress syndrome (including flow diagram): https://pubmed.ncbi.nlm.nih.gov/28179260/ Re-naming MTSS as Load Induced Medial Leg Pain (LIMP): https://www.jospt.org/doi/10.2519/jospt.2025.13411 Effectiveness of running gait retraining - systematic review: https://www.jospt.org/doi/10.2519/jospt.2022.10585

Over half of performing artists and artistic athletes report pelvic floor symptoms. Up to 80% of female artistic athletes report pelvic floor symptoms, yet many believe these issues—like urinary leakage during performance—are par for the course, part of the job. Today, Jessica Frydenberg explains who performing artists are, why they are particularly susceptible to pelvic floor symptoms, and what this means for your clinical practice. Jess is an experienced pelvic health physiotherapist and PhD candidate at La Trobe University in Melbourne, Australia. She has extensive experience working with performing artists, and recently led a systematic review investigating the epidemiology of pelvic floor symptoms in performing artists. ------------------------------ RESOURCES Prevalence and impact of pelvic floor symptoms systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13452

Who pays you, and how, for your work as a physical therapist? How health care is funded has implications for the way you work, and for the care that you can provide for patients. Societies all around the world are grappling with complex decisions about health care and how it is funded. Even more so as changing populations place different demands on health care systems, and as the health work force changes. Today, Dr Chris Bise (Assistant Professor, University of Pittsburgh) explains the changing face of health care funding, and what it means for the physical therapist. Chris has 25 years of experience as a physical therapist and health system analyst who studies value-based health care and physical therapy practice - trying to find better ways of funding health care to deliver outcomes that satisfy patients, clinicians and payers. ------------------------------ RESOURCES Building the foundation for value-based physical therapy: https://www.jospt.org/doi/10.2519/jospt.2025.13586 Perspectives for Payers - Heel pain/plantarfasciopathy: https://www.jospt.org/doi/10.2519/jospt.2025.0502 Perspectives for Payers - Achilles tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2025.0503

Welcome back to this explainer on health economics analyses in musculoskeletal rehabilitation. In part 1, Dr Codie Primeau explained the things you're looking for when reading a health economics analysis, to decide whether it's a good quality analysis. That's important because a good quality analysis can help you make decisions about whether the intervention being studied is worth considering. Today in part 2, we take things a step further to explore how you decide what "worthwhile" really means. Worth it for whom? The patient, your clinic, the health system, or even society? ------------------------------ RESOURCES From whose perspective is cost-effectiveness judged?: https://pmc.ncbi.nlm.nih.gov/articles/PMC6351264/ Review of health economics evaluations in hip and knee orthopaedics: https://pubmed.ncbi.nlm.nih.gov/34262974/

Whether you work in a solo private practice, or a large health network, no doubt you're considering costs when it comes to deciding what to change and perhaps what to implement - or de-implement - in your practice. Perhaps you're in the position of making decisions on behalf of a health service or you are trying to quantify and communicate the costs and benefits of treatments you study in a research setting? Today is part 1 of a 2-part chat with Dr Codie Primeau about health economics in musculoskeletal rehabilitation, which has something for everyone working in health care. We're covering how to read a health economics analysis to decide whether the analysis can help you navigate the complex decisions you're grappling with. Dr Primeau is a physiotherapist and Assistant Professor in the School of Physical Therapy at Western University in London, Canada, and an Affiliate Scientist with Arthritis Research Canada. His research focuses on arthritis, chronic pain, and pelvic health, using a blend of qualitative and quantitative methods to improve patient care and outcomes, including health economics evaluation. ------------------------------ RESOURCES From whose perspective is cost-effectiveness judged?: https://pmc.ncbi.nlm.nih.gov/articles/PMC6351264/ Review of health economics evaluations in hip and knee orthopaedics: https://pubmed.ncbi.nlm.nih.gov/34262974/

Wondering about whether large language models (generative AI) like ChatGPT, Co-Pilot or Claude, to name just a few, could add value to your clinical practice? Drs Mark Vorensky and Daniel Peredo (Rutgers University; NYU Langone Health) discuss the field of 'prompt engineering' - the approach to structuring and crafting the instructions (a.k.a. prompt) given to a generative AI model, to describe the task that the AI should perform. The quality of the output from generative AI is highly dependent on how the model is prompted. So, if you're looking to get the best out of generative AI, tune in! ------------------------------ RESOURCES Improving ChatGPT's performance using the CRISPE framework: https://www.jospt.org/doi/10.2519/josptmethods.2025.0151 Neck pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2017.0302

How do you think about supporting athletes to return to running after injury? Andrew Mitchell is someone who has thought about it a lot, and refined his approach over years of practice in top football/soccer. In today's episode, Andrew outlines the 5 elements of his criteria-based approach. Andrew is a sports physiotherapist and strength & conditioning practitioner with experience working in the hospital, private practice and professional sport arenas, including in the English Premier League, the German Bundesliga and the European Champions League. ------------------------------ RESOURCES Evidence-informed return-to-running framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0115 Criteria-based return-to-performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240 On the path to perfoming after injury (ep 193): https://pod.link/1522929437/episode/NmEzODliMjAtYmIyZi00YzkwLWIwMzctNjU3NzI4NTY3ZWUz

