JOSPT Insights: Recent Episodes
JOSPT
The Journal of Orthopaedic & Sports Physical Therapy brings you the JOSPT Insights podcast every Monday. On each episode, experienced clinicians and researchers unpack musculoskeletal rehabilitation topics in under 30 minutes. Guests share clinical tips and research discoveries with host Dr Clare Ardern, Editor-in-Chief of JOSPT. Sports physical therapists Dr Chelsea Cooman and Dr Dan Chapman are frequent co-hosts.
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.2025.13399Female, 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:
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RCRSP reflects the multifactorial nature of shoulder pain, biological, mechanical, and psychosocial.
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Clear and non-anatomic terminology helps patients understand and buy into treatment.
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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
Foot and ankle surgeon, Dr Casey Humbyrd, returns to JOSPT Insights to share the surgeon’s perspective on Achilles tendon repair.
What does she consider when helping patients to make a decision about surgery or no surgery? How does she perform the surgical repair, and why is she so fastidious with post-op restrictions?
Dr Humbyrd is a champion for physical therapy, and underscores wound care, person-centred care, and why tension can help the Achilles!
RESOURCES
For more about the American Orthopaedic Foot & Ankle Society: https://www.aofas.org/
More resources to share with patients: https://www.footcaremd.org/
For more on the AASPT x JOSPT Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.
Have you ever found yourself feeling uncertain or confused when choosing a patient-reported outcome measure (PROM)?
Today we're talking about the hallmarks of a PROM for people with patellofemoral pain. Physical therapist, educator and researcher, Professor Lisa Hoglund, fills in the gaps to help us find the promise in PROMs.
RESOURCES
Construct validity, reliability, responsiveness and interpretability of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2023.11730
Content validity and feasibility of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2022.11317
Find out more about the KOOS (including the Excel scoring sheet): http://www.koos.nu/index.html
The American Academy of Sports Physical Therapy and JOSPT are joining forces to bring you the Virtual Sports PT Conference on Friday the 3rd and Saturday the 4th of November, 2023. Visit the link below to see the full conference programme and to secure your ticket. If you purchase your ticket before the end of August, you can take advantage of a $50 discount.
https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427
Maybe you think of health literacy as the building blocks of knowing how to access the healthcare system, and knowing what to do when you have a cold?
Today, Dr Rachel Harris is guiding us as we consider our collective health literacy of the particular health, wellbeing and performance needs of female athletes.
Dr Harris represented Australia at the Olympics as a swimming athlete, and was the Chief Medical Officer for the Australian Paralympic team in Tokyo 2021. She leads the Australian Institute of Sport's female athlete performance and health, menstrual cycle and hormonal contraception project.
RESOURCES
For trustworthy education resources to share with athletes, coaches, parents and others who support female athletes, check out: https://www.ais.gov.au/fphi/education
Dr Lionel Chia joins Chelsea and Dan to bring his 2022 article in JOSPT, Beginning With The End In Mind: Implementing backward design to improve sports injury rehabilitation practices, to life.
Lionel outlines 4 categories to consider when planning return to sport and performance: (1) deconstructing goals, (2) determining key performance indicators, (3) assessing the challenge point, and (4) using the control-chaos continuum to guide interventions.
We work through examples of why and where to use the concept of backward design during rehabilitation.
RESOURCES
Find Lionel's paper here: https://www.jospt.org/doi/10.2519/jospt.2022.11440
More on designing effect exercise progressions during rehabilitation (Blanchard & Glasgow): https://pubmed.ncbi.nlm.nih.gov/28756390/
More on motor learning and the challenge point—where effective practice occurs: https://pubmed.ncbi.nlm.nih.gov/15130871/
The control-chaos continuum and progressing rehabilitation (Taberner and colleagues): https://pubmed.ncbi.nlm.nih.gov/30737202/
As a JOSPT Insights listener, you already know programs like the FIFA 11+, the PEP program and the GetSet app for reducing injury rates in team sports like soccer (football) and handball. When you're working with athletes, coaches and parents, how easy is it to get them set up with a warm-up program that athletes can follow and stick to a few times a week?
Today's chat might just give you a tool to make life easier for you and the athletes, coaches and parents you work with. Drs Hayley Root and Jeff Driban are here to tell us all about the new Remain in the Game toolkit.
RESOURCES
Get access to the Remain in the Game toolkit: https://oaaction.unc.edu/remain-in-the-game-a-joint-effort/
Learn more about all the work of the Osteoarthritis Action Alliance: https://oaaction.unc.edu/standup2oa/
The YAHiR (Young Athletes' Hip Research) Collaborative takes over the JOSPT Insights podcast today with a deep dive into best practice for imaging the painful hip.
What is the best approach to imaging for young people with hip pain? When do you reach for radiographs? What are the pros and cons of MRI for hip pain? And how do you interpret and act on the information you gather from the scan?
Never fear, Dr Vasco Mascarenhas—radiologist and Assistant Professor at Católica Medical School, Portugal—is here to explain all you need to know to confidently use imaging for hip pain in clinical practice.
RESOURCES
More on the methods of imaging for hip preservation: https://pubmed.ncbi.nlm.nih.gov/31163499/
Overview of the state of play for imaging in suspected femoroacetabular impingement syndrome: https://pubmed.ncbi.nlm.nih.gov/32845416/
In part 2 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield and Dr Laura Cutler, with Dr Jake Bleacher continue discussing how they used graded motor imagery to help a patient with low back pain.
Treatment sessions 3 and 4 include breakthroughs, progressions, graded movement exposure, and mindfulness training.
We discuss who finds pain neuroscience most helpful, and Dr Chris Hughes explains why this case was a perfect match for JOSPT Cases.
RESOURCES
Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875
Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI
Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ
The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/
Find the Why I Hurt Flashcards and heaps of helpful information about pain neuroscience education here: https://whyyouhurt.com/WYH-why.html
Find out more about Headspace, and download the app for free: https://www.headspace.com/
Find "Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation" here: https://www.jospt.org/doi/10.2519/jospt.2018.0610
The NOI Group's website has plenty of courses and resources for clinicians on managing pain: https://www.noigroup.com/
Don't forget, JOSPT has a terrific series called Pain Science in Practice, which is all about helping you understand and link basic pain science to the clinic and quality musculoskeletal rehabilitation care. Find part 1 in the series (6 editorials, and more on the way!) here: https://www.jospt.org/doi/10.2519/jospt.2022.10995
In part 1 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield, Dr Laura Cutler, and Dr Jake Bleacher review their approach to supporting a patient with chronic low back pain.
First, they review the history, clinical assessment, and the interventions performed over the first 2 treatment sessions.
Next, the clinical team reviews how they decided when to leave the biomechanical world and when to focus on graded motor imagery and laterality training.
Dr Chris Hughes, Editor-in-Chief for JOSPT Cases, introduces the journal. He explains why case reports are important in musculoskeletal health and rehabilitation.
RESOURCES
Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875
Dr Lorimer Moseley on the role of the brain in chronic pain (snake story): https://www.youtube.com/watch?v=bj9CUGzw6fs&t=26s
Dr Peter O’Sullivan and “Jack” sharing how Jack regained his life: https://www.youtube.com/watch?v=j4gmtpdwmrs&t=214s
Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI
Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ
The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/
Melissa Haberfield, very patiently, takes Chelsea and Dan through all things Australian Rules Football. From the field, scoring, and rules, to the punching, kicking, and tackling required to play—it’s a crash course in the game of footy.
Melissa breaks down the demands of the sport, the common injuries, and key things for clinicians to keep in mind when working with Australian football athletes.
RESOURCES
More on the Prep2Play injury prevention program, including player, coach and clinician resources: https://www.play.afl/coach/resources/prep-to-play/
Intro to footy video: https://www.youtube.com/watch?v=u_SqfNNfhmM&authuser=0
Tayla Harris and the landmark AFLW photo: https://www.abc.net.au/news/2019-03-21/tayla-harris-aflw-photo-could-be-landmark-moment-in-australia/10921892
Kids are resilient, but that doesn't mean they don't struggle with pain. Sometimes it can feel daunting to know how best to support a child in pain, and their family, as everyone navigates school, sport and other environments.
