Calf strains are challenging for athletes and clinicians to manage—with uncertain return to play times and risks for reinjury if they're not managed well. Dr Brady Green (University of Notre Dame, Perth, Australia) shares his research and clinical expertise on muscle strains in elite and subelite athletes, including from his previous work in elite Australian football at the Essendon Football Club. Today's episode launches from Dr Green's latest study of the epidemiology of calf strains, and discusses how musculoskeletal rehabilitation specialists, including sports physical therapists, can use this information to guide their practice. ------------------------------ RESOURCES Gastrocnemius muscle strain injury epidemiology: https://www.jospt.org/doi/10.2519/jospt.2025.13526
Over the past decade, the term rotator cuff–related shoulder pain (RCRSP) has gained traction as a more accurate, patient-centered way to describe shoulder pain. In this episode, Dr Amy McDevitt (Physical Medicine and Rehabilitation Department, University of Colorado) joins Dan Chapman and Marquis Sanabrais to unpack why shifting from structural labels like impingement or tendinopathy toward RCRSP can improve both communication and care. They discuss how imaging often fails to match symptoms, why language matters for patient engagement, and how clinicians can explain shoulder pain without over-pathologizing. Take home messages: 1. RCRSP reflects the multifactorial nature of shoulder pain, biological, mechanical, and psychosocial. 2. Clear and non-anatomic terminology helps patients understand and buy into treatment. 3. Future research should clarify mechanisms behind exercise and refine subgroups within RCRSP. ------------------------------ RESOURCES The case for using "rotator cuff-related shoulder pain" in practice: https://www.jospt.org/doi/10.2519/jospt.2025.13405
Some of the most powerful drivers of change in musculoskeletal rehabilitation aren’t researchers or administrators—but clinicians working shoulder-to-shoulder with their peers. These so-called "local opinion leaders" often shape practice more effectively than top-down mandates or distant guidelines. And they're more than simply influencers or savvy social media marketers. In today's episode, Dr Seth Peterson explores how local opinion leaders—those trusted voices within clinical settings—can play a pivotal role in translating research into practice. Dr Peterson shares practical strategies for fostering cultures of learning and supporting clinicians to lead. Dr Peterson is a clinician-researcher based in Tucson, Arizona. He leads care at his clinic, The Motive, and teaches nationally with The Movement Brainery. ------------------------------ RESOURCES Empowering local opinion leaders in physical therapy systems: https://www.jospt.org/doi/10.2519/jospt.2025.13508 Why higher standards are needed in physical therapist professional development: https://www.jospt.org/doi/10.2519/jospt.2022.11377 2025 hip osteoarthritis clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2025.0301
Pain near the posteromedial tibia is common in running and jumping athletes. Laura Anderson, physiotherapist and PhD candidate, is challenging the diagnostic labels "shin splits" and "medial tibial stress syndrome", and suggesting a new term: "load-induced medial leg pain" (LIMP). In today's episode, Laura explores ways to improve how you diagnose and manage shin pain in athletes, including how you talk with athletes about their condition. She discusses loading, red flags and the role of running retraining. ------------------------------ RESOURCES Diagnosing medial tibial stress syndrome (including flow diagram): https://pubmed.ncbi.nlm.nih.gov/28179260/ Re-naming MTSS as Load Induced Medial Leg Pain (LIMP): https://www.jospt.org/doi/10.2519/jospt.2025.13411 Effectiveness of running gait retraining - systematic review: https://www.jospt.org/doi/10.2519/jospt.2022.10585
Over half of performing artists and artistic athletes report pelvic floor symptoms. Up to 80% of female artistic athletes report pelvic floor symptoms, yet many believe these issues—like urinary leakage during performance—are par for the course, part of the job. Today, Jessica Frydenberg explains who performing artists are, why they are particularly susceptible to pelvic floor symptoms, and what this means for your clinical practice. Jess is an experienced pelvic health physiotherapist and PhD candidate at La Trobe University in Melbourne, Australia. She has extensive experience working with performing artists, and recently led a systematic review investigating the epidemiology of pelvic floor symptoms in performing artists. ------------------------------ RESOURCES Prevalence and impact of pelvic floor symptoms systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13452
