JOSPT Insights

Ep 216: Latest clinical recommendations for rotator cuff tendinopathy, with Dr François Desmeules Feb 17, 2025

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.

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RESOURCES

Rotator cuff tendinopathy diagnosis, non-surgical medical care and rehabilitation CPG: https://www.jospt.org/doi/10.2519/jospt.2025.13182

Ep 215: Assessing pain in athletes, with Ciarán Purcell Feb 10, 2025

How do you approach assessing pain when you're working with athletes? What tools do you find most helpful?

Today, sports physiotherapist and researcher, Ciarán Purcell (University of Limerick, Ireland) describes the project he is leading to gather consensus from athletes and sports medicine & rehabilitation clinicians about how best to assess athletes' pain. Listen to the end to learn about how you can get involved in the consensus!

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RESOURCES

IOC consensus on managing pain in elite athletes: https://pubmed.ncbi.nlm.nih.gov/28827314/

Framework for assessing upper and lower limb pain in athletes: https://www.jospt.org/doi/10.2519/jospt.2024.12807

Scoping review of tools for assessing pain in athletes: https://pubmed.ncbi.nlm.nih.gov/36759138/

To get in touch with Ciarán about the consensus project, email ciaran.purcell@ul.ie

Ep 214: What's new in treating Achilles tendinopathy? with Dr Ruth Chimenti Feb 03, 2025

The latest update to the midportion Achilles tendinopathy Clinical Practice Guideline is hot off the presses!

Dr Ruth Chimenti is a co-author of the updated clinical practice guideline, “Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2024”, and joins JOSPT Insights to share the key updates relevant for your practice.

Dr Chimenti highlights the most important changes from the last CPG update in 2018, including specifics on the best way to exercise, how to approach patient education, and which modalities to consider.

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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/

Ep 213: What women want to know after knee injury, with Melissa Haberfield Jan 27, 2025

Did you know that only about 10% of the participants in sports medicine and sports physical therapy research are women?

When people are under-represented in research, it might mean that clinicians and researchers miss key concerns of women and girls when working with them to achieve the best outcomes of treatment.

Melissa Haberfield - physiotherapist and PhD candidate at the La Trobe Sports and Exercise Medicine Research Centre in Melbourne, Australia - shares the results of her work with women who have experienced serious knee injury, about what they wanted to know about managing knee health.

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RESOURCES

Systematic review of self-reported activity and knee-related outcomes after ACL injury (sex and gender differences): https://pubmed.ncbi.nlm.nih.gov/36889918/

Sex/gender equity in sport and exercise medicine/physical therapy publishing: https://pubmed.ncbi.nlm.nih.gov/36631242/

What do women (with serious knee injury) want to know about knee health (article): https://www.jospt.org/doi/10.2519/jospt.2025.12869

Ep 212: REVISITED: "Is running bad for my knees?", with Dr Jean François Esculier Jan 20, 2025

You don't have to go far to find a media story warning people off the high impacts of running, especially on concrete, and claiming that running is no good for your knees.

Maybe you've had someone in the clinic who worries that running will wear their joints out? Today's guest has dedicated his career to helping runners stay healthy and running for life, and is adamant that running is a great physical activity choice, even for people with osteoarthritis and joint replacement.

Dr Jean François Esculier is a physiotherapist based in Kelowna, Canada. He leads the Research & Development team at The Running Clinic, and teaches at The University of British Columbia; his clinical practice is at MoveMed Physiotherapy.

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RESOURCES

Survey about perceptions on running and knee health: https://pubmed.ncbi.nlm.nih.gov/36199830/

Education resource on running and joint health, in 7 languages: http://hdl.handle.net/2429/82767

Evaluation of the education resource: https://www.jospt.org/doi/10.2519/josptopen.2024.0149

Free webinar (account required) about the influence of running on cartilage: https://therunningclinic.com/tv/?VideoId=185711&SelectedCategory=185731

Running with osteoarthritis case report: https://pubmed.ncbi.nlm.nih.gov/38725598/

Ep 211: REVISITED: Gimme an N-M-E-S (stimulator)! With Drs Elanna Arhos & Naoaki Ito Jan 13, 2025

In today's part 2 of an NMES masterclass from Dr Elanna Arhos (Northwestern University) and Dr Naoaki Ito (University of Wisconsin - Madison), we're getting into the nitty gritty of how to support patients to get the most out of a very beneficial intervention. Drs Arhos and Ito, and their team have tested a mix of common stimulators available on the market today, and are here to share the results with us. Let them help you make an informed decision about your next equipment purchase for your clinic.

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RESOURCES

Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028

Ep 210: REVISITED: Dose your NMES for success, with Drs Elanna Arhos & Naoaki Ito Jan 06, 2025

Neuromuscular electrical stimulation (NMES) hasn't quite had the coverage it deserves, especially when one considers the strength of evidence supporting NMES as a musculoskeletal rehabilitation intervention

Today, Drs Elanna Arhos (Northwestern University) and Naoaki Ito (University of Wisconsin - Madison) are re-visiting how NMES is applied in sports clinical practice. Get the low-down on why you need NMES in your sports rehabilitation toolkit, and how to figure out dose and intensity.

In part 2 we discuss how to support patients to get the most out of NMES, and which equipment is best for your clinic.

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RESOURCES

Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028

Ep 209: REVISITED: Saying "hasta la vista" to injections for tendinopathy, with Dr Robert-Jan de Vos Dec 30, 2024

Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy.