Physiotherapist, researcher and educator at University of Technology Sydney, Dr Joshua Pate, is on a mission to help kids and clinicians work better together when it comes to understanding and managing musculoskeletal pain. Today he shares the latest on pain neuroscience, and tips for honing your listening and communicating skills.
RESOURCES
More on assessing children's understanding of pain: https://pubmed.ncbi.nlm.nih.gov/32960825/ (Concept of Pain Inventory) and what paediatric pain experts think https://pubmed.ncbi.nlm.nih.gov/29342976/
More on the pGALS (paediatric Gait Arms Legs and Spine) quick musculoskeletal assessment tool: https://pubmed.ncbi.nlm.nih.gov/24219838/
https://www.zoeandzakspainhacks.com is the free online portal for kids, clinicians, parents and teachers. You'll find the books at: https://www.noigroup.com/product/zoe-and-zaks-pain-hacks/
More from Josh on his website: https://joshuawpate.com/
Look no further for the latest information on assessing, diagnosing, treating and making a prognosis about, lateral elbow pain!
CPG authors Dr Ann Lucado and Dr Joseph “Matt” Day review the key take-aways from the CPG. They share the important differential diagnoses to consider, the outcome measures to use, and impairment measures to track.
Clinicians will love the clever approach to classifying the irritability stage of elbow pain, to guide both treatment and prognosis and liberate you to decide what's best for tailoring your recommendations throughout rehabilitation.
RESOURCES
Read the full CPG for free: https://www.jospt.org/doi/10.2519/jospt.2022.0302
One-page summary of the key points for clinicians (including decision tree): https://www.jospt.org/doi/10.2519/jospt.2023.0501
One-page summary of the key CPG points for patients: https://www.jospt.org/doi/10.2519/jospt.2023.0504
Dr Mitchell Selhorst continues his chat about spondylosis/spondylolysis/spondylolisthesis in adolescent athletes. After reviewing the who, why, and what in part 1, today’s episode is full of clinical pearls about rehabilitation and return to sport.
Dr Selhorst presents a 3-stage approach to rehabilitation, and shares how he thinks differently when planning rehabilitation for an acute vs. a chronic injury. Another big take-home message: how important it is to consider the psychological aspect of these injuries for youth athletes.
RESOURCES
More on rehabilitation for spondylolysis in youth athletes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134351/
Micheli Functional Scale: https://pubmed.ncbi.nm.nih.gov/22382433/
Does the thought of dermatomes and myotomes, nerve trunks and nerve roots fill you with confidence or fill you with fear? Physiotherapist and neuroscientist, Dr Annina Schmid (Nuffield Department of Clinical Neurosciences, Oxford University), shares a checklist of what you need to know, and what you need to do, to nail your neurological assessment next time you're in the clinic.
RESOURCES
Does your neurological examination for suspected peripheral neuropathies measure up? Do a check-up here: https://doi.org/10.2519/jospt.2022.11281
Why you cannot trust the dermatomes: https://www.youtube.com/watch?v=BZYtAR4zUpg&t=283s
More from Dr Schmid's Neuromusculoskeletal Health and Science Laboratory: https://www.ndcn.ox.ac.uk/research/neuromusculoskeletal-health-and-science-lab
The masters woman athlete has high expectations on herself for performing in sport. She is often navigating the training, performance and musculoskeletal health care landscape with little support from a dedicated multidisciplinary team.
Today, Professor Kirsty Elliott-Sale brings her physiology and endocrinology expertise to help you understand how best to support masters women athletes to stay healthy and perform at their best during and beyond the menopause.
RESOURCES
Standards of practice for research on women in sport, sports medicine, sport science: https://pubmed.ncbi.nlm.nih.gov/33725341/
How comfortable do you feel when guiding women on how to stay active, healthy and injury-free beyond the menopause?
In today's episode, Professor Kirsty Elliott-Sale (Institute of Sport at Manchester Metropolitan University) walks through all you need to know about the menopause and how you might tailor your exercise prescription for women who are approaching, in the middle of, or post- menopausal.
We talk through the phases of menopause, typical signs and symptoms, and Kirsty's whole body approach to supporting women to stay active through their life.
Dr. Kevin Wernli unpacks his research on patients’ beliefs about relationships between low back pain, posture and movement. We’re helping you support patients as they challenge their own beliefs about pain and moving.
Kevin’s approach focuses on liberating the person to test their own beliefs with information and knowledge from trusted sources. Today we’re tackling the common belief that “my back is easy to injure and hard to heal”.
RESOURCES
Dr. Wernli’s paper and subject of today’s interview: https://pubmed.ncbi.nlm.nih.gov/35959703/
Ten facts every person should know about back pain: https://pubmed.ncbi.nlm.nih.gov/31892534/
Empowered Beyond Pain podcast (especially episodes 4, 5, 11-20 about back facts): https://open.spotify.com/show/3ogpeLlDGLRLiHofEWvCje
Cognitive Functional Therapy: https://pubmed.ncbi.nlm.nih.gov/29669082/
Pain-Ed: www.Pain-ed.com
Infographics and short videos: https://www.pain-ed.com/blog/2020/06/13/ten-low-back-pain-facts-videos/
PainHealth: https://painhealth.csse.uwa.edu.au/
Today we tackle some big-picture questions about what it means to exist between the sports performance and sports physical therapy arenas. Dr Mack explains how collaborating with and learning from a variety of people in a variety of professions helps her thrive in the rehabilitation and performance spheres.
As the director of education content for the American Academy of Sports Physical Therapy and a business owner, Dr Mack also shares her thoughts on working in the insurance and cash-based settings, and the resources available for clinicians to help them best serve their patients with rehabilitation and performance.
Is primary cam morphology a plain and simple bump on the hip—nothing to worry about? Or is it much more of a burden?
Dr Paul Dijkstra, Consultant Sport & Exercise Medicine Physician and Director of Medical Education at the Aspetar Orthopaedic & Sports Medicine Hospital in Doha, Qatar, walks through his approach to diagnosing and managing hip pain in youth athletes.
RESOURCES
Primary cam morphology concept analysis: https://pubmed.ncbi.nlm.nih.gov/34281962/
physioFIRST pilot study: https://pubmed.ncbi.nlm.nih.gov/29607766/
Physiotherapist-led treatment for hip-related pain: https://pubmed.ncbi.nlm.nih.gov/31732651/
Unravelling the relationship between cam morphology and hip osteoarthritis: https://pubmed.ncbi.nlm.nih.gov/30175856/
Zurich consensus recommendations for classifying hip-related pain: https://pubmed.ncbi.nlm.nih.gov/31959678/
More on the YAHiR collaborative work: https://www.ndorms.ox.ac.uk/events/Oxford-Hip-2022
What are the sport demands of professional kiteboarding? F1 racing? How would you best support a cliff diver who is returning from injury?
Dr Amy Arundale joins Dan and Chelsea to share her experiences working with elite extreme athletes at the Red Bull Athlete Performance Center, Austria.
Amy explains what a typical day looks like, how she approaches tailoring rehabilitation to the demands of training and competition, and how to authentically connect with an athlete who plays a sport you aren’t familiar with. Spoiler alert: humility and YouTube go a long way.
Today, Dan and Chelsea interview the Wake Forest Pitching Lab: Dr Garrett Bullock, who you may remember from episode 93, Dr Kristen Faith Nicholson, and pitching coach Mike McFerran, Lab Coordinator and Director of Player Development. The team covers common pitching faults they see in their lab, tips to help you pick up on these problems and their recommended cues for improving efficiency with pitchers suffering from shoulder pain.