Who pays you, and how, for your work as a physical therapist? How health care is funded has implications for the way you work, and for the care that you can provide for patients. Societies all around the world are grappling with complex decisions about health care and how it is funded. Even more so as changing populations place different demands on health care systems, and as the health work force changes. Today, Dr Chris Bise (Assistant Professor, University of Pittsburgh) explains the changing face of health care funding, and what it means for the physical therapist. Chris has 25 years of experience as a physical therapist and health system analyst who studies value-based health care and physical therapy practice - trying to find better ways of funding health care to deliver outcomes that satisfy patients, clinicians and payers. ------------------------------ RESOURCES Building the foundation for value-based physical therapy: https://www.jospt.org/doi/10.2519/jospt.2025.13586 Perspectives for Payers - Heel pain/plantarfasciopathy: https://www.jospt.org/doi/10.2519/jospt.2025.0502 Perspectives for Payers - Achilles tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2025.0503
Welcome back to this explainer on health economics analyses in musculoskeletal rehabilitation. In part 1, Dr Codie Primeau explained the things you're looking for when reading a health economics analysis, to decide whether it's a good quality analysis. That's important because a good quality analysis can help you make decisions about whether the intervention being studied is worth considering. Today in part 2, we take things a step further to explore how you decide what "worthwhile" really means. Worth it for whom? The patient, your clinic, the health system, or even society? ------------------------------ RESOURCES From whose perspective is cost-effectiveness judged?: https://pmc.ncbi.nlm.nih.gov/articles/PMC6351264/ Review of health economics evaluations in hip and knee orthopaedics: https://pubmed.ncbi.nlm.nih.gov/34262974/
Whether you work in a solo private practice, or a large health network, no doubt you're considering costs when it comes to deciding what to change and perhaps what to implement - or de-implement - in your practice. Perhaps you're in the position of making decisions on behalf of a health service or you are trying to quantify and communicate the costs and benefits of treatments you study in a research setting? Today is part 1 of a 2-part chat with Dr Codie Primeau about health economics in musculoskeletal rehabilitation, which has something for everyone working in health care. We're covering how to read a health economics analysis to decide whether the analysis can help you navigate the complex decisions you're grappling with. Dr Primeau is a physiotherapist and Assistant Professor in the School of Physical Therapy at Western University in London, Canada, and an Affiliate Scientist with Arthritis Research Canada. His research focuses on arthritis, chronic pain, and pelvic health, using a blend of qualitative and quantitative methods to improve patient care and outcomes, including health economics evaluation. ------------------------------ RESOURCES From whose perspective is cost-effectiveness judged?: https://pmc.ncbi.nlm.nih.gov/articles/PMC6351264/ Review of health economics evaluations in hip and knee orthopaedics: https://pubmed.ncbi.nlm.nih.gov/34262974/
Wondering about whether large language models (generative AI) like ChatGPT, Co-Pilot or Claude, to name just a few, could add value to your clinical practice? Drs Mark Vorensky and Daniel Peredo (Rutgers University; NYU Langone Health) discuss the field of 'prompt engineering' - the approach to structuring and crafting the instructions (a.k.a. prompt) given to a generative AI model, to describe the task that the AI should perform. The quality of the output from generative AI is highly dependent on how the model is prompted. So, if you're looking to get the best out of generative AI, tune in! ------------------------------ RESOURCES Improving ChatGPT's performance using the CRISPE framework: https://www.jospt.org/doi/10.2519/josptmethods.2025.0151 Neck pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2017.0302
How do you think about supporting athletes to return to running after injury? Andrew Mitchell is someone who has thought about it a lot, and refined his approach over years of practice in top football/soccer. In today's episode, Andrew outlines the 5 elements of his criteria-based approach. Andrew is a sports physiotherapist and strength & conditioning practitioner with experience working in the hospital, private practice and professional sport arenas, including in the English Premier League, the German Bundesliga and the European Champions League. ------------------------------ RESOURCES Evidence-informed return-to-running framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0115 Criteria-based return-to-performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240 On the path to perfoming after injury (ep 193): https://pod.link/1522929437/episode/NmEzODliMjAtYmIyZi00YzkwLWIwMzctNjU3NzI4NTY3ZWUz