In part 2 of this series, Dr de Vos covers the multitude of options for treatment, outside of exercise therapy. Should you and the patient consider corticosteroid injections, PRP injections, heel lifts, shockwave, NSAIDs, or surgery? And when? What are the important clinical considerations when patients choose these options? Part 2 has it all!

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RESOURCES

Terminating corticosteroid injection in tendinopathy? https://www.jospt.org/doi/10.2519/jospt.2023.11875/

Dutch multidisciplinary guideline on Achilles tendinopathy: (https://pubmed.ncbi.nlm.nih.gov/34187784/

Platelet-rich plasma injection for chronic Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/20068208/

Time to put down the scalpel when treating tendinopathy? https://pubmed.ncbi.nlm.nih.gov/31653777/

Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/

Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/

Clinical tool for identifying spondyloarthropathy: http://tinyurl.com/3my87hma

More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/

Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/

Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/

Achilles Pain, Stiffness, and Muscle Power Deficits - 2024 updated clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2024.0302

Ep 208: REVISITED: Getting your tendinopathy diagnosis and treatment right, with Dr Robert-Jan de Vos Dec 23, 2024

Dr Robert-Jan de Vos, sports physician and associate professor at Erasmus Medical Centre in Rotterdam, The Netherlands, dives deep into all things Achilles tendinopathy. As lead author of the Dutch Multidisciplinary Guideline on Achilles Tendinopathy (https://pubmed.ncbi.nlm.nih.gov/34187784/), he shares the key messages from this in-depth review.

In today’s episode, Dr de Vos covers the important tendon anatomy to guide your differential diagnosis, what information he is most focused on communicating to patients, and the key factors that can affect your choices when managing Achilles tendinopathy.

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RESOURCES

Why tendons like load: https://pubmed.ncbi.nlm.nih.gov/29920664/

Clinical diagnosis of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/34692248/

Clinical tool for identifying spondyloarthropathy: https://www.researchgate.net/profile/Paul-Kirwan/publication/332275130_D18_SCREEND%27EM_BEFORE_YOU_TREAT%27EM_A_CLINICAL_TOOL_TO_HELP_IDENTIFY_SPONDYLOARTHROPATHY_IN_PATIENTS_WITH_TENDINOPATHY/links/5cab530da6fdcca26d06aaf1/D18-SCREENDEM-BEFORE-YOU-TREATEM-A-CLINICAL-TOOL-TO-HELP-IDENTIFY-SPONDYLOARTHROPATHY-IN-PATIENTS-WITH-TENDINOPATHY.pdf

More on the pain monitoring model: https://pubmed.ncbi.nlm.nih.gov/17307888/

Dosing your resistance training in tendinopathy: https://pubmed.ncbi.nlm.nih.gov/37169370/

Best treatment for Achilles tendinopathy (living systematic review): https://pubmed.ncbi.nlm.nih.gov/32522732/

Achilles Pain, Stiffness, and Muscle Power Deficits - updated clinical practice guideline from AOPT: https://www.jospt.org/doi/10.2519/jospt.2024.0302

Ep 207: The intervention effect or the vibe? With Dr Giacomo Rossettini Dec 16, 2024

When patients improve following treatment, how much can be attributed to the intervention delivered, and how much is due to contextual factors and nonspecific effects that lie outside of the clinician's control?

Dr. Giacomo Rossettini joins the podcast again as a co-author of a paper (link below) that answers that very question.

Dr. Rossettini and his research colleagues tried to quantify the effect of contextual factors with a meta-analysis. They found non-specific effects play a big role in patients' outcomes. Today's discussion covers what these contextual factors are, how the researchers quantified them, and how musculoskeletal rehabilitation clinicians can harness non-specific effects to boost patients' outcomes.

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RESOURCES

Non-specific effects in musculoskeletal pain treatment outcomes (meta-analysis): https://www.jospt.org/doi/10.2519/jospt.2024.12126

Ep 206: Managing musicians' musculoskeletal health, with Marianne Roos Dec 09, 2024

Musicians and athletes might sometimes appear to exist in very different cultures. And yet, the single-minded focus, thousands of hours of practice, and high training loads on their musculoskeletal systems mean that musicians and athletes probably have more in common than they have differences. At least from a musculoskeletal rehabilitation perspective.

Today's guest is Marianne Roos - a former clarinetist and forever musician-at-heart, who now practices as a physiotherapist and conducts her PhD research from Laval University, Canada. Marianne explains the physical and psychological demands of orchestra performance on the musician's body, and shares the results of her PhD research in developing programmes to reduce musculoskeletal injuries among orchestra musicians.

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RESOURCES

Barriers and facilitators to implementing rehabilitation and wellness programs for orchestral musicians: https://pubmed.ncbi.nlm.nih.gov/33853373/

Workplace injury prevention and wellness program for orchestra musicians: https://www.jospt.org/doi/10.2519/jospt.2024.12277

Ep 205: Returning to college sport after ACL reconstruction, with Dr Cortez Brown Dec 04, 2024

When it comes to serious injury, like an ACL tear, in college sport, how many young athletes return to their previous level of performance?

Today's guest led a team that has done the hard yards of synthesising all the available data to find an answer.

Dr Cortez Brown is a junior orthopaedic surgery resident at the University of Pittsburgh Medical Centre.

In today's episode, Dr Brown shares the results of his systematic review, and guides listeners through the complex factors that affect return to play outcomes for college athletes.

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RESOURCES

Return to college sport after ACL reconstruction systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12483

Systematic review of return to competitive sport (all levels) after ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/25157180/

Ep 204: Expanding roles for musculoskeletal rehabilitation clinicians, with Dr Simon Lafrance Nov 25, 2024

Ballooning wait times, overworked and burnt out staff. No doubt you're only too familiar with the signs of a health system that's under serious strain. And not just since the Covid-19 pandemic.