What's the latest thinking in managing patellofemoral pain? Drs Erin Macri (Erasmus MC University Medical Centre, The Netherlands) and Harvi Hart (Michigan State University) join JOSPT Insights ahead of the International Patellofemoral Research Network meeting to share the latest in patellofemoral research, and what it means for clinical practice. ------------------------------ RESOURCES JOSPT Insights Ep 229: Best practice in managing patellofemoral pain, with Dr Brad Neal: https://pod.link/1522929437/episode/ZDBkY2Q0ZDYtMzNhZS00OWVjLWJlYTQtNTYwMzBkZTVhM2Iw Patellofemoral pain CPG: https://www.jospt.org/doi/10.2519/jospt.2019.0302 Clinical priorities for psychological factors in patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2022.10647 Prognosis for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2025.13491 Find out more about the International Patellofemoral Research Network's work: https://ipfrn.org/

Recurrent back pain is common, and debilitating for some people. What if there was a simple, low cost way to prevent these recurring flare ups of back pain? Dr Tash Pocovi (Macquarie University, Sydney, Australia) explains the research she's been leading to test a walking + education program for preventing recurrent back pain. Dr Pocovi's research focuses on improving how low back pain is managed, and especially how it is prevented. ------------------------------ RESOURCES Walking, cycling and swimming for nonspecific low back pain systematic review: https://www.jospt.org/doi/10.2519/jospt.2022.10612 WalkBack trial: https://pubmed.ncbi.nlm.nih.gov/38908392/ Effect of WalkBack on duration and severity of recurrences of back pain: https://www.jospt.org/doi/10.2519/jospt.2025.13361

The latest update to the midportion Achilles tendinopathy Clinical Practice Guideline is live! Dr Ruth Chimenti is a co-author of the updated clinical practice guideline, “Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2024”, and joins JOSPT Insights to share the key updates relevant for your practice. Dr Chimenti highlights the most important changes from the last CPG update in 2018, including specifics on the best way to exercise, how to approach patient education, and which modalities to consider. ------------------------------ RESOURCES Updated Achilles CPG: https://www.jospt.org/doi/10.2519/jospt.2024.0302 (no paywall) ICON 2019: International Scientific Tendinopathy Symposium consensus on terminology: https://pubmed.ncbi.nlm.nih.gov/31399426/ ICON 2020: International Scientific Tendinopathy Symposium consensus on psychological outcome measures: https://www.jospt.org/doi/10.2519/jospt.2022.11005 Dutch multidisciplinary guideline on Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34187784/ TENDINopathy Severity Assessment - Achilles (TENDINS-A) outcome measure: https://www.jospt.org/doi/10.2519/jospt.2023.11964

The anterior talofibular ligament (ATFL) and the Achilles tendon captures much of our ankle attention. As JOSPT Insights listeners know, there's plenty more to the ankle than the ATFL. Today, Liz Bayley shares her approach to diagnosing, managing and ideally, preventing ankle pain in active people. Liz covers diagnosing the problem, where imaging fits, and how to support return to function, including high-level sport. Liz is a former professional dancer, who now works as a dance-specialist physiotherapist. Her clinic is in London's West End, in close proximity to the freelance professional and student dancers she works with, at Trinity Laban Conservatoire of Music and Dance, and on 'Matilda The Musical' in Covent Garden. ------------------------------ RESOURCES Lateral ankle ligament sprains clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2021.0302 Updated model of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/31162943/ Predictors of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/26912285/ Intrinsic foot muscle training systematic review: https://pubmed.ncbi.nlm.nih.gov/35724360/ Neuromuscular electrical stimulation for foot intrinsic muscles: https://pubmed.ncbi.nlm.nih.gov/35142810/

Clinicians appreciate the value of a trustworthy clinical practice guideline for helping guide decisions in practice. Professor François Desmeules (University of Montréal) led an international team of shoulder experts who synthesised the latest evidence on diagnosing and non-surgically managing rotator cuff tendinopathy. Today he shares the headlines of the CPG and explains how the guideline group made sense of all the evidence to come up with recommendations for assessment, diagnosis, treatment and prognosis, including return to sport. ------------------------------ RESOURCES Rotator cuff tendinopathy diagnosis, non-surgical medical care and rehabilitation CPG: https://www.jospt.org/doi/10.2519/jospt.2025.13182

Today, we continue the conversation on the latest consensus for managing acute and degenerative meniscus tears. We jump into non-surgical treatment, and all the return to sport considerations for athletes and active people with meniscus injury. Dr Arielle Giordano (University of Delaware) shares the results of the EU-US Meniscus Rehabilitation Consensus. ------------------------------ RESOURCES EU-US Meniscus Rehabilitation Consensus on prevention, non-operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539 DREAM trial primary report: https://pubmed.ncbi.nlm.nih.gov/38319181/ Should symptoms guide treatment choice in young patients? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/ Early surgery vs exercise therapy + education for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245 Ep 224: Saving the meniscus: https://pod.link/1522929437/episode/NTg3YTgzZWUtYTZjZC00ZDYwLWI2OTAtYTczMzAzNTEyNzgz Ep 192: DREAMing of better care for meniscus tears: https://pod.link/1522929437/episode/Yzk2YzkyOWItMDk1MS00YWZkLWI2MjQtNmRlYjIwZGJmOTg0

Clinical Practice Guidelines (CPGs) are an incredible resource for clinicians of all experience levels—synthesizing all the research on a topic and packaging it into bite-sized recommendations and flow charts. But how often are clinicians adhering to these guidelines? In today’s episode, Dr Maggie Horn (Duke University) walks us through her research team’s work to assess if, how, and when clinicians follow CPG recommendations. The team worked with clinicians in their hospital system to embed templates in the EMR, and used self-report strategies to answer these questions, specifically for the neck pain CPG. Dr Horn reviews the neck pain CPG, how the research team evaluated adherence, and what the findings mean for CPGs and clinicians. ------------------------------ RESOURCES Neck pain clinical practice guideline (revised in 2017): https://www.jospt.org/doi/10.2519/jospt.2017.0302 Translating the neck pain CPG into practice framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0101

