Avsnitt
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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.
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RESOURCES
When is a prognostic prediction model ready for clinical use?: https://www.jospt.org/doi/10.2519/jospt.2026.13868
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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.
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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/
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Saknas det avsnitt?
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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.
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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
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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.
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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.
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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
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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.
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RESOURCES
Addressing shoulder weakness systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13445
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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.
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RESOURCES
Effects of neuromuscular training warm-up for preventing injury and concussion in girl's rugby: https://www.jospt.org/doi/10.2519/jospt.2026.13373
SHRED injuries neuromuscular training warm-up programs: https://www.ucalgary.ca/shred-injuries
Tips for supporting athletes to return to sport after concussion, with Dr Kathryn Schneider: https://pod.link/1522929437/episode/YTA0ZWY0NDgtYzNmZi00ODlmLTg5ZWQtMTAyMDE3ZTUxNjhk
Female, woman, and/or girl Athlete Injury pRevention: https://fairconsensus.com/
FAIR practical recommendations: https://pubmed.ncbi.nlm.nih.gov/41330629/
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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.
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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
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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.
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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
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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.
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RESOURCES
Internet-based self-management for chronic pain (ReabilitaDOR Trial): https://www.jospt.org/doi/10.2519/jospt.2025.13418
Effectiveness of activity trackers and smartphone apps for increasing physical activity: https://www.jospt.org/doi/10.2519/jospt.2026.13825
Physiotherapy Evidence Database (PEDro): https://pedro.org.au/
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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.
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RESOURCES
Evoolve Pain Care Academy: https://evoolvepaincare.academy/
Videos, infographics and written resources for clinicians: https://evoolvepaincare.academy/clinician-resources
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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.
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RESOURCES
Psychological phenotyping in osteoarthritis: https://www.jospt.org/doi/10.2519/josptopen.2025.0177
OSPRO yellow flags tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487
Clinical framework for screening yellow flags: https://www.jospt.org/doi/10.2519/jospt.2021.10570
STarT MSK research programme review: https://pubmed.ncbi.nlm.nih.gov/37490570/
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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.
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RESOURCES
RESTORE trial: https://pubmed.ncbi.nlm.nih.gov/37146623/
Patterns of change in forward bending, and pain self-efficacy during CFT: https://www.jospt.org/doi/10.2519/jospt.2025.13114
Relationship between forward bending and improvement in pain and disability during CFT: https://www.jospt.org/doi/10.2519/jospt.2024.12727
Network meta-analysis of tailored exercise therapies with or without psychological interventions: https://www.jospt.org/doi/10.2519/jospt.2025.13281
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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.
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RESOURCES
RESTORE trial: https://pubmed.ncbi.nlm.nih.gov/37146623/
Patterns of change in forward bending, and pain self-efficacy during CFT: https://www.jospt.org/doi/10.2519/jospt.2025.13114
Relationship between forward bending and improvement in pain and disability during CFT: https://www.jospt.org/doi/10.2519/jospt.2024.12727
Network meta-analysis of tailored exercise therapies with or without psychological interventions: https://www.jospt.org/doi/10.2519/jospt.2025.13281
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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.
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RESOURCES
Modern definition and description of manual therapy: https://pubmed.ncbi.nlm.nih.gov/38457654/
Modern way to teach and practice manual therapy: https://pubmed.ncbi.nlm.nih.gov/38773515/
Living review of manual therapy mechanisms: https://pubmed.ncbi.nlm.nih.gov/40100908/
Unravelling the mechanisms of manual therapy: https://www.jospt.org/doi/10.2519/jospt.2018.7476
Developing manual therapy frameworks: https://www.jospt.org/doi/10.2519/josptopen.2023.0002
Integrating person-centred concepts and modern manual therapy: https://www.jospt.org/doi/full/10.2519/josptopen.2023.0812
How do patients believe manual therapy works? https://www.jospt.org/doi/10.2519/josptopen.2025.0149
Does it matter how you apply spinal manipulation? JOSPT Insights ep 221: https://pod.link/1522929437/episode/NmM0MTg4OGMtODMwMi00ZTA3LTg1NzUtYjY2ZjBiMThiZGUy
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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.
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RESOURCES
EU-US Meniscus Rehabilitation Consensus on prevention, non-operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539
DREAM trial primary report: https://pubmed.ncbi.nlm.nih.gov/38319181/
Should symptoms guide treatment choice in young patients? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/
Early surgery vs exercise therapy + education for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245
Ep 224: Saving the meniscus: https://pod.link/1522929437/episode/NTg3YTgzZWUtYTZjZC00ZDYwLWI2OTAtYTczMzAzNTEyNzgz
Ep 192: DREAMing of better care for meniscus tears: https://pod.link/1522929437/episode/Yzk2YzkyOWItMDk1MS00YWZkLWI2MjQtNmRlYjIwZGJmOTg0
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Trust is integral to the therapeutic relationship between patients and clinicians in musculoskeletal rehabilitation. But does that trust go both ways?
If you do a deep dive into the literature on trust, you'll find that it almost always talks about whether patients trust clinicians, not if clinicians trust patients. There's also an inherent bias built into the biomedical environment where so called 'objective' tests - the imaging, the bloodwork, the physical performance tests that clinicians administer - are prioritised over patients' lived experience and expertise, which is derided as 'subjective' and somehow less trustworthy.
Today's guests today invite you to join a revolution of starting from a place of trusting people with pain, and acknowledging the patient's expertise.
Joletta Belton is an author, advocate and patient engagement in research specialist, who makes sense of pain through science and stories. Dr Ben Darlow is a physiotherapy specialist and Professor of Primary Health Care at The University of Otago in Aotearoa/New Zealand.
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RESOURCES
Do we trust patients in pain viewpoint: https://www.jospt.org/doi/10.2519/jospt.2025.13725
Jo's substack (MyCuppaJo): https://mycuppajo.substack.com/
Framework for establishing connections in physiotherapy practice: https://pubmed.ncbi.nlm.nih.gov/29432058/
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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.
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RESOURCES
Health And Performance Promotion in Youth Sport (HAPPY) study of concussion: https://www.jospt.org/doi/10.2519/jospt.2025.13399Female, woman and/or girl Athlete Injury pRevention (FAIR) practical recommendations: https://pubmed.ncbi.nlm.nih.gov/41330629/
Consensus statement on concussion in sport: https://pubmed.ncbi.nlm.nih.gov/37316210/
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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.
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RESOURCES
Read the CPG yourself here: https://www.jospt.org/doi/10.2519/jospt.2025.0301
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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.
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RESOURCES
Clinician's guide to assessing and addressing sleep dysfunction in people with musculoskeletal pain: https://www.jospt.org/doi/10.2519/josptopen.2025.0198
Spine pain and sleep study: https://pubmed.ncbi.nlm.nih.gov/35642567/
UK Biobank study on predictors of persistent pain: https://pubmed.ncbi.nlm.nih.gov/37414898/
Systematic review on lack of sleep measures: https://pubmed.ncbi.nlm.nih.gov/37259893/
APTA position paper on the PT’s role in sleep health: https://www.apta.org/apta-and-you/leadership-and-governance/policies/role-pt-apta-sleep-health
DPT students and sleep behaviours: https://pubmed.ncbi.nlm.nih.gov/39425093/
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