Simon Lafrance, physiotherapist and researcher from the University of Montreal, explains musculoskeletal care models that flip the traditional medical model of the doctor as the first contact point a patient has with the health system, to a musculoskeletal specialist, like a physical therapist, leading instead.

Simon's clinical work and research work merge as he works to develop and evaluate advance practice physiotherapy models.

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RESOURCES

Trial of single vs. multiple sessions of advanced practice physiotherapy: https://www.jospt.org/doi/10.2519/jospt.2024.12618

Ep 203: Helping new mothers to move more, with Dr Jenna Schulz Nov 18, 2024

Musculoskeletal rehabilitation clinicians are well versed in the physical and mental benefits of regular physical activity. Unfortunately there is limited evidence to guide clinicians on how to best support return to sport and physical activity after childbirth. That's where today's guest comes in.

Dr Jenna Schulz (physiotherapist and postdoctoral researcher from Western University, Canada) specializes in pelvic health and sport, women’s health, and improving longevity in sport for females across the lifespan. Today, Jenna shares how she approaches supporting physical and mental readiness for sport postpartum, and when to refer to your colleagues in the multidisciplinary health care team.

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RESOURCES

Systematic review of exercise interventions for physical activity and cardiorespiratory fitness: https://www.jospt.org/doi/10.2519/jospt.2024.12666

Scoping review of guidelines for returning to physical activity and sport postpartum: https://pubmed.ncbi.nlm.nih.gov/37898507/

Relative Energy Deficiency in Sport (REDs) and the lactating athlete: https://pubmed.ncbi.nlm.nih.gov/37752008/

Ep 202: Boosting access to outpatient physical therapy for all, with Dr Roy Film Nov 11, 2024

Most people who pursue a career in health care do so because they want to help people. Depending on where you work, patients might find it easier or harder to access high-value musculoskeletal care, and you might run into barriers to providing the care you would like to provide.

Dr Roy Film is a physical therapist, educator and current President of APTA Maryland. In today's episode, Roy explains his work trying to make it easier for people to choose high-value musculoskeletal rehabilitation.

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RESOURCES

Racial disparities in outpatient PT use: https://www.jospt.org/doi/10.2519/jospt.2024.12641

Ep 201: A note to my newly-graduated self, with Jared Powell Oct 28, 2024

The complex world of clinical practice in musculoskeletal rehabilitation brings many challenges. Some you might feel prepared for, while others...not so much.

Musculoskeletal physiotherapist and shoulder specialist, Jared Powell, is here to reassure us that no-one expects you to have all the answers, encourage us all to think carefully and critically when evaluating information, and to embrace a work-related niche that resonates with your passions and strengths.

Jared shares ideas on how to succeed as a compassionate and effective musculoskeletal rehabilitation specialist.

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RESOURCES

"Dear newly graduated physical therapst" article: https://www.jospt.org/doi/10.2519/jospt.2024.12676

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The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours.

Registration and information: https://tinyurl.com/3xkcrtu2

Ep 200: Excellent exercise for shaky shoulders, with Dr Karen McCreesh Oct 21, 2024

Today brings a refresher on best practice in managing non-traumatic shoulder pain.

Professor Karen McCreesh (University of Limerick) guides the listener to the best available clinical practice guidelines and runs the ruler over different approaches to exercise therapy.

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RESOURCES

Diagnosing, managing and supporting return to work for people with rotator cuff disorders (practice guideline): https://www.jospt.org/doi/10.2519/jospt.2022.11306

Efficacy of exercise therapy - systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12453

GRASP trial: https://pubmed.ncbi.nlm.nih.gov/34382931/

JOSPT Insights episode 173 (shared decision making): https://podcasts.apple.com/ca/podcast/ep-173-shared-decision-making-what-it-is-and-what-it/id1522929437?i=1000651049481 or https://open.spotify.com/episode/6CCh5FRTGAsz54bdpWbYGB?si=c40b2c227eb94a12

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The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours.

Registration and information: https://tinyurl.com/3xkcrtu2

Ep 199: What do people with back pain want? with Dr Giovanni Ferreira Oct 14, 2024

If you consult a clinical practice guideline for any musculoskeletal condition, you'll probably see advice and education included as part of the recommendations for helping someone manage their musculoskeletal pain.

How well do the recommendations in clinical practice guidelines about what topics advice and education should cover align with the main concerns of people with back pain?

Dr Giovanni Ferreira (University of Sydney) joins JOSPT Insights to explain.

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RESOURCES

Concerns of people with acute back pain: https://www.jospt.org/doi/10.2519/jospt.2024.12571

AI chatbots answering questions about low back pain: https://pubmed.ncbi.nlm.nih.gov/39299722/

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The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours.

Registration and information: https://tinyurl.com/3xkcrtu2

Ep 198: Careers in sports medicine, with Dr Ciara Burgi Oct 07, 2024

Today's episode takes the spirit of our popular SPORTS CORNER series, and flips it to learning about playing a leading role in the world of sports medicine and rehabilitation.

Dr Ciara Burgi has worked across collegiate, professional men's, and professional women's sport, and has a ton of wisdom to share.

From building rapport with athletes and patients, to valuing your work in the present without looking too far ahead to what might (or might not) come next, and doing what you can with the resources at your disposal, are among the topics Dr Burgi covers.

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RESOURCES

The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the extended early-bird price and the opportunity for up to 13 continuing education contact hours.