No doubt you've come across people using the analogy of a broken down machine to describe an osteoarthritic joint. Or perhaps that too much loading on the joint is responsible for wearing it out - assuming that each joint has a finite number of movements in its lifetime. You've probably also heard from patients who are concerned that the exercise therapy you prescribe might do more harm to their already worn-out joint. But is that true? Today, Dr Alessio Bricca (Centre for Muscle and Joint Health, University of Southern Denmark) explores the evidence and refutes these beliefs. ------------------------------ RESOURCES Exercise Therapy "Wears Down" My Knee Joint: Myth or Reality?: https://www.jospt.org/doi/10.2519/jospt.2025.13069

Today is part 2 of a 2-part chat about hip health and training load for the youth athlete. Last episode, Dr Sara Lyn Terrell (Florida Southern College) discussed the developing hip, and the important distinction between primary cam morphology and femoroacetabular impingement syndrome. Many athletes have a bony bump on their hip that doesn't cause any problems - it's the morphology in combination with symptoms that clinicians might worry about. Today's episode builds on the foundation of the developing hip, and covers appropriate loads for youth athletes. Dr Terrell discusses how to plan, monitor and progress a loading programs, and how you might incorporate strength & conditioning principles into your practice. ------------------------------ RESOURCES Strategies to deter primary cam morphology in youth athletes: https://www.jospt.org/doi/10.2519/josptopen.2025.0128 Can we reduce injury risk during the adolescent growth spurt?: https://pubmed.ncbi.nlm.nih.gov/37823577/ “My kid is going through a growth spurt – what should I do?”: https://shorturl.at/FqqCM

The hip health of youth athletes as their skeletons grow and mature while the athlete copes with the physical and mental stressors of sport and life, has been receiving renewed attention. Today's episode of JOSPT Insights is part 1 of a 2-part chat about training load and the youth athlete's hip. We discuss how primary cam morphology and femoroacetabular impingement syndrome might develop. Dr Sara Lynn Terrell (Florida Southern College) shares her >20 years of experience in exercise science and strength & conditioning, and walks listeners through the complexity of working with youth athletes to support their best sports performance. ------------------------------ RESOURCES Strategies to deter primary cam morphology in youth athletes: https://www.jospt.org/doi/10.2519/josptopen.2025.0128 Oxford consensus on primary cam morphology and FAI (part 1): https://pubmed.ncbi.nlm.nih.gov/36588401/ Oxford consensus on primary cam morphology and FAI (part 2): https://pubmed.ncbi.nlm.nih.gov/36588402/

Patellofemoral pain can affect anyone at any age, which mean you're likely to come across it in your clinical career. What is best practice in managing patellofemoral pain? Today, Dr Brad Neal (Queen Mary University of London) walks us through how to apply the best research to your practice. Dr Neal has worked for over a decade in elite sport, private and public health care settings as a specialist musculoskeletal physiotherapist. His PhD work in biomechanics has helped guide understanding of how to manage patellofemoral pain. ------------------------------ RESOURCES Best practice guide for patellofemoral pain: https://pubmed.ncbi.nlm.nih.gov/39401870/ Effects of treatment for patellofemoral pain - systematic review with meta-analysis: https://www.jospt.org/doi/full/10.2519/jospt.2022.11359 Patellofemoral pain 2019 clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2019.0302

Pain is often what prompts patients to seek the care of a musculoskeletal rehabilitation clinician. In today's episode, Dr Paul Mintken guides listeners through different ways to work with a person to help make sense of, and explain, unexplained pain. Dr Mintken (Hawai'i Pacific University) is a board-certified Orthopaedic Clinical Specialist and a Fellow of the American Academy of Orthopaedic and Manual Physical Therapists. ------------------------------ RESOURCES JOSPT Viewpoint article - The Worst Pain is an Unexplained Pain: https://www.jospt.org/doi/10.2519/jospt.2025.13167

In Part 2 of our conversation with Dr Olivia Abdoo (Ultimate Fighting Championship), we dive deeper into one of the most common injuries in mixed martial arts (MMA) - concussion. Dr Abdoo's experience treating UFC athletes provides an insight into working with athletes for whom skills including wrestling, striking, and grappling are crucial to performing well. How to approach educating the athlete and everyone involved with them about concussion, ensuring the athlete can participate safely while recovering from concussion, what an MMA-specific concussion evaluation looks like, and the importance of sport-specificity in concussion rehabilitation - we hit on it all!

Given how common rotator cuff tears are, chances are you will work with someone who has a tear at some point in your career. Do you know what patients will want from their rehabilitation? Are you confident with your approach to managing rotator cuff tears? Today, Dr Kathryn Fahy, physiotherapist and researcher from Aspetar Orthopaedic & Sports Medicine Hospital, Doha discusses the CALMeR Cuff pathway. Dr Fahy developed CALMeR Cuff with patients, clinicians and researchers to guide care for people with large to massive rotator cuff tears. ------------------------------ RESOURCES Co-design of the CALMeR Cuff pathway: https://www.jospt.org/doi/10.2519/jospt.2025.13342

A mention of pre-professional or professional dance might conjure thoughts of relentless, gruelling training hours, incredible performances and bodies pushed through high musculoskeletal demands. Dr Melanie Fuller (University of Southern Queensland) has devoted her clinical career of almost 20 years to working with dancers - helping them stay healthy and performing well - and she has a similar focus in her research work. Today we discuss the prevalence of musculoskeletal injury, specifically focusing on osteoarthritis. ------------------------------ RESOURCES Osteoarthritis in dancers (systematic review with meta-analysis): https://www.jospt.org/doi/10.2519/jospt.2025.12918