What's the latest thinking in managing patellofemoral pain? Drs Erin Macri (Erasmus MC University Medical Centre, The Netherlands) and Harvi Hart (Michigan State University) join JOSPT Insights ahead of the International Patellofemoral Research Network meeting to share the latest in patellofemoral research, and what it means for clinical practice. ------------------------------ RESOURCES JOSPT Insights Ep 229: Best practice in managing patellofemoral pain, with Dr Brad Neal: https://pod.link/1522929437/episode/ZDBkY2Q0ZDYtMzNhZS00OWVjLWJlYTQtNTYwMzBkZTVhM2Iw Patellofemoral pain CPG: https://www.jospt.org/doi/10.2519/jospt.2019.0302 Clinical priorities for psychological factors in patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2022.10647 Prognosis for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2025.13491 Find out more about the International Patellofemoral Research Network's work: https://ipfrn.org/
Recurrent back pain is common, and debilitating for some people. What if there was a simple, low cost way to prevent these recurring flare ups of back pain? Dr Tash Pocovi (Macquarie University, Sydney, Australia) explains the research she's been leading to test a walking + education program for preventing recurrent back pain. Dr Pocovi's research focuses on improving how low back pain is managed, and especially how it is prevented. ------------------------------ RESOURCES Walking, cycling and swimming for nonspecific low back pain systematic review: https://www.jospt.org/doi/10.2519/jospt.2022.10612 WalkBack trial: https://pubmed.ncbi.nlm.nih.gov/38908392/ Effect of WalkBack on duration and severity of recurrences of back pain: https://www.jospt.org/doi/10.2519/jospt.2025.13361
The latest update to the midportion Achilles tendinopathy Clinical Practice Guideline is live! Dr Ruth Chimenti is a co-author of the updated clinical practice guideline, “Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2024”, and joins JOSPT Insights to share the key updates relevant for your practice. Dr Chimenti highlights the most important changes from the last CPG update in 2018, including specifics on the best way to exercise, how to approach patient education, and which modalities to consider. ------------------------------ RESOURCES Updated Achilles CPG: https://www.jospt.org/doi/10.2519/jospt.2024.0302 (no paywall) ICON 2019: International Scientific Tendinopathy Symposium consensus on terminology: https://pubmed.ncbi.nlm.nih.gov/31399426/ ICON 2020: International Scientific Tendinopathy Symposium consensus on psychological outcome measures: https://www.jospt.org/doi/10.2519/jospt.2022.11005 Dutch multidisciplinary guideline on Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34187784/ TENDINopathy Severity Assessment - Achilles (TENDINS-A) outcome measure: https://www.jospt.org/doi/10.2519/jospt.2023.11964
The anterior talofibular ligament (ATFL) and the Achilles tendon captures much of our ankle attention. As JOSPT Insights listeners know, there's plenty more to the ankle than the ATFL. Today, Liz Bayley shares her approach to diagnosing, managing and ideally, preventing ankle pain in active people. Liz covers diagnosing the problem, where imaging fits, and how to support return to function, including high-level sport. Liz is a former professional dancer, who now works as a dance-specialist physiotherapist. Her clinic is in London's West End, in close proximity to the freelance professional and student dancers she works with, at Trinity Laban Conservatoire of Music and Dance, and on 'Matilda The Musical' in Covent Garden. ------------------------------ RESOURCES Lateral ankle ligament sprains clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2021.0302 Updated model of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/31162943/ Predictors of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/26912285/ Intrinsic foot muscle training systematic review: https://pubmed.ncbi.nlm.nih.gov/35724360/ Neuromuscular electrical stimulation for foot intrinsic muscles: https://pubmed.ncbi.nlm.nih.gov/35142810/
Clinicians appreciate the value of a trustworthy clinical practice guideline for helping guide decisions in practice. Professor François Desmeules (University of Montréal) led an international team of shoulder experts who synthesised the latest evidence on diagnosing and non-surgically managing rotator cuff tendinopathy. Today he shares the headlines of the CPG and explains how the guideline group made sense of all the evidence to come up with recommendations for assessment, diagnosis, treatment and prognosis, including return to sport. ------------------------------ RESOURCES Rotator cuff tendinopathy diagnosis, non-surgical medical care and rehabilitation CPG: https://www.jospt.org/doi/10.2519/jospt.2025.13182