Dan and Chelsea’s guest today is Dr Marie Boo—physical therapist for the US Women’s National Soccer Team (USWNT). Dr Boo outlines the physical demands of women’s soccer, including how the demands change by position when it comes to accelerations, decelerations, changes of direction, top speed, and overall volume. She covers the typical injuries in elite women’s soccer, and how injury patterns in soccer are changing with the ever-increasing physical performance demands.
To wrap up, Marie shares her tips for supporting elite-level soccer players, and what a day in the life of the USWNT physical therapist looks like.
Dr Lynn McKinnis (Associate Editor for JOSPT Cases, the sister journal for JOSPT) takes Dan and Chelsea through a case that reminds us of a rare but important differential diagnosis. Without giving the diagnosis away, this case highlights the importance of performing the upper quarter screen, choosing the right neurological special tests, and timely referral for imaging.
RESOURCES
Read more about the case here: https://doi.org/10.2519/josptcases.2021.10049
Seen an interesting clinical case lately and want to share it with the JOSPT Community? Why not submit the case to JOSPT Cases? We offer timely, fair and quality peer review. For more information, check out the instructions for authors: https://www.jospt.org/pb-assets/JOSPT%20Cases/JOSPT%20Cases%20Instructions%20for%20Authors%20with%20form_02112021-1613587003923.pdf
Subscribe to JOSPT Cases: https://www.jospt.org/action/ecommerce
We're celebrating the 100th episode of JOSPT Insights with an extra special guest!
Dr Emma Stokes, President of World Physiotherapy (formerly WCPT), is a fierce ambassador for the physiotherapy/physical therapy profession. Tune in as Emma shares her advice for the next generation of profession leaders, and her thoughts on the future for musculoskeletal rehabilitation.
RESOURCES
World Physiotherapy briefing papers: https://world.physio/resources/publications
In part 1 of this mini shoulder masterclass with clinical physiotherapy specialist, Jo Gibson, we tackled a simple approach to assessing and diagnosing shoulder problems in athletes. Today, we launch into supporting the athlete to return to sport: key considerations? Which return to sport tests? How do you know when the athlete is ready to return? All this and more in part 2.
RESOURCES
Bern 2022 consensus on shoulder injury prevention, rehabilitation and return to sport: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952
The Athletic Shoulder (ASH) test: https://pubmed.ncbi.nlm.nih.gov/30057775/
Upper-extremity performance tests: https://pubmed.ncbi.nlm.nih.gov/33874850/
In part 1 of this 2-part series with clinical physiotherapy specialist, Jo Gibson, we're making assessing and diagnosing shoulder problems simple. What are the keys to communicating well with athletes, and the tests you need in your clinical arsenal to best support injured athletes?
RESOURCES
The Athletic Shoulder (ASH) test: https://pubmed.ncbi.nlm.nih.gov/30057775/
Upper-extremity performance tests: https://pubmed.ncbi.nlm.nih.gov/33874850/
Join the indomitable Dr Lynn Snyder-Mackler (University of Delaware) for a mini-masterclass on tailoring rehabilitation to the nuances of the most common ACL reconstruction graft types. Hamstrings tendon, bone-patellar tendon-bone, quadriceps tendon, allograft—what's different? What's the same?
RESOURCES
More on graft type differences in time to meet milestones and return to sport criteria: https://www.jospt.org/doi/10.2519/jospt.2020.9111
University of Delaware rehabilitation guidelines: https://sites.udel.edu/ptclinic/professionals/guidelines/
Sports physiotherapist, PhD and strength & conditioning coach, Dr Matt Whalan, breaks down the demands of the beautiful game by position. Did you realize how much coaching philosophy can alter the physical and mental demands on players?
Dr Whalan explains which injuries you can expect to see, and the best (free!) resources for preventing these injuries. You’ll also hear tips for building trust relationships with coaches and players, educating athletes, and how using empowering language when athletes are returning to sport can make all the difference.
RESOURCES
Football Australia Perform+ program: https://www.footballaustralia.com.au/performance
Fit To Play: https://fittoplay.org/
FIFA 11+ program: https://www.yrsa.ca/wp-content/uploads/2019/11/pdf/Fifa11/11plus_workbook_e.pdf
Do niggles matter infographic: https://adamvirgile.com/2020/01/09/do-niggles-matter-increased-injury-risk-following-physical-complaints-in-football-soccer/
Today is hamstring strain care from start to finish! Prof Heiderscheit joins Chelsea and Dan to share the headlines from the 2022 JOSPT Clinical Practice Guideline (CPG) for managing hamstring strains in athletes. This CPG includes evidence-based recommendations for accurately diagnosing, treating, and preventing hamstring strains.
RESOURCES
Hamstring strain injury in athletes CPG: https://www.jospt.org/doi/10.2519/jospt.2022.0301
Hamstring injury: what is it? What should I do about it? When can I get back to my sport? Patient information: https://www.jospt.org/doi/10.2519/jospt.2022.0502
Infographic: criteria-based progression for hamstring injury rehabilitation: https://www.jospt.org/doi/10.2519/jospt.2022.9001
Pain-free vs. pain-threshold rehabilitation: https://www.jospt.org/doi/10.2519/jospt.2020.8895
There's plenty to think about when you're trying to diagnose and then manage shoulder instability. Sometimes simply teasing out exactly what is going on can frustrate clinicians and patients alike. Today we hear from Dr Amee Seitz, who has spent her clinical and research career trying to improve how clinicians and patients manage musculoskeletal shoulder disorders for best recovery and performance.
RESOURCES
2022 Bern consensus on shoulder injury prevention, rehabilitation and return to sport: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952
3 findings that are key to diagnosing multidirectional instability: https://www.jospt.org/doi/10.2519/jospt.2020.0602
Derby Shoulder Instability Rehabilitation Programme: https://derbyshoulderunit.co.uk/download/derby-shoulder-instability-rehabilitation-programme/
Dr Garrett Bullock shares his perspectives on the demands of different playing positions in baseball, and the implications of different demands for the types of injuries clinicians are likely to encounter. He also shares his pick of the best metrics to use when supporting athletes to gradually return to play.
RESOURCES
More on humeral torsion: https://www.sciencedirect.com/science/article/pii/S1058274621005218
More on prediction models for humeral torsion: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8975570/
How do you make the most of the information available to you about sports injuries while you focus on building a strong trust relationship with the athlete? Dr Nicol van Dyk—medical research lead with the Irish Rugby Football Union—brings his trademark innovative thinking and practical advice to JOSPT Insights. We draw on Nicol’s extensive experience in sports medicine research and practice to walk step-by-step through simple solutions to diagnosing and managing hamstring injuries.
RESOURCES
2016 Bern Consensus on return to sport: https://pubmed.ncbi.nlm.nih.gov/27226389/
Early versus delayed rehabilitation after acute muscle injury: https://pubmed.ncbi.nlm.nih.gov/28953439/
Rehabilitation after acute hamstring injury: https://www.jospt.org/doi/10.2519/jospt.2020.8895
Clinical Practice Guideline Hamstring Injury in Athletes: https://www.jospt.org/doi/10.2519/jospt.2022.0301
Biology of muscle tissue healing: https://skeletalmusclejournal.biomedcentral.com/articles/10.1186/s13395-017-0142-x
Steven Covey's 7 Habits of Highly Effective People: https://www.goodreads.com/book/show/36072.The_7_Habits_of_Highly_Effective_People
How confident do you feel to design and deliver a quality rehabilitation program for someone who has had a total knee replacement? Today, Professor Jennifer Stevens-Lapsley, who is one of the leading lights in clinical research in this field, shares her tips for clinical success and an update on the open research questions in the field. Professor Stevens-Lapsley gives us the inside running on the work going on to help provide answers to those important clinical questions.