Tune in today for the latest consensus on rehabilitation approaches for people who have had meniscus surgery. Orthopaedic surgeons and physical therapists from Europe and the US debated the best research evidence, and brought extensive clinical experience to the table, ultimately producing a 2-part series of summary papers. Dr Arielle Giordano (University of Delaware) was one of the physical therapy leads on the project, and today she shares the most important messages from the consensus. ------------------------------ RESOURCES EU‐US Meniscus Rehabilitation 2024 Consensus - Rehabilitation after meniscus surgery: https://www.jospt.org/doi/10.2519/josptopen.2025.0162

In the return of Sports Corner, Dr Olivia Abdoo chats all things UFC (Ultimate Fighting Championship) and MMA (mixed martial arts). UFC combines wrestling, grappling and striking, which makes for complex demands that contribute to complex injury epidemiology. Whether working with a Championship fighter or a recreational martial arts athlete, Dr Abdoo provides excellent guidance for clinicians who are planning rehabilitation and return to sport. Concussion is common in UFC, so stay tuned for an upcoming episode with Dr Abdoo about her approach to concussion rehabilitation with UFC athletes.

Researchers are increasingly partnering with patients, clinicians and others who use research to design, conduct, report and disseminate research studies. Today we hear about a conversation that involved over 600 patients, clinicians and carers, who were supported to nominate their top priorities for research on shoulder pain. Kristian Lyng (physiotherapst, PhD student at Aalborg University's Department of Health Science and Technology, and Center for General Practice) led the work as part of his PhD research looking at interventions for shared decision-making in collaboration with patients with subacromial pain syndrome. Kristian discusses the challenges and opportunities in translating research to clinical practice, and the benefits to researchers of engaging patients and the public in doing musculoskeletal research. ------------------------------ RESOURCES Research priorities for atraumatic shoulder pain: https://www.jospt.org/doi/10.2519/jospt.2025.13059 Patients as partners in research - It's the right thing to do: https://www.jospt.org/doi/10.2519/jospt.2019.0106 Help for researchers wanting to engage patients as research partners: https://www.jospt.org/doi/10.2519/jospt.2020.0104 How to talk about compensation with patient partners: https://www.jospt.org/doi/10.2519/jospt.2020.0106 Engaging patients and the public in musculoskeletal research: https://www.jospt.org/doi/10.2519/jospt.2024.12668

There's a range of different interventions at your disposal when managing spine pain. Today we're focusing on spinal manipulative therapy, and asking questions like: does it matter how you apply a manipulation to get the best outcomes for the patient? Answering the questions is Dr Casper Nim from the University of Southern Denmark. Casper is an Associate Professor, chiropractor, and senior researcher at the Spine Centre of Southern Denmark. ------------------------------ RESOURCES Does it matter how you apply spinal manipulative therapy? Network meta-analysis: https://www.jospt.org/doi/10.2519/jospt.2025.12707 Does targeting a specific vertebral level make a difference? Systematic review: https://www.jospt.org/doi/10.2519/jospt.2023.11962 Effect on clinical outcomes when targeting spinal manipulative therapy. Randomised controlled trial: https://pubmed.ncbi.nlm.nih.gov/32884045/ Preference randomised trials: https://www.jospt.org/doi/10.2519/josptmethods.2025.0129 JOSPT Methods journal website: https://www.jospt.org/toc/jospt-methods/current

The anterior talofibular ligament (ATFL) and the Achilles tendon captures much of our ankle attention. As JOSPT Insights listeners know, there's plenty more to the ankle than the ATFL. Today, Liz Bayley shares her approach to diagnosing, managing and ideally, preventing ankle pain in active people. Liz covers diagnosing the problem, where imaging fits, and how to support return to function, including high-level sport. Liz is a former professional dancer, who now works as a dance-specialist physiotherapist. Her clinic is in London's West End, in close proximity to the freelance professional and student dancers she works with, at Trinity Laban Conservatoire of Music and Dance, and on 'Matilda The Musical' in Covent Garden. ------------------------------ RESOURCES Lateral ankle ligament sprains clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2021.0302 Updated model of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/31162943/ Predictors of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/26912285/ Intrinsic foot muscle training systematic review: https://pubmed.ncbi.nlm.nih.gov/35724360/ Neuromuscular electrical stimulation for foot intrinsic muscles: https://pubmed.ncbi.nlm.nih.gov/35142810/

Hip arthroscopy is a common surgical procedure in athletes and active people, and it's not surprising that this clinical population is focused on returning to sport. Today, Dr Matthew King, physiotherapist and Senior Lecturer from La Trobe University's Discipline of Physiotherapy in Melbourne, Australia, discussed return to sport outcomes after hip arthroscopy. Dr King led a team that synthesised and analysed return to sport outcomes after hip arthroscopy from 45 studies and over 5000 participants. The team's focus was on sex and gender differences, and how the return to sport outcomes change with increasing time after surgery. ------------------------------ RESOURCES Are women less likely to return to sport compared to men following hip arthroscopy? A systematic review with meta-analysis: https://www.jospt.org/doi/10.2519/jospt.2025.12813