Registration and information: https://tinyurl.com/3xkcrtu2

Ep 197: SPORTS CORNER: Shouldering the handball load (plus bonus mini-masterclass!), with Dr Martin Asker Sep 30, 2024

In this episode, we throw ourselves into the world of team handball with Dr Martin Asker (Sophiahemmet University, Sweden).

If your exposure to handball is every 4 years at the Olympic Games, we've got you covered with a review of the game and the demands of the sport.

Martin's shoulder expertise shines as he covers the common injuries and key things to keep in mind while treating these tricky, well-rounded athletes.

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RESOURCES

Handball Medicine & Science website: https://www.handballmedicine.com/

Bern consensus on managing shoulder injuries in athletes: https://www.jospt.org/doi/10.2519/jospt.2022.10952

Ep 196: Taking care of strength business in ACL rehabilitation, with Olivia Barbosa Sep 23, 2024

Muscle strength is a core focus of many sports injury rehabilitation programmes, and often a prominent discharge criterion. Today's guest has an important message about the uninjured limb in ACL rehabilitation: "beware the moving target of strength".

Olivia Barbosa is a sports physiotherapist with over a decade of experience in soccer and rugby. She currently works at the Aspetar Orthopaedic & Sports Medicine Hospital where she contributes to the concussion and the ACL clinical teams, and does research focused on muscle activation and strength recovery in ACL rehabilitation.

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RESOURCES

More on changes in quadriceps and hamstrings muscle strength over rehabilitation: https://www.jospt.org/doi/10.2519/jospt.2023.11961

Aspetar ACL rehabilitation clinical practice guideline: https://www.aspetar.com/en/professionals/aspetar-clinical-guidelines/recommendations-on-rehabilitation-after-aclr

Ep 195: Building a career in high-performance sports medicine, with Dr Enda King Sep 16, 2024

Ever wondered what a day in the life of a busy sports medicine clinic and research unit looks like?

Dr Enda King combines his roles as a sports physiotherapist, strength and conditioning coach, researcher, and educator through his work with individual athletes and elite teams across a spectrum of sports and disciplines.

Currently, he is the Head of Elite Performance and Development at the Aspetar Orthopaedic & Sports Medicine Hospital in Doha, Qatar.

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RESOURCES

For more on the Aspetar International Sports Medicine Conference - complete guide to thigh muscle injuries (November 2024): https://www.aspetar.com/en/professionals/our-events/complete-guide-to-thigh-muscle-injuries

Ep 194: Teaching runners to RUNSAFE, with Dr Rasmus Nielsen Sep 09, 2024

Today's episode is all about running load and injuries. Dr Rasmus Nielsen (Aarhus University, Denmark) leads the RUNSAFE research group, and today he provides an update on the latest research in running-related injuries.

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RESOURCES

Garmin-RUNSAFE Study (injury data from >7000 runners in 87 countries): https://www.jospt.org/doi/10.2519/jospt.2023.11959

Garmin-RUNSAFE Study protocol: https://pubmed.ncbi.nlm.nih.gov/31494626/

Changing distance and the association with injuries: https://www.jospt.org/doi/10.2519/jospt.2019.8541

Ep 193: On the path to performing after injury, with Andrew Mitchell Sep 02, 2024

Andrew Mitchell (RB Leipzig) knows a thing or two about supporting athletes to return to play after injury, especially in professional football/soccer.

Today, Andrew explains his return to performance pathway, which is a criteria-based approach to help you and the athlete keep focused on the athlete's return to performance goal.

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RESOURCES

Andrew's return to performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240

Clinical pearls for supporting return to performance: https://www.jospt.org/doi/10.2519/josptcases.2021.0103

Control-chaos continuum for progressing rehabilitation: https://pubmed.ncbi.nlm.nih.gov/30737202/

On-field rehabilitation progression (part 1): https://www.jospt.org/doi/10.2519/jospt.2019.8954

On-field rehabilitation progression (part 2): https://www.jospt.org/doi/10.2519/jospt.2019.8952

Ep 192: DREAMing of better care for meniscus tears, with Drs Jonas Thorlund and Søren Skou Aug 19, 2024

A thirty-year-old woman, who plays social basketball once each week and goes to the climbing gym at least twice each week, has been diagnosed with a traumatic medial meniscus tear.

The woman was told that surgery is the only way to 'fix' her knee so she can get back to basketball and climbing. But is that really what the research evidence says?

Professors Jonas Thorlund and Søren Skou (University of Southern Denmark) share the key findings of their DREAM trial, and its clinical implications for managing traumatic meniscal tears.

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RESOURCES

DREAM trial report: https://pubmed.ncbi.nlm.nih.gov/38319181/

STARR trial report: https://pubmed.ncbi.nlm.nih.gov/35676079/

Comparing treatment strategies for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245

Should symptom onset guide treatment choice for meniscus tears? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/

Ep 191: SPORTS CORNER in the WNBA, with Dr Kala Flagg Aug 12, 2024

Dr Kala Flagg of the Washington Mystics answers the classic Sports Corner questions for high-level women's basketball. She covers the demands of the sport, the most common injuries, and key things to plan for during injury rehabilitation.

Considering playing style, shoe fit, and physical fitness are all in a day's work when supporting high-level women's basketball athletes to perform at their best.

Ep 190: Progressing the visual-cognitive control chaos continuum, with Dr Meredith Chaput (part 2) Aug 05, 2024

Today's episode builds on last week's discussion of how changes in the way that the nervous system works after injury can compensate for impairments like joint instability, pain and muscle inhibition.