Clinical practice guidelines for physical therapy after total knee replacement: https://pubmed.ncbi.nlm.nih.gov/32542403/
Tune in for a view of baseball injuries across the lifespan and across the field positions with clinician-scientists Dr Ellen Shanley and Dr Chuck Thigpen. We cover what the clinician can expect in early season vs. late season injuries, how baseball injuries have changed, the changes in injuries across the athlete’s lifespan, and how communicating well with athletes and coaches will make lasting changes in injury rates.
We're premiering a new series focused on JOSPT Cases—a teaching tool to help develop your clinical reasoning and highlight how to apply evidence in your practice. Today, Dr Kimiko Yamada explains an orthopedic case from JOSPT Cases. She outlines how JOSPT Cases works, how you can subscribe, and how you can submit your own cases to be highlighted in future editions.
To visit JOSPT Cases you can follow the link here: https://www.jospt.org/loi/jospt-cases
You've probably read clinical practice guidelines that tell you to screen for so-called yellow flags. But how do you approach screening? Today, Dr Trevor Lentz shares a practical, 3-step framework on how to screen for yellow flags, and that important next step—what to do with the information.
Learn more about screening for yellow flags in orthopaedic physical therapy: https://www.jospt.org/doi/10.2519/jospt.2021.10570
Downlad the Optimal Screening for Prediction of Referral and Outcome (OSPRO) tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487
Sports Corner is a brand-new series from JOSPT Insights! Dan and Chelsea talk with experts in a specific sport, and ask them to share their knowledge on how to deliver best care for athletes. Dr Tim Stone is a physical therapist who specializes in treating lacrosse players, and is an athlete himself. He details the demands of lacrosse by position and shares tips on how to handle “lax back”.
Why do we hurt, and why does pain persist for some people? Today, Dr Tasha Stanton—clinical pain neuroscientist and physiotherapist from the University of South Australia—is exploring ways to hijack the complex processes going on in our body for good. All in the name of managing pain better.
DR STANTON'S RESOURCE RECOMMENDATIONS NOI Group: https://www.noigroup.com/
Pain Chats: https://painchats.com/
HealthSkills Blog (Dr Bronnie Lennox Thompson): https://healthskills.wordpress.com/
JOSPT Pain Science in Practice is a new series that aims to decode the basic science of pain and how it applies to your clinical practice. Dr Morten Høgh—physiotherapist, educator and researcher—leads the series, and today he explains how #JOSPTPainScienceInPractice will help you help the patients you work with.
We're co-developing #JOSPTPainScienceInPractice with you! Let us know what you want to read about. Follow the discussion on social media (Twitter: @JOSPT, @MH_DK, #JOSPTPainScienceInPractice).
You can read the first article in the series here: https://www.jospt.org/doi/10.2519/jospt.2022.10992.
We couldn't interview 2 experts in running and running shoes without talking about the shoe that's taking the running world by storm: the Nike Vaporfly. Dr Nathan Brown and Dr Matt Klein walk you through the technology that's in the Vaporfly, and explain what makes this shoe different to most other running shoes on the market today.
Visit www.doctorsofrunning.com to connect with Nathan and Matt.
Stack height, drop, rocker soles, cushioning and more. Join Dr Nathan Brown and Dr Matt Klein—runners and physical therapists—for the low-down on the latest in running shoe construction and technology: what really works and how to help runners choose the best shoe for them.
More on the effects of motion-control shoes: https://www.jospt.org/doi/10.2519/jospt.2021.9710.
More on monitoring training load in runners: https://www.jospt.org/doi/10.2519/jospt.2020.9533.
Visit www.doctorsofrunning.com to connect with Nathan and Matt.
The ground feels like it's forever shifting for clinicians who work with runners—whether you work with high performance athletes, or the person who likes to run for physical and mental health a few times a week—in this intersection between technology, marketing, biomechanics and health. It can be hard to know where the research is at, and how to tease out what is marketing hype from the truth. Today, Dr Nathan Brown and Dr Matt Klein, who specialise in running injuries and performance, cut through the confusing information, to help you help the runners you work with.
Managing stress fractures in runners: https://www.jospt.org/doi/10.2519/jospt.2021.9982
Gait re-training for preventing injury and improving performance: https://www.jospt.org/doi/abs/10.2519/jospt.2022.10585
Visit www.doctorsofrunning.com to connect with Nathan and Matt.
When working with a patient who has femoroacetabular impingement syndrome (FAI), knowing how and when to work with an orthopaedic surgeon can feel daunting. Dr. Travis Maak puts your mind at ease today as he chats with Dan and Chelsea to share the surgeon's perspective. Dr Maak is a strong proponent of multidisciplinary practice—he’s a big fan of physical therapists and surgeons working together. In today’s episode, he covers when to refer a patient to a surgeon, what happens when hip treatments aren’t going to plan, different surgical techniques and how they can influence rehabilitation.
It is sometimes difficult to know what the best approach is for preventing and treating shoulder injuries in athletes. Enter, the 2022 Bern Consensus Statement on Shoulder Injury Prevention, Rehabilitation, and Return to Sport—a paper that delivers a flexible, principle-based approach that you can implement with any athlete in any sport. Today, the two clinician researchers who led the consensus—Ariane Schwank and Paul Blazey—bring you the key messages.
Download the consensus statement for free: https://www.jospt.org/doi/full/10.2519/jospt.2022.10952
“Help! I’ve tried everything—nothing has worked!” When the exasperated patient in front of you tells you that she has tried all the treatments for Achilles tendinopathy to no avail, where do you go? Specialist sports physiotherapist and clinician researcher, Dr Ebonie Rio, brings her trademark pragmatic approach to JOSPT Insights, as she shares top clinical tips for diagnosing and managing tricky tendons.
More on tissue capacity: https://pubmed.ncbi.nlm.nih.gov/26255142/
Revisit the continuum model of tendon pathology: https://pubmed.ncbi.nlm.nih.gov/27127294/
In part 1 of this 2-part series on post-exertion symptom exacerbation, Dr Todd Davenport explained what post-exertion symptom exacerbation is, what it feels like, and how to test and monitor it. In part 2, we dive into pacing - the less is more approach to managing post-exertion symptom exacerbation that will challenge you to think differently about how you prescribe exercise and what the goals of therapy are for people who are living with post-exertion symptom exacerbation.
Long COVID physio: https://longcovid.physio/
World Physio COVID-19 briefing papers (including briefing paper #9 on safe rehabilitation approaches for people living with long covid): https://world.physio/covid-19-information-hub/covid-19-briefing-papers
WorkWell Foundation: https://workwellfoundation.org/resources/
How prepared are you to support someone who is living with post-exertion symptom exacerbation? Dr Todd Davenport wants to start a conversation about re-imagining the way most of us have thought about fatigue, physical activity and exercise. Tune in to learn more about post-exertion symptom exacerbation, including what it feels like, and how to test and monitor it.
For a deeper dive on post-exertion symptom exacerbation, check out the JOSPT blog:
Lessons for long COVID from myalgic encephalomyelitis: https://www.jospt.org/do/10.2519/jospt.blog.20220202/full/
Abnormal physiologic response during acute exercise: https://www.jospt.org/do/10.2519/jospt.blog.20220209/full/
Returning to work after work-related injury often throws up some curveballs. Beyond the usual health care practitioners, there are multiple stakeholders who are invested in the person's care. Outside pressures, and factors specific to the person's situation and work requirements also demand careful attention. That’s where the clinical practice guideline can help you know what to pay attention to, to support participation in work after injury or illness.
Access the CPG here: https://www.jospt.org/doi/10.2519/jospt.2021.0303
What happens when the athlete is not taking in sufficient energy to meet the demands of day-to-day life, including training and performance? Today, endocrinologist and sports physician, Dr Kathryn Ackerman, explains what relative energy deficiency in sport is, expands the female athlete triad of energy intake, bone health and menstrual function, and shares 3 important ways that you can support athlete health and performance.