Myofascial pain syndrome is common - affecting somewhere around 1 in every 5 people. Yet there is plenty of debate about what causes myofascial pain syndrome, how to diagnose it, and even whether myofascial pain syndrome is a primary condition. Today, Professor Chad Cook (Duke University) discusses whether it is even possible to differentiate myofascial pain syndrome from other pain conditions, and the implications for you, the clinician. ------------------------------ RESOURCES Myofascial pain syndromes - controversies and suggestions for improving diagnosis and treatment: https://www.jospt.org/doi/10.2519/jospt.2025.13072 International Association for the Study of Pain - Myofascial pain fact sheet 14: https://www.iasp-pain.org/wp-content/uploads/2022/10/14.-Myofascial-Pain-Fact-Sheet-Revised-2017.pdf

Postmenopausal women can build some serious bone AND stay safe with the right instruction and the right load. What’s the right load? Dr Belinda Beck can answer that, and in today's episode, she takes us through the results of the LIFTMOR trial. With the right instruction and supervision, postmenopausal women can be lifting 85% of their 1 repetition maximum safely, and make a substantial change in their bone density, strength, and quality of life while doing it. ------------------------------ RESOURCES For more on the LIFTMOR trial: https://pubmed.ncbi.nlm.nih.gov/30861219/

Clinicians appreciate the value of a trustworthy clinical practice guideline for helping guide decisions in practice. Professor François Desmeules (University of Montréal) led an international team of shoulder experts who synthesised the latest evidence on diagnosing and non-surgically managing rotator cuff tendinopathy. Today he shares the headlines of the CPG and explains how the guideline group made sense of all the evidence to come up with recommendations for assessment, diagnosis, treatment and prognosis, including return to sport. ------------------------------ RESOURCES Rotator cuff tendinopathy diagnosis, non-surgical medical care and rehabilitation CPG: https://www.jospt.org/doi/10.2519/jospt.2025.13182

How do you approach assessing pain when you're working with athletes? What tools do you find most helpful? Today, sports physiotherapist and researcher, Ciarán Purcell (University of Limerick, Ireland) describes the project he is leading to gather consensus from athletes and sports medicine & rehabilitation clinicians about how best to assess athletes' pain. Listen to the end to learn about how you can get involved in the consensus! ------------------------------ RESOURCES IOC consensus on managing pain in elite athletes: https://pubmed.ncbi.nlm.nih.gov/28827314/ Framework for assessing upper and lower limb pain in athletes: https://www.jospt.org/doi/10.2519/jospt.2024.12807 Scoping review of tools for assessing pain in athletes: https://pubmed.ncbi.nlm.nih.gov/36759138/ To get in touch with Ciarán about the consensus project, email ciaran.purcell@ul.ie

The latest update to the midportion Achilles tendinopathy Clinical Practice Guideline is hot off the presses! Dr Ruth Chimenti is a co-author of the updated clinical practice guideline, “Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2024”, and joins JOSPT Insights to share the key updates relevant for your practice. Dr Chimenti highlights the most important changes from the last CPG update in 2018, including specifics on the best way to exercise, how to approach patient education, and which modalities to consider. ------------------------------ RESOURCES Updated Achilles CPG: https://www.jospt.org/doi/10.2519/jospt.2024.0302 (no paywall) <>ICON 2019: International Scientific Tendinopathy Symposium consensus on terminology: https://pubmed.ncbi.nlm.nih.gov/31399426/ ICON 2020: International Scientific Tendinopathy Symposium consensus on psychological outcome measures: https://www.jospt.org/doi/10.2519/jospt.2022.11005 Dutch multidisciplinary guideline on Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34187784/

Did you know that only about 10% of the participants in sports medicine and sports physical therapy research are women? When people are under-represented in research, it might mean that clinicians and researchers miss key concerns of women and girls when working with them to achieve the best outcomes of treatment. Melissa Haberfield - physiotherapist and PhD candidate at the La Trobe Sports and Exercise Medicine Research Centre in Melbourne, Australia - shares the results of her work with women who have experienced serious knee injury, about what they wanted to know about managing knee health. ------------------------------ RESOURCES Systematic review of self-reported activity and knee-related outcomes after ACL injury (sex and gender differences): https://pubmed.ncbi.nlm.nih.gov/36889918/ Sex/gender equity in sport and exercise medicine/physical therapy publishing: https://pubmed.ncbi.nlm.nih.gov/36631242/ What do women (with serious knee injury) want to know about knee health (article): https://www.jospt.org/doi/10.2519/jospt.2025.12869

You don't have to go far to find a media story warning people off the high impacts of running, especially on concrete, and claiming that running is no good for your knees. Maybe you've had someone in the clinic who worries that running will wear their joints out? Today's guest has dedicated his career to helping runners stay healthy and running for life, and is adamant that running is a great physical activity choice, even for people with osteoarthritis and joint replacement. Dr Jean François Esculier is a physiotherapist based in Kelowna, Canada. He leads the Research & Development team at The Running Clinic, and teaches at The University of British Columbia; his clinical practice is at MoveMed Physiotherapy. ------------------------------ RESOURCES Survey about perceptions on running and knee health: https://pubmed.ncbi.nlm.nih.gov/36199830/ Education resource on running and joint health, in 7 languages: http://hdl.handle.net/2429/82767 Evaluation of the education resource: https://www.jospt.org/doi/10.2519/josptopen.2024.0149 Free webinar (account required) about the influence of running on cartilage: https://therunningclinic.com/tv/?VideoId=185711&SelectedCategory=185731 Running with osteoarthritis case report: https://pubmed.ncbi.nlm.nih.gov/38725598/