Dr Meredith Chaput (University of Central Florida) extends the 5 phases of the visual-cognitive control chaos continuum, to link the ways to assess for cognitive compensations and how to progressively load the visual-cognitive system during sports injury rehabilitation.

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RESOURCES

From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443

The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

Ep 189: Training the brain for the chaos of sport, with Dr Meredith Chaput (part 1) Jul 29, 2024

Sports injury rehabilitation has moved well beyond simply focusing on physical function and recovery. There's various emphases on psychological responses to injury, mental readiness to return to sport, and now, the visual-cognitive components of recovery and return to sport.

Today, Dr Meredith Chaput (University of Central Florida) introduces the visual-cognitive control chaos continuum as a framework for sports injury rehabilitation. Her research uses functional MRI to evaluate neuroplasticity after knee injuries, focusing on understanding how people use visual attention to compensate for motor control, and how rehabilitation may better target these compensations.

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RESOURCES

From control to chaos - visual-cognitive progression during recovery: https://www.jospt.org/doi/10.2519/jospt.2024.12443

The control-chaos continuum adapted to basketball: https://www.jospt.org/doi/10.2519/jospt.2023.11981

Ep 188: "Is running bad for my knees?" with Dr Jean-François Esculier Jul 22, 2024

You don't have to go far to find a media story warning people off the high impacts of running, especially on concrete, and claiming that running is no good for your knees.

Maybe you've had someone in the clinic who worries that running will wear their joints out? My guest today has dedicated his career to helping runners stay healthy and running for life, and is adamant that running is a great physical activity choice, even for people with osteoarthritis and joint replacement.

Dr Jean François Esculier is a physiotherapist based in Kelowna, Canada. He leads the Research & Development team at The Running Clinic, and teaches at The University of British Columbia; his clinical practice is at MoveMed Physiotherapy.

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RESOURCES

Survey about perceptions on running and knee health: https://pubmed.ncbi.nlm.nih.gov/36199830/

Education resource on running and joint health, in 7 languages: http://hdl.handle.net/2429/82767

Evaluation of the education resource: https://www.jospt.org/doi/10.2519/josptopen.2024.0149

Free webinar (account required) about the influence of running on cartilage: https://therunningclinic.com/tv/?VideoId=185711&SelectedCategory=185731

Running with osteoarthritis case report: https://pubmed.ncbi.nlm.nih.gov/38725598/

Ep 187: Finding a digital way through depression and chronic pain, with Dr Pavlos Bobos Jul 15, 2024

The relationship between musculoskeletal pain and mental distress is complex. Sometimes it can feel challenging to know where to start when supporting people to get their life back when they're struggling with chronic or persistent pain.

Today, Dr Pavlos Bobos (Western University, Canada) shares his own story of recovery from serious musculoskeletal injury, and how that experience drives the work he does now as a researcher. He discusses the results of a network meta-analysis of digital interventions for managing musculoskeletal pain and depression.

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RESOURCES

Network meta-analysis of digital interventions: https://www.jospt.org/doi/10.2519/jospt.2024.12216

Ep 186: Adding telerehabilitation to your clinical practice, with Dr Belinda Lawford Jul 08, 2024

Were you someone who started delivering telerehabilitation for the first time during the pandemic? Or perhaps you're an early adopter?

Have you ever wondered how effective delivering rehabilitation via a screen is versus seeing the patient in the clinic?

Dr Belinda Lawford (The University of Melbourne) shares the latest research illustrating the benefits of telerehabilitation for managing chronic knee pain.

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RESOURCES

More on patients' perceptions of telerehabilitation/digital health: https://www.jospt.org/doi/10.2519/jospt.2024.12383

PEAK trial of telerehabilitation vs. in-person care for knee osteoarthritis: https://pubmed.ncbi.nlm.nih.gov/38461844/

Ep 185: GPT vs. CPG - Is AI coming for your job? with Dr Giacomo Rossettini Jul 01, 2024

What are the pros and cons of using AI chatbots in musculoskeletal rehabilitation? What are chatbot applications in education, clinical practice, and research?

How does the chatbot advice compare to the recommendations of trusted clinical practice guidelines? Dr Giacomo Rossettini shares the results of 2 new papers from his research team to answer these questions.

This episode is about the best ways clinicians can think about using AI chatbots to advance their clinical practice, while avoiding the pitfalls.

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RESOURCES

Pros and cons of AI chatbots in musculoskeletal rehabilitation practice: https://www.jospt.org/doi/10.2519/jospt.2023.12000

ChatGPT vs. CPGs for managing lumbosacral radicular pain: https://www.jospt.org/doi/10.2519/jospt.2024.12151

Ep 184: Popping pills in elite youth sport - fact or fiction? with Julie Pedersen Jun 24, 2024

Surveys of elite adult athletes reveal high use of analgesics, particularly non-steroidal anti-inflammatory drugs (NSAIDs). While medications like paracetamol have a generally low risk profile, certainly compared with NSAIDs or opioids, using pain medications to mask an injury or prevent pain might increase the risk of injury or make an existing injury worse.

Julie Pedersen - physiotherapist and PhD student (University of Southern Denmark) - is studying what, how, when and why youth athletes use pain medications. Today, Julie discusses how clinicians, coaches, parents and schools can support safe use of analgesics among youth athletes.

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RESOURCES

Prospective study of Danish youth analgesic use: https://www.jospt.org/doi/10.2519/jospt.2024.12407

Prevalence, frequency, adverse events data from youth athletes: https://pubmed.ncbi.nlm.nih.gov/36100523/

Ep 183: AI as a clinical assistant, with Rebecca Fechner, Dr Joshua Pate and Dr Mick Thacker Jun 17, 2024

There's plenty of work going into how AI can make health care better - including in recording consultation notes, or making early cancer diagnoses, or opening up low cost ways of doing musculoskeletal imaging.