International Olympic Committee consensus statement on RED-S: https://pubmed.ncbi.nlm.nih.gov/29773536/
RED-S CAT (Relative Energy Deficiency in Sport Clinical Assessment Tool): https://bjsm.bmj.com/content/bjsports/49/7/421.full.pdf
Australian Institute of Sport Female Performance & Health Initiative (including free education resources): https://www.ais.gov.au/fphi
How long will it take for my whiplash symptoms to improve? In this episode, Dr Michele Sterling helps answer that important question. She shares the basics of whiplash: diagnosis and mechanisms, key factors to consider when determining prognosis, and planning treatment. Learn more about assessing pain-related disability and hyperarousal symptoms, as well as the benefits of a proactive approach to treatment.
More info on using WhipPredict: https://recover.centre.uq.edu.au/whiplash-associated-disorders-clinician-resources#0 https://www.jospt.org/doi/10.2519/jospt.2016.6918
Over the past decade, the way clinicians and researchers understand patellofemoral pain—what causes it and how to manage it—has evolved from a focus on the biomechanics of joint alignment and posture to embracing a more rounded biopsychosocial model of musculoskeletal pain. Tune in as Professors Bill Vicenzino and Michael Rathleff share the results of the recent consensus they led to establish the clinical and research priorities on pain features and psychological factors in people with patellofemoral pain.
Access the consensus at: https://www.jospt.org/doi/10.2519/jospt.2022.10647
The words of the Irish poet and Nobel Prize laureate Seamus Heaney frame the key message for today’s episode: “If you have the words, there’s always a chance that you’ll find the way.” Dr Lindsey Plass draws on her own experience managing femoroacetabular impingement syndrome, as well as a decade of clinical experience, to share her top tips for communicating and supporting patients with musculoskeletal pain to, in the words of Seamus Heaney, find the way to recovery and do the things they love.
Access the Young Athlete’s Hip webinar series at: https://www.ndorms.ox.ac.uk/events/Oxford-Hip-2021
Despite the excellent benefits of knee replacement surgery for reducing pain and improving knee function, people are just as physically inactive after surgery as they were before. If it's not an issue of knee symptoms and function, then what's going on? Dr Daniel White, physical activity and osteoarthritis (OA) expert from the University of Delaware explains 3 common myths about physical activity with knee OA and shares up-to-date research to help you counter those myths when you're in the clinic.
2018 physical activity guidelines for Americans: https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines
What's new in the 2018 physical activity guidelines: https://www.jospt.org/doi/10.2519/jospt.2019.0609
Dr Luciana de Michelis Mendonça realized very early on in her physical therapy career that something wasn't quite right in the sports physical therapy arena; very few of her women colleagues progressed through the ranks of general training to the specialist field of sports, and even fewer worked at the top level of sports, especially with elite or professional teams. She was determined to drive change.
Register for the 4th World Congress of Sports Physical Therapy (early bird closes May 1): https://www.conferencemanager.dk/wcspt2022
Gender bias in sports physical therapy: https://www.jospt.org/do/10.2519/jospt.blog.20210825/full/
Tactical athletes work and cope with injury in complex and often changing environments. In today’s episode, Dr John J Fraser shares his expertise and advice on working with tactical athletes, such as military, fire, and police. He explains the most common injuries, what makes a tactical athlete different than other athletes, how musculoskeletal rehabilitation clinicians can best communicate their allyship, and the #1 thing to remember when working with tactical athletes.
Frozen shoulder is an enigma characterized by uncertainty, pain, stiffness and disability. It is difficult for patients and clinicians to know how best to manage the symptoms and what is the likely prognosis. In today’s episode, Part 2 of a 2-part series, Prof Jeremy Lewis gives us the low-down on the best evidence for treating frozen shoulder. Manual therapy, injections, exercise therapy: what, when, and how much? Tune in for the answers you’re looking for.
Framework for assessing and managing frozen shoulder: https://pubmed.ncbi.nlm.nih.gov/25107826/
Effectiveness of non-surgical interventions: https://pubmed.ncbi.nlm.nih.gov/31233183/
UK FROST trial: https://pubmed.ncbi.nlm.nih.gov/33010843/
Prof Lewis’ new book "The Shoulder: Theory & Practice" is available from Handspring Publishing: https://www.handspringpublishing.com/product/the-shoulder-theory-and-practice/
Frozen shoulder is an enigma characterized by uncertainty, pain, stiffness and disability. It is difficult for patients and clinicians to know how best to manage the symptoms and what is the likely prognosis. In today’s episode, Part 1 of a 2-part series, you’ll hear ideas about how you might approach assessing a painful and stiff shoulder, and how you might talk with patients to make a decision together about the best way forward.
Framework for assessing and managing frozen shoulder: https://pubmed.ncbi.nlm.nih.gov/25107826/
Effectiveness of non-surgical interventions: https://pubmed.ncbi.nlm.nih.gov/31233183/
UK FROST trial: https://pubmed.ncbi.nlm.nih.gov/33010843/
Prof Lewis’ new book "The Shoulder: Theory & Practice" is available from Handspring Publishing: https://www.handspringpublishing.com/product/the-shoulder-theory-and-practice/
Professor Nicola Phillips is here to guide us through how to best load the upper extremity after injury. She shares her expertise on how rehabilitation professionals can change the way we prescribe functional exercise to maximize the benefits of how patients learn. She also provides insight into considerations for both short- and long-term programming for an upper limb rehabilitation plan.
For more, check out: http://dx.doi.org/10.1136/bjsports-2014-094443
How would you approach diagnosing concussion for an athlete with underlying balance problems? Or for an athlete who is blind? The usual concussion tests simply may not be appropriate. Dr Osman Ahmed is a physical therapist on a mission to improve how athletes receive and experience care after concussion. Tune in to hear all about the work of the Concussion in Para Sport Group.
Download the position statement of the Concussion in Para Sport (CIPS) Group: https://pubmed.ncbi.nlm.nih.gov/33837003/
Find out more about the CIPS Group’s work: https://www.parafootball.com/our-projects/concussion-in-para-sport
Join JOSPT Insights hosts Drs Chelsea Cooman, Dan Chapman and Clare Ardern as they revisit their favorite episodes from a jam-packed 2021, from treating ACL injuries and shoulder pain to designing quality rehabilitation for patients with meniscus repair and building authentic connections with patients. Share your favorite episodes on social media using #JOSPTInsights.
Athletes, large and small, old and young, elite and recreational experience low back pain at some time in their sporting lives. So, how do you best help athletes manage their pain, stay healthy and perform to their full potential? Dr Fiona Wilson from Trinity College Dublin shares the latest evidence with the JOSPT community, including the 2021 consensus on preventing and managing low back pain in rowers.
Download the 2021 consensus from: https://pubmed.ncbi.nlm.nih.gov/33685861/ Delphi study of clinicians’ opinions: https://pubmed.ncbi.nlm.nih.gov/33431498/ Systematic review of treatment strategies: https://pubmed.ncbi.nlm.nih.gov/33355180/
You’ve figured out contributing impairments—now what? Exercise therapy or taping? Foot orthoses or manual therapy? Dr Christian Barton continues his chat with Drs Dan Chapman and Chelsea Cooman in the second episode of our 2-part patellofemoral pain CPG series to share the most effective treatment strategies for reducing pain and improving function.
The patellofemoral pain CPG is freely available on JOSPT's website at the following link: https://doi.org/10.2519/jospt.2019.0302
Dr Christian Barton joins Drs Dan Chapman and Chelsea Cooman to dive into the patellofemoral pain CPG published in JOSPT in April 2019. In the first episode of this 2-part series, we hit the highlights of this extensive CPG, including the true definition of patellofemoral pain syndrome, as well as the 4 categories of impairments the CPG lays out to allow for a simplified diagnosis. Dr Barton makes the case for looking beyond the research—widening the clinical lens for better diagnosis and better musculoskeletal care.