In today's part 2 of an NMES masterclass from Dr Elanna Arhos (Northwestern University) and Dr Naoaki Ito (University of Wisconsin - Madison), we're getting into the nitty gritty of how to support patients to get the most out of a very beneficial intervention. Drs Arhos and Ito, and their team have tested a mix of common stimulators available on the market today, and are here to share the results with us. Let them help you make an informed decision about your next equipment purchase for your clinic. ------------------------------ RESOURCES Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028

Neuromuscular electrical stimulation (NMES) hasn't quite had the coverage it deserves, especially when one considers the strength of evidence supporting NMES as a musculoskeletal rehabilitation intervention Today, Drs Elanna Arhos (Northwestern University) and Naoaki Ito (University of Wisconsin - Madison) are re-visiting how NMES is applied in sports clinical practice. Get the low-down on why you need NMES in your sports rehabilitation toolkit, and how to figure out dose and intensity. In part 2 we discuss how to support patients to get the most out of NMES, and which equipment is best for your clinic. ------------------------------ RESOURCES Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028

Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. In part 2 of this series, Dr de Vos covers the multitude of options for treatment, outside of exercise therapy. Should you and the patient consider corticosteroid injections, PRP injections, heel lifts, shockwave, NSAIDs, or surgery? And when? What are the important clinical considerations when patients choose these options? Part 2 has it all! ------------------------------ RESOURCES Terminating corticosteroid injection in tendinopathy? https://www.jospt.org/doi/10.2519/jospt.2023.11875/ Dutch multidisciplinary guideline on Achilles tendinopathy: (https://pubmed.ncbi.nlm.nih.gov/34187784/ Platelet-rich plasma injection for chronic Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/20068208/ Time to put down the scalpel when treating tendinopathy? https://pubmed.ncbi.nlm.nih.gov/31653777/ Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/ Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/ Clinical tool for identifying spondyloarthropathy: http://tinyurl.com/3my87hma More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/ Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/ Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/ Achilles Pain, Stiffness, and Muscle Power Deficits - 2024 updated clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2024.0302

Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. As lead author of the Dutch Multidisciplinary Guideline on Achilles Tendinopathy (https://pubmed.ncbi.nlm.nih.gov/34187784/), he shares the key messages from this in-depth review. In today’s episode, Dr de Vos covers the important tendon anatomy to guide your differential diagnosis, what information he is most focused on communicating to patients, and the key factors that can affect your choices when managing Achilles tendinopathy. ------------------------------ RESOURCES Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/ Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/ Clinical tool for identifying spondyloarthropathy: https://www.researchgate.net/profile/Paul-Kirwan/publication/332275130_D18_SCREEND%27EM_BEFORE_YOU_TREAT%27EM_A_CLINICAL_TOOL_TO_HELP_IDENTIFY_SPONDYLOARTHROPATHY_IN_PATIENTS_WITH_TENDINOPATHY/links/5cab530da6fdcca26d06aaf1/D18-SCREENDEM-BEFORE-YOU-TREATEM-A-CLINICAL-TOOL-TO-HELP-IDENTIFY-SPONDYLOARTHROPATHY-IN-PATIENTS-WITH-TENDINOPATHY.pdf More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/ Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/ Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/ Achilles Pain, Stiffness, and Muscle Power Deficits - updated clinical practice guideline from AOPT: https://www.jospt.org/doi/10.2519/jospt.2024.0302

When patients improve following treatment, how much can be attributed to the intervention delivered, and how much is due to contextual factors and nonspecific effects that lie outside of the clinician's control? Dr. Giacomo Rossettini joins the podcast again as a co-author of a paper (link below) that answers that very question. Dr. Rossettini and his research colleagues tried to quantify the effect of contextual factors with a meta-analysis. They found non-specific effects play a big role in patients' outcomes. Today's discussion covers what these contextual factors are, how the researchers quantified them, and how musculoskeletal rehabilitation clinicians can harness non-specific effects to boost patients' outcomes. ------------------------------ RESOURCES Non-specific effects in musculoskeletal pain treatment outcomes (meta-analysis): https://www.jospt.org/doi/10.2519/jospt.2024.12126

Musicians and athletes might sometimes appear to exist in very different cultures. And yet, the single-minded focus, thousands of hours of practice, and high training loads on their musculoskeletal systems mean that musicians and athletes probably have more in common than they have differences. At least from a musculoskeletal rehabilitation perspective. Today's guest is Marianne Roos - a former clarinetist and forever musician-at-heart, who now practices as a physiotherapist and conducts her PhD research from Laval University, Canada. Marianne explains the physical and psychological demands of orchestra performance on the musician's body, and shares the results of her PhD research in developing programmes to reduce musculoskeletal injuries among orchestra musicians. ------------------------------ RESOURCES Barriers and facilitators to implementing rehabilitation and wellness programs for orchestral musicians: https://pubmed.ncbi.nlm.nih.gov/33853373/ Workplace injury prevention and wellness program for orchestra musicians: https://www.jospt.org/doi/10.2519/jospt.2024.12277

When it comes to serious injury, like an ACL tear, in college sport, how many young athletes return to their previous level of performance? Today's guest led a team that has done the hard yards of synthesising all the available data to find an answer. Dr Cortez Brown is a junior orthopaedic surgery resident at the University of Pittsburgh Medical Centre. In today's episode, Dr Brown shares the results of his systematic review, and guides listeners through the complex factors that affect return to play outcomes for college athletes. ------------------------------ RESOURCES Return to college sport after ACL reconstruction systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12483 Systematic review of return to competitive sport (all levels) after ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/25157180/

