JOSPT Insights

Does the ACL have the capacity to heal following injury? And if it does, what might that mean for how clinicians approach ACL rehabilitation? The prevailing assumption has been that a ruptured ACL has limited capacity to heal and restore structural continuity without reconstruction. Now, a growing body of research is challenging that assumption. In today's episode, Professor Joanna Kvist (Linköping University, Sweden) discusses new findings from the NACOX cohort examining how ACL structure changes on MRI during the first 2 years following acute ACL injury. Dr Kvist and her team found that ACL structure and fiber continuity improved over time in many participants managed without ACL reconstruction, and greater ACL continuity was associated with less knee laxity on objective measurement. Dr Kvist explains what the ACL looked like on MRI over those 2 years, the changes in ligament thickness and fiber continuity, how those structural findings related to clinical outcomes, and what clinicians should (and…

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

How many patients describe receiving what sounds like inadequate care for osteoarthritis before they reached your clinic? Osteoarthritis is one of the most common chronic musculoskeletal conditions. When there are many trustworthy, international clinical guidelines that clearly outline what best-practice osteoarthritis care should entail, why are so many patients missing out on high-value care? Today's guest, Dr Jodi Young, discusses her team's analysis of data from nearly 25,000 patients who received osteoarthritis care in the United States, and what these data say about osteoarthritis care. Dr Young is the Director of Research for the Doctor of Science in Physical Therapy program at Bellin College in Green Bay, Wisconsin. She is also a fellow of the American Academy of Orthopaedic Manual Physical Therapists. ------------------------------ RESOURCES Real-world use of exercise and manual therapy for managing knee osteoarthritis: https://www.jospt.org/doi/10.2519/josptopen.2026.0221 Opioid prescribing to…

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

Psychological factors like a person's thoughts, beliefs and emotions can exert a strong influence on rehabilitation outcomes for people with chronic musculoskeletal conditions. When a person has pain, they might feel scared to move or convinced that moving in a certain way will damage their body. Today's discussion focuses on how a person's thoughts about shoulder pain can change over an 8-week exercise-based rehabilitation program, and the implications for how musculoskeletal rehabilitation clinicians approach discussions about fear and moving with the patients you work with. Dr Courtney Mears and Dr Matthew Heindel discuss their recent JOSPT publication (linked below). Dr Mears is a physical therapist at the University of Southern California, and a researcher in the Clinical Biomechanics Orthopedic and Sports Outcomes Research Lab. Her research focuses on understanding the relationship between psychosocial factors, shoulder pain, and functional outcomes. Dr Heindel is a physical therapist, and a…

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

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

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:…

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…

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…

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…

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…

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):…

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…

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…

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…

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:…

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…

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…

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

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

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

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…

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…

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…

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…

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…

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…

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:…

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:…