The patellofemoral pain CPG is freely available on JOSPT's website at the following link: https://doi.org/10.2519/jospt.2019.0302
When it comes to rehabilitation after ACL injury, return to running can get a bit overshadowed by return to sport. Yet running is a key function milestone for athletes. Why is return to running so important and how do you help set the athlete up for successful return to running? Dr Rich Willy from the University of Montana is here to help.
Profs Lori Michener and Joe Donnelly, Vice President and President, respectively, of the APTA’s Academy of Orthopaedic Physical therapy (AOPT), share the inside track on the AOPT’s new strategic framework, opportunities for grants, and how you can get involved with AOPT.
Visit http://www.orthopt.org to find out more about the Academy and its work.
Sports physical therapist Elisa Nédélec heard so many harmful myths about when and how girls and women should play sport that she decided to start a PhD. In today’s episode, Elisa explains why girls and women should stay active, and what research can (and can’t) tell us about the relationship between reproductive hormones and musculoskeletal injury. Elisa co-leads the FAIR-ACL Project with Professor Kirsty Elliott-Sale, which tracks female athletes’ hormone profiles at the time of ACL injury.
Find out more about the FAIR-ACL Project at: https://fairaclproject.isrg.org.uk
In the second episode of our 2-part masterclass on late-phase ACL rehabilitation, Dr Dan Lorenz shares what it means to bring sport specificity to rehab. It’s not about replicating every drill the athlete will do at practice. Rather, Dr Lorenz encourages clinicians to understand how the athlete moves during sport and treat the impairment that’s preventing the athlete from unleashing powerful movements.
In Part 1 of this 2-part podcast, Dr Dan Lorenz joins Drs Dan Chapman and Chelsea Cooman to dig into what quality rehab looks like in the late stages after an ACL reconstruction. Dr Lorenz covers the importance of loading, including where to start, how to load for the demands of the sport, and how it can look different at 4 vs 8 months. He shares his criteria for returning to run, prerunning drills, when and how to progress into plyometrics, and a peek into what he thinks the early stages should look like to prepare for later success.
A young handball player walks into your clinic tomorrow—she tells you her shoulder pain is bad, and getting worse. What should she do?
Sports physical therapist Suzanne Gard is here to help untangle shoulder instability. Tune in for tips on assessing and treating shoulder instability and building strong and supportive lines of communication with youth athletes.
The International Federation of Sports Physical Therapy (IFSPT) World Congress will take place in Denmark in August 2022. Head to http://www.ifspt.org to find out more.
Dr Caitlin McGee is back for the second of a two-part episode to outline the challenges and opportunities for diversity and inclusion in esports. Like many industries, esports is grappling with a past that did not embrace the rich and diverse gaming community as much as it could have. How is change happening, and who is driving it?
Dr McGee is the co-owner and Performance & Esports Medicine Director of 1HP, a company that provides health and performance services to esports players, teams, and organizations.
For more on the role for the musculoskeletal rehabilitation practitioner in esports, check out Dr McGee's recent editorial in JOSPT: https://www.jospt.org/doi/10.2519/jospt.2021.0109
Ease your way into the billion-dollar esports industry in this first of a two-part episode as Dr Caitlin McGee explains what esports are and the common musculoskeletal problems seen in gamers, then walks through how she approaches an initial clinical evaluation. Dr McGee is the co-owner and Performance & Esports Medicine Director of 1HP, a company that provides health and performance services to esports players, teams, and organizations.
For more on the role for the musculoskeletal rehabilitation practitioner in esports, check out Dr McGee's recent editorial in JOSPT: https://www.jospt.org/doi/10.2519/jospt.2021.0109
Dr Marcie Harris-Hayes joins Drs Dan Chapman and Chelsea Cooman to share her extensive knowledge of hip-related groin pain. We dive into 3 of her papers to get to the bottom of 3 important questions: What counts as hip-related groin pain? Can physical therapy help? Which treatment interventions are most effective for improving function?
2021 has been a big year for trials studying the benefits of different approaches to rehabilitation for rotator cuff–related shoulder pain. Keeping up with the latest research can feel a bit like chasing your tail—today, Professor Lori Michener is here to help! We look at the latest research, explain what it all means, and how to apply it tomorrow in the clinic.
GRASP trial: https://pubmed.ncbi.nlm.nih.gov/34265255/ SExSI trial: https://pubmed.ncbi.nlm.nih.gov/34048281/
Join Kate Mahony—sports physical therapist and Head of Performance Health at the New South Wales Institute of Sport—for a post-Olympics wrap-up of the achievements and advocacy of women athletes, clinicians and coaches in sport. Kate shares her tips for supporting women athletes to help them perform at their best and her advice for clinicians who aspire to work in elite sport.
Can you tell a bone stress reaction from a stress fracture? What is safe cross-training for the athlete with bone stress injury? Dr Stuart Warden returns with Drs Chelsea Cooman and Dan Chapman to map out key principles for rehabilitation of low-risk bone stress injuries: (1) manage load, (2) consider healing supplements, (3) maintain fitness, (4) address muscle function, (5) recommence and progress running, and (6) reduce risk of subsequent injury. Part 1 covered key rehabilitation principles 1-4; this episode, Part 2, covers key principles 5 and 6.
Check out the article on the JOSPT website: https://bit.ly/3BLt4Cz
Can you tell a bone stress reaction from a stress fracture? What is safe cross-training for the athlete with bone stress injury? Dr Stuart Warden joins Drs Chelsea Cooman and Dan Chapman to map out the key principles for rehabilitation of low-risk bone stress injuries: (1) manage load, (2) consider healing supplements, (3) maintain fitness, (4) address muscle function, (5) recommence and progress running, and (6) reduce risk of subsequent injury. This episode, Part 1, covers key rehabilitation principles 1-4; stay tuned for Part 2, which covers key principles 5 and 6.
Check out the article on the JOSPT website: https://bit.ly/3BLt4Cz
Delivering quality musculoskeletal rehabilitation practice is a balancing act of art and science. Dr Jason Beneciuk, physical therapist and clinical research scientist at Brooks Rehabilitation and University of Florida, understands the challenges—and he’s here to offer practical solutions.
Find the article "What does best practice care for musculoskeletal pain look like?" (Lin et al 2020) here: https://bit.ly/3kMtFxM
Concussion can loom as an intimidating and daunting challenge—there’s much to consider from headaches to heart rates, vision to vestibular function. Dr Kathryn Schneider is at the front line of clinical practice and research in return-to-sport after concussion. Today, she shares her tips to help the JOSPT community feel confident, not confused, about concussion.
For more, check out the Berlin Concussion in Sport Consensus: https://bit.ly/3wGHosc
Dr Tracy Blake joins us from a pre-Olympics training camp to give us an inside look at how she and her high-performance team have supported Canada’s men’s volleyball team to reach Tokyo in peak condition. Lockdowns, travel bubbles, COVID tests, and long stints living out of a suitcase: the life of a pandemic-era team physical therapist.
Dr Todd Davenport joins Drs Chelsea Cooman and Dan Chapman to share the headlines from the fresh, updated clinical practice guideline (CPG) for lateral ankle sprains and chronic ankle instability. We discuss the advantages of prophylactic bracing, how ankle dorsiflexion influences mechanics, the importance of neurodynamic control, and why ice is no longer #1.
Download the CPG here: https://www.jospt.org/doi/10.2519/jospt.2021.0302
How many times have you reached for the explanation that pain hurts when the brain concludes that the body’s tissues need protecting from an external threat? Specialist clinician and pain educator Laura Rathbone wants to challenge the nociception view of pain and invite clinicians to cultivate a philosophy of pain.