The technology and applications of AI in healthcare changes just about every week. Today, we're exploring generative AI as a help, not a hindrance to musculoskeletal rehabilitation practice.

Physiotherapists Rebecca Fechner (Queensland Paediatric Persistent Pain Service), Dr Josh Pate (University of Technology Sydney) and Professor Mick Thacker (Royal College of Surgeons Ireland) talk about ways to use chatbots and generative AI to generate ideas and solve clinical problems.

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RESOURCES

The Prompt Engineering Guide is a deep dive into how to craft effective prompts for generative AI: https://www.promptingguide.ai/

More on the science of active inference: https://pubmed.ncbi.nlm.nih.gov/25563935/

Ep 182: Working at the top of your licence - a day in the life of a trauma physical therapist, with Dr Patricia Weber Jun 10, 2024

Welcome to a chat with a physical therapist who is using their orthopaedic and sports skills outside the typical practice environment. Dr Patricia Weber shares her experience as a senior physical therapist in the shock trauma setting–a world that blends orthopedic, neurologic and multi-trauma in a challenging emotional and psychological environment.

Dr Weber is a senior physical therapist at the University of Maryland Medical Center. She primarily treats within the R. Adams Cowley Shock Trauma center in downtown Baltimore.

Ep 181: The ethics of your clinical decisions, with Dr Nathan Vannatta Jun 03, 2024

In today's episode, Dr Nathan Vannatta outlines some ethical frameworks that the musculoskeletal rehabilitation clinician might use when working through clinical decisions, including about return to play.

Dr Vannatta outlines ethical theories and 4 approaches to bioethics. He explains how one might justify different decisions, depending on the ethical framing, illustrating the complexity of return to play decisions with the clinical example of 'Ellie', who is returning to soccer after ACL reconstruction.

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RESOURCES

More on ethics frameworks and return to sport decisions: https://www.jospt.org/doi/10.2519/jospt.2024.12310

Ep 180: Tackling apprehension after Bankart repair (part 2), with Marianne van Gastel & Karin Hekman May 27, 2024

Specialist shoulder physiotherapists, Marianne van Gastel and Karin Hekman, are back for the second part of their discussion on rehabilitation for peple with anterior shoulder dislocation and Bankart repair.

Marianne and Karin share how they use a psychologically-informed practice type of approach to support athletes and patients to work through and overcome anxiety and apprehension.

The chat focuses on supporting patients to return to high levels of function, including sport, after their shoulder surgery.

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RESOURCES

Rehabilitation guideline for managing apprehension after anterior shoulder dislocation and Bankart repair: https://www.jospt.org/doi/10.2519/jospt.2024.12106

To find out more and register for the YAHiR-JOSPT Young athlete’s Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/

Ep 179: Tackling apprehension after Bankart repair (part 1), with Marianne van Gastel & Karin Hekman May 20, 2024

Physiotherapists and clinician-researchers, Marianne van Gastel and Karin Hekman, share a new rehabilitation guideline on managing apprehension in people with anterior shoulder dislocation and Bankart repair.

Over the next 2 episodes of JOSPT Insights, Marianne and Karin will take us through the rehabilitation guideline, explain what's new in shoulder rehabilitation, and share their approaches to helping people feel confident to get back to the sports and recreation activities they love after shoulder dislocation.

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RESOURCES

Rehabilitation guideline for managing apprehension after anterior shoulder dislocation and Bankart repair: https://www.jospt.org/doi/10.2519/jospt.2024.12106

Patients' perspectives after treatment for anterior instability: https://pubmed.ncbi.nlm.nih.gov/37811392/

To find out more and register for the YAHiR-JOSPT Young athlete’s Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/

Ep 178: Leading from every chair, with Dr Nicol van Dyk May 13, 2024

Musculoskeletal rehabilitation practitioners spend years honing our clinical skills—how much time do we spend thinking about and practicing skills like listening, working in teams, and making decisions?

Today, Dr Nicol van Dyk - physiotherapist and Assistant Professor at University College Dublin - is here to make the case for real skills as keys to expert musculoskeletal rehabilitation practice.

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RESOURCES

To find out more and register for the YAHiR-JOSPT Young athlete’s Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/

Essential skills for Physiotherapists led by David Clancy: https://www.us.elsevierhealth.com/essential-skills-for-physiotherapists-9780443111280.html

Seth Godin blog on real skills: https://itsyourturnblog.com/lets-stop-calling-them-soft-skills-9cc27ec09ecb and TED talk https://ideas.ted.com/soft-skills-and-real-skills/

Harvard Business Review - In praise of the incomplete leader: https://hbr.org/2007/02/in-praise-of-the-incomplete-leader

More on listening as a clinical skill: https://pubmed.ncbi.nlm.nih.gov/30279218/

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NICOL'S TOP BOOK RECOMMENDATIONS

How to win friends and influence people (Dale Carnegie): https://www.amazon.com/How-Win-Friends-Influence-People/dp/0671027034

Leaders eat last (Simon Sinek): https://simonsinek.com/books/leaders-eat-last/

Dare to lead (Brene Brown): https://brenebrown.com/book/dare-to-lead/

The 21 Irrefutable Laws of Leadership: Follow Them and People Will Follow You (John C Maxwell): https://www.amazon.com/21-Irrefutable-Laws-Leadership-Anniversary/dp/0785288376

Amazing discussion about vulnerability from Adam Grant with Brene Brown: https://www.youtube.com/watch?v=uXVhDSBiZCI

Ep 177: Diagnosing and managing inguinal-related groin pain, with Willem Heijboer Apr 30, 2024

The YAHiR (Young Athletes Hip Research) Collaborative takes over the JOSPT Insights podcast today. Tune in to learn about best practice in diagnosing and managing inguinal-related groin pain. Willem Heijboer, sports physiotherapist and clinical epidemiologist from the Amsterdam University Medical Centre, joins Dr Josh Heerey to share the latest research to inform your practice.