Ballooning wait times, overworked and burnt out staff. No doubt you're only too familiar with the signs of a health system that's under serious strain. And not just since the Covid-19 pandemic. Simon Lafrance, physiotherapist and researcher from the University of Montreal, explains musculoskeletal care models that flip the traditional medical model of the doctor as the first contact point a patient has with the health system, to a musculoskeletal specialist, like a physical therapist, leading instead. Simon's clinical work and research work merge as he works to develop and evaluate advance practice physiotherapy models. ------------------------------ RESOURCES Trial of single vs. multiple sessions of advanced practice physiotherapy: https://www.jospt.org/doi/10.2519/jospt.2024.12618

Musculoskeletal rehabilitation clinicians are well versed in the physical and mental benefits of regular physical activity. Unfortunately there is limited evidence to guide clinicians on how to best support return to sport and physical activity after childbirth. That's where today's guest comes in. Dr Jenna Schulz (physiotherapist and postdoctoral researcher from Western University, Canada) specializes in pelvic health and sport, women’s health, and improving longevity in sport for females across the lifespan. Today, Jenna shares how she approaches supporting physical and mental readiness for sport postpartum, and when to refer to your colleagues in the multidisciplinary health care team. ------------------------------ RESOURCES Systematic review of exercise interventions for physical activity and cardiorespiratory fitness: https://www.jospt.org/doi/10.2519/jospt.2024.12666 Scoping review of guidelines for returning to physical activity and sport postpartum: https://pubmed.ncbi.nlm.nih.gov/37898507/ Relative Energy Deficiency in Sport (REDs) and the lactating athlete: https://pubmed.ncbi.nlm.nih.gov/37752008/

Most people who pursue a career in health care do so because they want to help people. Depending on where you work, patients might find it easier or harder to access high-value musculoskeletal care, and you might run into barriers to providing the care you would like to provide. Dr Roy Film is a physical therapist, educator and current President of APTA Maryland. In today's episode, Roy explains his work trying to make it easier for people to choose high-value musculoskeletal rehabilitation. ------------------------------ RESOURCES Racial disparities in outpatient PT use: https://www.jospt.org/doi/10.2519/jospt.2024.12641

The complex world of clinical practice in musculoskeletal rehabilitation brings many challenges. Some you might feel prepared for, while others...not so much. Musculoskeletal physiotherapist and shoulder specialist, Jared Powell, is here to reassure us that no-one expects you to have all the answers, encourage us all to think carefully and critically when evaluating information, and to embrace a work-related niche that resonates with your passions and strengths. Jared shares ideas on how to succeed as a compassionate and effective musculoskeletal rehabilitation specialist. ------------------------------ RESOURCES "Dear newly graduated physical therapst" article: https://www.jospt.org/doi/10.2519/jospt.2024.12676 ------------------------------ The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2

Today brings a refresher on best practice in managing non-traumatic shoulder pain. Professor Karen McCreesh (University of Limerick) guides the listener to the best available clinical practice guidelines and runs the ruler over different approaches to exercise therapy. ------------------------------ RESOURCES Diagnosing, managing and supporting return to work for people with rotator cuff disorders (practice guideline): https://www.jospt.org/doi/10.2519/jospt.2022.11306 Efficacy of exercise therapy - systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12453 GRASP trial: https://pubmed.ncbi.nlm.nih.gov/34382931/ JOSPT Insights episode 173 (shared decision making): https://podcasts.apple.com/ca/podcast/ep-173-shared-decision-making-what-it-is-and-what-it/id1522929437?i=1000651049481 or https://open.spotify.com/episode/6CCh5FRTGAsz54bdpWbYGB?si=c40b2c227eb94a12 ------------------------------ The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2

If you consult a clinical practice guideline for any musculoskeletal condition, you'll probably see advice and education included as part of the recommendations for helping someone manage their musculoskeletal pain. How well do the recommendations in clinical practice guidelines about what topics advice and education should cover align with the main concerns of people with back pain? Dr Giovanni Ferreira (University of Sydney) joins JOSPT Insights to explain. ------------------------------ RESOURCES Concerns of people with acute back pain: https://www.jospt.org/doi/10.2519/jospt.2024.12571 AI chatbots answering questions about low back pain: https://pubmed.ncbi.nlm.nih.gov/39299722/ ------------------------------ The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2

Today's episode takes the spirit of our popular SPORTS CORNER series, and flips it to learning about playing a leading role in the world of sports medicine and rehabilitation. Dr Ciara Burgi has worked across collegiate, professional men's, and professional women's sport, and has a ton of wisdom to share. From building rapport with athletes and patients, to valuing your work in the present without looking too far ahead to what might (or might not) come next, and doing what you can with the resources at your disposal, are among the topics Dr Burgi covers. ------------------------------ RESOURCES The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the extended early-bird price and the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2

In this episode, we throw ourselves into the world of team handball with Dr Martin Asker (Sophiahemmet University, Sweden). If your exposure to handball is every 4 years at the Olympic Games, we've got you covered with a review of the game and the demands of the sport. Martin's shoulder expertise shines as he covers the common injuries and key things to keep in mind while treating these tricky, well-rounded athletes. ------------------------------ RESOURCES Handball Medicine & Science website: https://www.handballmedicine.com/ Bern consensus on managing shoulder injuries in athletes: https://www.jospt.org/doi/10.2519/jospt.2022.10952