For more, check out these links: NoiJam blog: https://bit.ly/35RFH02 Philosophers Chatting with Clinicians podcast: https://spoti.fi/3quCL31 The Words Matter Podcast: http://www.wordsmatter-education.com/blog Why pain experience is not a controlled hallucination of the body: http://philsci-archive.pitt.edu/18770/
Quality musculoskeletal rehabilitation covers more than whether the athlete can run, jump, and land without pain or swelling. But how comfortable do you designing a rehabilitation program to train the brain as well as the body? Ohio University’s Dustin Grooms explains how to harness neuroscience in your sports injury rehabilitation programs and shares his tips for using the latest virtual reality technology in the clinic. For more help getting started with virtual reality, check out Dustin’s helpful guide here: https://bit.ly/3zBL9Sl
Physical therapists Linda Truong and Christina Le share their evidence-based approach to group rehabilitation for athletes of all ages and abilities. The Functional Agility Strength Training (FAST) program is a tailored approach that balances and promotes the physical and mental sides of recovery after serious injury such as ACL tear. Tune in for tips on how you can set up your own group-based program to support patients to reach their sports participation goals.
Dr Rob Landel boils down the 75 pages of the concussion clinical practice guideline (CPG) into a 25 min podcast episode. He highlights the key points from the CPG—including how to plan and deliver effective assessment (complete with chart), an efficient way to organize clinical information—and offers practical tips on how to educate patients and take irritability into consideration when choosing interventions. Join Chelsea Cooman and Dan Chapman to learn how to best help patients in a multi-disciplinary approach.
Link to the CPG: https://www.jospt.org/doi/10.2519/jospt.2020.0301
More than 10 million people across the world are living with the long-term consequences of COVID-19. But the crushing fatigue experienced by so many with long COVID—the postexertion malaise—is not new. People have lived with postviral illness and postexertion malaise, and they've faced stigma and harm for decades. Sabrina Poirier and Dr Simon Décary are working tirelessly to ensure the mistakes and harms inflicted on so many people living with postviral illness are not repeated for people living with long COVID.
For more, please read the recent JOSPT editorial: https://www.jospt.org/doi/10.2519/jospt.2021.0106
Have you pivoted to telerehabilitation during the coronavirus pandemic? Are you wondering what the digital future of musculoskeletal rehabilitation is? Professor Kim Bennell leads a multidisciplinary team designing, implementing, and studying telehealth for musculoskeletal rehabilitation. Join her for a run-down of the key issues to consider when you’re planning and delivering telerehabilitation and an overview of what the research says about its effectiveness.
Dr Saurab Sharma knows first hand the challenges and opportunities of working across different cultures and in different resource settings. From his work as a physical therapist in Nepal, to his research at University of Otago, and his current work at Neuroscience Research Australia, Saurab is committed to improving the lives of people living with chronic pain. Tune in as Saurab shares his ideas for improving how clinicians and people living with pain can talk about and understand pain.
“If we’ve learned anything from all these different studies, it’s that different meniscus tears behave differently, require different treatment, and ultimately have a different prognosis.” Dr James Dreese is an orthopedic surgeon at MedStar Health in Baltimore, MD, who joined Chelsea and Dan to share his thoughts on how different meniscus tears in different locations in the meniscus might influence the choices you make in rehabilitation.
How do you start a clinical consultation, and what do you do with the information that comes from the patient’s story? Jo Belton and Professor Pete O’Sullivan are tireless advocates for patient-centered care in the truest sense of the phrase. They share their insights on building authentic connections with patients—how to be a human to a human.
The Dutch COMPARE trial landed in BMJ at the end of February 2021, adding much needed weight to the nuanced discussion of best treatment for ACL injury: early surgery versus exercise therapy first with the option for late ACL reconstruction if needed. Leading clinician-researcher Dr Hege Grindem dissects the key results and shares her views on who succeeds without ACL reconstruction.
When 2 in every 3 people with a musculoskeletal condition also have at least one other underlying health condition, it’s time for rehabilitation clinicians to up our game in understanding complex health needs. Thankfully, Professor Søren Skou is here to help. Who is best placed to help patients manage their complex health needs? And is exercise—the veritable polypill—always the answer?
Link to the START trial: https://pubmed.ncbi.nlm.nih.gov/33591346/
Dr Claire Minshull joins Drs Dan Chapman and Chelsea Cooman to unpack rate of force development (RFD): what it is, what it isn’t, and how to measure it. We take a deep dive into how fatigue affects RFD, differences between the sexes, potential implications for injury, and the best ways to incorporate RFD training into your rehabilitation plans.
Join IFOMPT Vice President Paolo Sanzo for his interview with IFOMPT President Laura Finucane on assessing and managing red flags in practice, and how you can add the international framework for screening for serious spine pathology to your practice tomorrow. Over 50,000 people have downloaded the framework for free from the JOSPT website (https://www.jospt.org/doi/10.2519/jospt.2020.9971). Thanks to IFOMPT and World Physiotherapy for their partnership with JOSPT—together we’re bringing you coverage of important issues in global musculoskeletal healthcare.
Sports podiatrists and researchers Dr Katrine Kryger and Dr Athol Thomson raise the profile of footwear for improving athletes’ health and performance. Today’s episode jumps into the impact of footwear in sport—how the right footwear can help athletes avoid injury, what athletes should look for when selecting footwear, and the long overdue investment in footwear specifically for women athletes.
A healthier society for less cost? Value-based health care aims to achieve just that by focusing on what matters to patients. Dr Chuck Thigpen from ATI Physical Therapy unpacks value in musculoskeletal care, the rehabilitation clinician’s role in delivering best care, and why you need to be a good team player.
What happens when your ACL rehabilitation plan isn’t going as well as you hoped? In this follow up to episode 25, Dr Erik Meira shares his thoughts on some of the more challenging issues in ACL reconstruction and rehabilitation. We discuss rehab after second and third ACL tears, sleepy quads, underdosing, and concurrent meniscus repair, and aim to help you find concrete solutions.
If you thought concussion was all about big hits in collision sports like rugby and American football, then think again. Dr Kerry Peek— physical therapist, strength and conditioning coach, and researcher—is committed to protecting the next generation of young soccer/football players. Tune in for the latest on exercise programs to prevent concussion in youth athletes.
Dr Sarah Haag brings her engaging brand of practical tips and her down-to-earth demeanor as she demystifies how to assess and treat the pelvic floor, whatever the clinical setting. No longer fear the pelvic floor—instead, head into the clinic this week confident in your skills.
Dr Erik Meira joins Drs Dan Chapman and Chelsea Cooman to discuss ACL rehabilitation at every stage: acute, strengthening, plyometric, and returning to sport. Dr Meira breaks down the typical timelines and priorities, shares his favorite interventions, and outlines progression criteria for each stage of rehabilitation.
Don’t let managing Achilles tendon rupture become your Achilles heel. In Part 2 of this 2-part series on managing Achilles tendon problems, JOSPT Editor Dr Karin Silbernagel outlines the foundations for quality rehabilitation planning, load progression, and return to high performance in sport. Achilles tendon rupture need not sound the death knell on the athlete’s career.
On your marks, get set, go! Get off to a flying start when managing Achilles tendon problems. JOSPT Editor Dr Karin Silbernagel blends the best of science and practice in her approach to diagnosing and managing Achilles tendon problems. In Part 1 of a 2-part series, we dive into Achilles tendinopathy and get the low down on load progression for happy tendons and happy athletes.
Are you delivering musculoskeletal care based on the most up-to-date model of chronic pain? Professor Steve Kamper explains why he’s riding his bicycle around Australia on the Pain Revolution Tour, shares his tips for framing a conversation with a person experiencing chronic pain, and encourages clinicians to move from treating a body part to treating a person. Learn more about Pain Revolution at www.painrevolution.org.
Dr Mike Reinold brings his wealth of experience at the pinnacle of pro baseball to JOSPT Insights this week, sharing his practical advice on how to measure and manage baseball pitchers’ workload, and explaining how he collaborates with coaches to help athletes perform at their best. Don’t miss Mike’s tips for return to sport.