Today, we continue the conversation on the latest consensus for managing acute and degenerative meniscus tears. We jump into non-surgical treatment, and all the return to sport considerations for athletes and active people with meniscus injury. Dr Arielle Giordano (University of Delaware) shares the results of the EU-US Meniscus Rehabilitation Consensus. ------------------------------ RESOURCES EU-US Meniscus Rehabilitation Consensus on prevention, non-operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539 DREAM trial primary report: https://pubmed.ncbi.nlm.nih.gov/38319181/ Should symptoms guide treatment choice in young patients? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/ Early surgery vs exercise therapy + education for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245 Ep 224: Saving the meniscus: https://pod.link/1522929437/episode/NTg3YTgzZWUtYTZjZC00ZDYwLWI2OTAtYTczMzAzNTEyNzgz Ep 192: DREAMing of better care for meniscus tears: https://pod.link/1522929437/episode/Yzk2YzkyOWItMDk1MS00YWZkLWI2MjQtNmRlYjIwZGJmOTg0
Clinical Practice Guidelines (CPGs) are an incredible resource for clinicians of all experience levels—synthesizing all the research on a topic and packaging it into bite-sized recommendations and flow charts. But how often are clinicians adhering to these guidelines? In today’s episode, Dr Maggie Horn (Duke University) walks us through her research team’s work to assess if, how, and when clinicians follow CPG recommendations. The team worked with clinicians in their hospital system to embed templates in the EMR, and used self-report strategies to answer these questions, specifically for the neck pain CPG. Dr Horn reviews the neck pain CPG, how the research team evaluated adherence, and what the findings mean for CPGs and clinicians. ------------------------------ RESOURCES Neck pain clinical practice guideline (revised in 2017): https://www.jospt.org/doi/10.2519/jospt.2017.0302 Translating the neck pain CPG into practice framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0101
No doubt you've come across people using the analogy of a broken down machine to describe an osteoarthritic joint. Or perhaps that too much loading on the joint is responsible for wearing it out - assuming that each joint has a finite number of movements in its lifetime. You've probably also heard from patients who are concerned that the exercise therapy you prescribe might do more harm to their already worn-out joint. But is that true? Today, Dr Alessio Bricca (Centre for Muscle and Joint Health, University of Southern Denmark) explores the evidence and refutes these beliefs. ------------------------------ RESOURCES Exercise Therapy "Wears Down" My Knee Joint: Myth or Reality?: https://www.jospt.org/doi/10.2519/jospt.2025.13069
Today is part 2 of a 2-part chat about hip health and training load for the youth athlete. Last episode, Dr Sara Lyn Terrell (Florida Southern College) discussed the developing hip, and the important distinction between primary cam morphology and femoroacetabular impingement syndrome. Many athletes have a bony bump on their hip that doesn't cause any problems - it's the morphology in combination with symptoms that clinicians might worry about. Today's episode builds on the foundation of the developing hip, and covers appropriate loads for youth athletes. Dr Terrell discusses how to plan, monitor and progress a loading programs, and how you might incorporate strength & conditioning principles into your practice. ------------------------------ RESOURCES Strategies to deter primary cam morphology in youth athletes: https://www.jospt.org/doi/10.2519/josptopen.2025.0128 Can we reduce injury risk during the adolescent growth spurt?: https://pubmed.ncbi.nlm.nih.gov/37823577/ “My kid is going through a growth spurt – what should I do?”: https://shorturl.at/FqqCM
The hip health of youth athletes as their skeletons grow and mature while the athlete copes with the physical and mental stressors of sport and life, has been receiving renewed attention. Today's episode of JOSPT Insights is part 1 of a 2-part chat about training load and the youth athlete's hip. We discuss how primary cam morphology and femoroacetabular impingement syndrome might develop. Dr Sara Lynn Terrell (Florida Southern College) shares her >20 years of experience in exercise science and strength & conditioning, and walks listeners through the complexity of working with youth athletes to support their best sports performance. ------------------------------ RESOURCES Strategies to deter primary cam morphology in youth athletes: https://www.jospt.org/doi/10.2519/josptopen.2025.0128 Oxford consensus on primary cam morphology and FAI (part 1): https://pubmed.ncbi.nlm.nih.gov/36588401/ Oxford consensus on primary cam morphology and FAI (part 2): https://pubmed.ncbi.nlm.nih.gov/36588402/
J
great talk Steve.