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RESOURCES

Learn more about how the YAHiR collaborative is partnering to promote and protect athletes' hip health through high-quality research: https://www.ndorms.ox.ac.uk/research/yahir

The next Young Athlete's Hip Symposium is on 25-27 September, 2024, at Worcester College, Oxford University

The YAHiR Collaborative, La Trobe University and JOSPT are co-hosting a webinar mini series in May and June 2024. In these webinars, you'll hear more from experienced clinician-researchers Drs Josh Heerey, Jo Kemp, Kate Jochimsen and Mike Reiman. Dr Lindsey Plass and Luke Kearney, who both have lived experience of hip pain limiting their sporting careers, bring the athlete's perspective. For more information, and to register: https://semrc.blogs.latrobe.edu.au/events/yahir/

More on the terminology of inguinal-related groin pain: https://pubmed.ncbi.nlm.nih.gov/36111127/

Reliability and accuracy of clinical tests for diagnosing inguinal-related groin pain: https://pubmed.ncbi.nlm.nih.gov/36643406/

Rehabilitation and return to sport after surgery for inguinal-related groin pain: https://www.sciencedirect.com/science/article/abs/pii/S1060187217300382

Ep 176: Musculoskeletal rehabilitation in a digital age, with Dr Alessio Bricca and Nikolaj Nøhr Apr 22, 2024

There's an app for just about everything these days, including in musculoskeletal rehabilitation and exercises therapy. Have you been scrolling the app store wondering if there's anything worthwhile to recommend to patients?

Today, we're uncovering what makes a quality app for monitoring and promoting physical activity in chronic conditions, including musculoskeletal pain. Dr Alessio Bricca (Assistant Professor, University of Southern Denmark) and physiotherapist, Nikolaj Nøhr, share their latest research and discuss how to apply it in practice.

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RESOURCES

World Health Organization's global strategy on digital health (2020-2025): https://www.who.int/publications/i/item/9789240020924

More on the quality of health apps available in major app stores: https://pubmed.ncbi.nlm.nih.gov/35119367/

Research waste in musculoskeletal pain apps: https://pubmed.ncbi.nlm.nih.gov/30324177/

Benefits and harms of digital health interventions for promoting physical activity: https://pubmed.ncbi.nlm.nih.gov/37410534/

International consensus on research priorities for telehealth in musculoskeletal pain: https://pubmed.ncbi.nlm.nih.gov/37789304/

Making sense of digital health data in primary care: https://pubmed.ncbi.nlm.nih.gov/37096688/

Ep 175: Measuring for success in ACL rehabilitation, with Dr Eric Hamrin Senorski Apr 15, 2024

If you're looking for a guide to testing function and readiness to return to sport after injury, you're in the right place! Dr Eric Hamrin Senorski (PT, PhD; University of Gothenburg, Sweden) shares how he blends his research training with his clinical skills to help athletes and active people with ACL injury.

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RESOURCES

Project ACL ("Project Korsband") registry: https://projektkorsband.se/

Quadriceps and hamstrings strength reference values for soccer/football, basketball and handball: https://www.jospt.org/doi/10.2519/jospt.2022.10693

Hop and jump test reference values for soccer/football, and basketball: https://www.jospt.org/doi/10.2519/jospt.2024.12374

Knee injuries after returning to sport following ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/27162233/

Return to sport rates after ACL reconstruction: https://pubmed.ncbi.nlm.nih.gov/25157180/

Ep 174: SPORTS CORNER: The ins and outs of climbing, with Dr Carrie Cooper Apr 08, 2024

Dr Carrie Cooper does the lead climbing and helps you belay (see what we did there?) into the world of climbing. From bouldering to sport climbing—there's no need to go free solo (ok, ok...we'll stop now) if you don't know much about climbing. JOSPT Insights has you covered.

Dr Cooper discusses how climbing is like gymnastics, baseball, and rugby, with their shared hand, shoulder, and knee injuries. Some other key take-aways from the episode are how to identify weakness that climbers are so good at hiding, and how to progress a return to climb program. Hang on; it’s a good one!

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RESOURCES

Knee injuries in bouldering and rock climbing: https://pubmed.ncbi.nlm.nih.gov/32004071/

Classifying and managing flexor pulley injuries: https://pubmed.ncbi.nlm.nih.gov/30904240/

Ep 173: Shared decision-making - what it is, and what it isn't, with Diane Slater Apr 01, 2024

Health care practice is slowly transitioning from a paternalistic way of delivering care (doing to the patient) to a shared decision-making model (doing with the patient). Health systems, clinical professions and individual clinicians are at different points along the transition.

As a process, shared decision-making provides a scaffold for the patient's values, preferences and circumstances to receive primacy when discussing options, benefits and risks. As a mindset, shared decision-making is a standard of excellence in clinical practice - it ensures your are focused supporting the patient to authentically engage in decisions about their health.