Join Dr Max Paquette on a deep dive into his October 2020 JOSPT article, "Moving Beyond Weekly 'Distance': Optimizing Quantification of Training Load in Runners". How do you measure running load? What about wearables? Dr Paquette will bring you up to speed on the external and internal factors to consider when working with runners and how to figure out which factors are most relevant to the runner you’re working with. You can access Dr Paquette’s article for free at https://www.jospt.org/doi/10.2519/jospt.2020.9533
“My hip still hurts. I’m doing everything you’ve suggested, but it’s not getting better”. In this bonus episode, Dr Alison Grimaldi shares her approach to troubleshooting hip pain when things aren’t going as planned. For more from Dr Grimaldi, check out episode 3 of JOSPT Insights—a deep dive into gluteal tendinopathy and tendon loading.
JOSPT Editor of Patient and Public Partnerships Joletta Belton shares the story of her journey from physical therapy patient to pain patient advocate and describes a day in the life of her work in chronic pain rehabilitation.
Looking to hone your skills in managing hamstring injuries? We have you covered! To kick off 2021, Professor Bryan Heiderscheit shares his must-read articles of the past 5 years and how you can apply the results to level-up your clinical practice tomorrow.
Protecting the health of our best and brightest stars of the future holds a special place in Dr Jackie Whittaker's heart. How do you ensure youth athletes stay healthy and happy in sport, and what do you do if it goes pear-shaped? Dr Whittaker shares her tips, honed from years of clinical practice and field-leading research, on planning and managing return to sport after serious knee injury. Find the International Olympic Committee's paediatric ACL consensus statement at: https://pubmed.ncbi.nlm.nih.gov/29478021/
In Part 2 of our 2-episode interview, Dr Merv Travers walks through his experience of musculoskeletal trauma (and Lego), and the questions to ask patients about their beliefs and experiences of chronic pain. Dr Travers implores clinicians to adopt an anti-fragile mindset—placing exercise and movement at the top of the priority list for people with chronic pain.
Physical therapist, researcher, and strength & conditioning coach Dr Merv Travers kicks off Part 1 of a 2-episode dive into managing chronic pain by discussing what is known about using transcutaneous electrical nerve stimulation (TENS) for managing chronic pain. He shares how clinicians can rethink their approach to managing chronic pain to best help patients. Stay tuned for Part 2, available on Monday, December 7th.
Dr Stephanie Mathieson (Institute for Musculoskeletal Health, University of Sydney) is sounding the alarm and tackling the super-wicked problem of opioid prescription. She covers the opioid epidemic, why communication within the multidisciplinary team is critical to helping patients manage pain, and how musculoskeletal clinicians can be part of the solution to overuse of medicines. Dr Mathieson's work is nested in the WISER Healthcare collaboration, a leading multidisciplinary research collaboration focused on reducing overdiagnosis and overtreatment in health care.
Physical therapist, researcher, and runner Dr Jean-Francois Esculier, PT, PhD, from The Running Clinic and the University of British Columbia, is on a mission to help runners avoid injuries and perform well. Dr Esculier shares his views on choosing the right running shoes, including how he classifies shoes as minimalist or maximalist based on shoe weight, stack height, heel-to-toe drop, technology, and flexibility. We dive into the research on running shoes, changing a runner's gait, and how to apply the research in clinical practice. Physical therapist, runner, and JOSPT social media editor Paul Blazey asks the questions on today's episode.
It's time to put shoulder special tests out to pasture. In this episode, Drs Dan Chapman and Chelsea Cooman talk with Prof Jeremy Lewis and Dr Paul Salamh about their recent JOSPT Viewpoint article on the treatment of rotator cuff–related shoulder pain. Prof Lewis and Dr Salamh argue why imaging and shoulder special tests won’t help you identify structures that are contributing to symptoms, then lay out what a shoulder examination looks like without special tests and how to begin treatment.
Musculoskeletal disorders are the number one contributor to the number of years lived with disability, and osteoarthritis—which affects over 300 million people across the world—is one of the top contributors to global disability. Chances are, you have treated a patient with knee pain this week. So how did you approach that clinical session? Patients might ask for your advice when they are making a decision about knee surgery—what do you tell them? Professor Ewa Roos, international leader in exercise-based osteoarthritis care, joins JOSPT Insights to answer these questions and share her thoughts.
How much do you know about the social and economic factors that influence health? Did you know that the social determinants of health are central drivers of health inequities? Orthopaedic physical therapy leader Professor Chad Cook helps unmask the characteristics and factors that play a key role in how people access and experience health care. We look at what the social determinants of health are and why clinicians should care about them, then do a quick wrap-up of research on social determinants of musculoskeletal health.
Dr Amy Arundale, physical therapist and biomechanist with the Brooklyn Nets, gives you the low down on why you want to add clinical practice guidelines to your reading list. Guest host Dr Karen Litzy of Karen Litzy Physical Therapy and the Healthy Wealthy & Smart podcast asks the questions, diving into the knee and anterior cruciate ligament injury prevention guideline that Dr Arundale led, published in JOSPT in 2018, and exploring why Dr Arundale is a strong advocate for educating, collaborating, and consistently following up with athletes.
Are you spending your time reading worthwhile research articles? How can you tell if you should be integrating the findings into your practice? In this episode, Dr Chelsea Cooman and Dr Dan Chapman talk with Prof Steven Kamper about how to evaluate articles and how best to use the Physiotherapy Evidence Database (PEDro). They also quiz Dr Kamper, in a lightning round, on research concepts that he covers in his Evidence in Practice series in JOSPT. Finally, Dr Kamper tackles the question, "Is evidence-based practice simply cookbook medicine?"
“Concussion is a clinical diagnosis only.” As a concussion physical therapy specialist and someone with lived experience of concussion, Dr Jessica Schwartz provides sage advice about assessing concussion (orthopaedic, neurological, vestibular system, exercise tolerance) and progressing rehabilitation after concussion. She also shares her top tips for structuring your concussion assessment to help you prioritize rehabilitation.
Leading clinician-researcher Prof Ann Cools irons out the wrinkles of the rotator cuff and helps confidently design a quality exercise therapy program for people with degenerative rotator cuff tear. What are the main goals of exercise therapy? What types of exercises should you choose? Which exercises should you avoid? Tune in for answers to these questions and practical tips.
”Load management is not simply about resting”. Sport scientist and dual PhD Professor Tim Gabbett shares his philosophy on training load management and recovery and explains why athletes should be training smarter and harder. How do you know if an athlete has trained too much? What are the next major developments in training load monitoring? Listen to this episode for some answers.
”My hip hurts when I sit, sleep, and walk up stairs—what is the problem?” Dr Alison Grimaldi joins Dr Chelsea Cooman and Dr Dan Chapman to take a deep dive into gluteal tendinopathy: how to accurately diagnose lateral hip pain, typical symptoms to watch out for, and the best objective tests and measures. Dr Grimaldi shares her gluteal tendon loading progression, and expert tips on rehabilitation including patient education, gait cues, and posture adjustments.
“Do I really need this test, treatment, or procedure?” is the patient’s question. What is your answer? Orthopaedic physical therapy leader Professor Chad Cook wrestles the elephant in the treatment room: that there is too much measurement, too much diagnosis, and too much treatment in orthopaedic and sports practice. Tune in for top tips on how to avoid perpetuating too much musculoskeletal rehabilitation.
Quadriceps are Queen. Knee and ACL rehabilitation leader Professor Lynn Snyder-Mackler is a vocal advocate for quality rehabilitation. What should you include in an ACL rehabilitation program? How should you measure quadriceps strength? Which return-to-sport tests should you choose? In today’s episode, we disentangle fact from fiction.
The Journal of Orthopaedic & Sports Physical Therapy presents JOSPT Insights. Join host and Editor-in-Chief of JOSPT Dr Clare Ardern as she talks with experienced musculoskeletal rehabilitation clinicians and researchers, who share clinical tips and research discoveries. Sports physical therapists Dr Chelsea Cooman and Dr Dan Chapman are frequent co-hosts. Subscribe to receive new episodes as soon as they are available, every other Monday.