Muscle strength is a core focus of many sports injury rehabilitation programmes, and often a prominent discharge criterion. Today's guest has an important message about the uninjured limb in ACL rehabilitation: "beware the moving target of strength". Olivia Barbosa is a sports physiotherapist with over a decade of experience in soccer and rugby. She currently works at the Aspetar Orthopaedic & Sports Medicine Hospital where she contributes to the concussion and the ACL clinical teams, and does research focused on muscle activation and strength recovery in ACL rehabilitation. ------------------------------ RESOURCES More on changes in quadriceps and hamstrings muscle strength over rehabilitation: https://www.jospt.org/doi/10.2519/jospt.2023.11961 Aspetar ACL rehabilitation clinical practice guideline: https://www.aspetar.com/en/professionals/aspetar-clinical-guidelines/recommendations-on-rehabilitation-after-aclr

Ever wondered what a day in the life of a busy sports medicine clinic and research unit looks like? Dr Enda King combines his roles as a sports physiotherapist, strength and conditioning coach, researcher, and educator through his work with individual athletes and elite teams across a spectrum of sports and disciplines. Currently, he is the Head of Elite Performance and Development at the Aspetar Orthopaedic & Sports Medicine Hospital in Doha, Qatar. ------------------------------ RESOURCES For more on the Aspetar International Sports Medicine Conference - complete guide to thigh muscle injuries (November 2024): https://www.aspetar.com/en/professionals/our-events/complete-guide-to-thigh-muscle-injuries

Today's episode is all about running load and injuries. Dr Rasmus Nielsen (Aarhus University, Denmark) leads the RUNSAFE research group, and today he provides an update on the latest research in running-related injuries. ------------------------------ RESOURCES Garmin-RUNSAFE Study (injury data from >7000 runners in 87 countries): https://www.jospt.org/doi/10.2519/jospt.2023.11959 Garmin-RUNSAFE Study protocol: https://pubmed.ncbi.nlm.nih.gov/31494626/ Changing distance and the association with injuries: https://www.jospt.org/doi/10.2519/jospt.2019.8541

Andrew Mitchell (RB Leipzig) knows a thing or two about supporting athletes to return to play after injury, especially in professional football/soccer. Today, Andrew explains his return to performance pathway, which is a criteria-based approach to help you and the athlete keep focused on the athlete's return to performance goal. ------------------------------ RESOURCES Andrew's return to performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240 Clinical pearls for supporting return to performance: https://www.jospt.org/doi/10.2519/josptcases.2021.0103 Control-chaos continuum for progressing rehabilitation: https://pubmed.ncbi.nlm.nih.gov/30737202/ On-field rehabilitation progression (part 1): https://www.jospt.org/doi/10.2519/jospt.2019.8954 On-field rehabilitation progression (part 2): https://www.jospt.org/doi/10.2519/jospt.2019.8952

A thirty-year-old woman, who plays social basketball once each week and goes to the climbing gym at least twice each week, has been diagnosed with a traumatic medial meniscus tear. The woman was told that surgery is the only way to 'fix' her knee so she can get back to basketball and climbing. But is that really what the research evidence says? Professors Jonas Thorlund and Søren Skou (University of Southern Denmark) share the key findings of their DREAM trial, and its clinical implications for managing traumatic meniscal tears. ------------------------------ RESOURCES DREAM trial report: https://pubmed.ncbi.nlm.nih.gov/38319181/ STARR trial report: https://pubmed.ncbi.nlm.nih.gov/35676079/ Comparing treatment strategies for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245 Should symptom onset guide treatment choice for meniscus tears? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/

Dr Kala Flagg of the Washington Mystics answers the classic Sports Corner questions for high-level women's basketball. She covers the demands of the sport, the most common injuries, and key things to plan for during injury rehabilitation. Considering playing style, shoe fit, and physical fitness are all in a day's work when supporting high-level women's basketball athletes to perform at their best.

Today's episode builds on last week's discussion of how changes in the way that the nervous system works after injury can compensate for impairments like joint instability, pain and muscle inhibition. Dr Meredith Chaput (University of Central Florida) extends the 5 phases of the visual-cognitive control chaos continuum, to link the ways to assess for cognitive compensations and how to progressively load the visual-cognitive system during sports injury rehabilitation. ------------------------------ RESOURCES From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443 The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

Sports injury rehabilitation has moved well beyond simply focusing on physical function and recovery. There's various emphases on psychological responses to injury, mental readiness to return to sport, and now, the visual-cognitive components of recovery and return to sport. Today, Dr Meredith Chaput (University of Central Florida) introduces the visual-cognitive control chaos continuum as a framework for sports injury rehabilitation. Her research uses functional MRI to evaluate neuroplasticity after knee injuries, focusing on understanding how people use visual attention to compensate for motor control, and how rehabilitation may better target these compensations. ------------------------------ RESOURCES From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443 The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

You don't have to go far to find a media story warning people off the high impacts of running, especially on concrete, and claiming that running is no good for your knees. Maybe you've had someone in the clinic who worries that running will wear their joints out? My guest today has dedicated his career to helping runners stay healthy and running for life, and is adamant that running is a great physical activity choice, even for people with osteoarthritis and joint replacement. Dr Jean François Esculier is a physiotherapist based in Kelowna, Canada. He leads the Research & Development team at The Running Clinic, and teaches at The University of British Columbia; his clinical practice is at MoveMed Physiotherapy. ------------------------------ RESOURCES Survey about perceptions on running and knee health: https://pubmed.ncbi.nlm.nih.gov/36199830/ Education resource on running and joint health, in 7 languages: http://hdl.handle.net/2429/82767 Evaluation of the education resource: https://www.jospt.org/doi/10.2519/josptopen.2024.0149 Free webinar (account required) about the influence of running on cartilage: https://therunningclinic.com/tv/?VideoId=185711&SelectedCategory=185731 Running with osteoarthritis case report: https://pubmed.ncbi.nlm.nih.gov/38725598/