Today, Diane Slater, physiotherapist and educator from Aalborg University, Denmark is helping you self-diagnose your shared decision-making practice. Diane shares tips for staying up-to-date with the best information to support quality shared decision-making, which she has honed through her work as a coach and mentor to musculoskeletal health practitioners.

Ep 172: SPORTS CORNER: Primary and secondary injury prevention in men's Australian football (AFLM), with Nick Kane Mar 25, 2024

Nick Kane, the head physio at Essendon Football Club in Australia, brings our attention back to Australian Rules Football. Like in all Sports Corner episodes, he reviews the demands of the sport, the common injuries, and key things to keep in mind when designing and progressing rehabilitation programs with Australian football athletes.

In today’s episode, we take a deep dive into the hard preseason work that goes into preventing injuries, as Nick shares the specific primary and secondary strategies his team uses to keep athletes healthy and performing at their best.

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RESOURCES

For more on the Sports MAP Network: https://sportsmap.com.au/

Normative isometric plantarflexion strength values: https://www.sciencedirect.com/science/article/pii/S1466853X23000469?via%3Dihub

More on the relationship between fascicle length and hamstring strength: https://bjsm.bmj.com/content/50/24/1524

JOSPT Insights episode 138 with Melissa Haberfield: https://open.spotify.com/episode/0qizZvG0ESHDfvWhOxq1Nd?si=c052ab2987e141f8 or https://podcasts.apple.com/us/podcast/ep-138-sports-corner-footy-the-game-they-play-in/id1522929437?i=1000619109573

JOSPT Insights episode 124 with Dr Seth O'Neill: https://open.spotify.com/episode/4n4wkxGK1hwBykR1MZyzJm?si=be616b82cc9542d6 or https://podcasts.apple.com/us/podcast/ep-124-caring-for-the-calf-with-dr-seth-oneill/id1522929437?i=1000604944985

Ep 171: Mind-body connections in people with hip pain - how clinicians can help, with Dr Kate Jochimsen Mar 18, 2024

How do you approach evaluating psychological health factors when working with people in pain? Do you have an established process for screening? How about an approach to managing the psychological aspects of injury and health?

Athletes say they would like psychological support, while many musculoskeletal rehabilitation clinicians feel ill-equipped to provide appropriate support. What to do?!

Fortunately, Dr Kate Jochimsen (ATC, PhD; Massachusetts General Hospital) is leading a research program geared towards developing and evaluating mind-body interventions for chronic hip pain, and she addresses some of the clinical challenges in today's episode.

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RESOURCES

Psychologically-informed practice when managing sports injuries: https://pubmed.ncbi.nlm.nih.gov/37647239/

More on the prevalence of hip morphology in athletes: https://www.jospt.org/doi/10.2519/jospt.2021.9622

Physiotherapist-led treatment for hip-related pain: https://pubmed.ncbi.nlm.nih.gov/31732651/

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Find out more about the Pain Science in Practice courses delivered by Prof Lorimer Mosley: https://tinyurl.com/25kzcfmh

Direct links for each of the North American Pain Science in Practice courses:

Vancouver, Canada (27-28 September, 2024): https://clinicalsportsmedicine.com/lorimer-moseley

San Francisco, USA (5-6 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-san-francisco/

New York City, USA (12-13 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-nyc/

Ep 170: Gimme an N - M - E - S (stimulator)! Part 2 with Drs Elanna Arhos & Naoaki Ito Mar 11, 2024

In today's part 2 of an NMES masterclass from Dr Elanna Arhos and Dr Naoaki Ito, we're getting into the nitty gritty of how to support patients to get the most out of a very beneficial intervention. Drs Arhos and Ito, and their team have tested a mix of common stimulators available on the market today, and are here to share the results with us. Let them help you make an informed decision about your next equipment purchase for your clinic.

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RESOURCES

Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028

Find out more about the Pain Science in Practice courses delivered by Prof Lorimer Mosley: https://tinyurl.com/25kzcfmh

Direct links for each of the North American Pain Science in Practice courses:

Vancouver, Canada (27-28 September, 2024): https://clinicalsportsmedicine.com/lorimer-moseley

San Francisco, USA (5-6 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-san-francisco/

New York City, USA (12-13 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-nyc/

Ep 169: Dose your NMES for success, with Drs Elanna Arhos & Naoaki Ito (part 1) Mar 06, 2024

Neuromuscular electrical stimulation (NMES) hasn't quite had the coverage it deserves, especially when one considers the strength of evidence supporting NMES as a musculoskeletal rehabilitation intervention

Today, Drs Elanna Arhos (Ohio State University) and Naoaki Ito (University of Wisconsin - Madison) are re-visiting how NMES is applied in sports clinical practice. Get the low-down on why you need NMES in your sports rehabilitation toolkit, and how to figure out dose and intensity.

In part 2 we discuss how to support patients to get the most out of NMES, and which equipment is best for your clinic.

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RESOURCES

Who's afraid of electrical stimulation? Let's revisit the application of NMES at the knee: https://www.jospt.org/doi/10.2519/jospt.2023.12028

Find out more about the Pain Science in Practice courses delivered by Prof Lorimer Mosley: https://tinyurl.com/25kzcfmh

Direct links for each of the North American Pain Science in Practice courses:

Vancouver, Canada (27-28 September, 2024): https://clinicalsportsmedicine.com/lorimer-moseley

San Francisco, USA (5-6 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-san-francisco/

New York City, USA (12-13 October, 2024): https://www.noigroup.com/event/pain-science-in-practice-moseley-nyc/

Ep 168: Saying "hasta la vista" to injections for tendinopathy, with Dr Robert-Jan de Vos Feb 26, 2024