JOSPT Insights

Calf strains are challenging for athletes and clinicians to manage—with uncertain return to play times and risks for reinjury if they're not managed well. Dr Brady Green (University of Notre Dame, Perth, Australia) shares his research and clinical expertise on muscle strains in elite and subelite athletes, including from his previous work in elite Australian football at the Essendon Football Club. Today's episode launches from Dr Green's latest study of the epidemiology of calf strains, and discusses how musculoskeletal rehabilitation specialists, including sports physical therapists, can use this information to guide their practice. ------------------------------ RESOURCES Gastrocnemius muscle strain injury epidemiology: https://www.jospt.org/doi/10.2519/jospt.2025.13526

Over the past decade, the term rotator cuff–related shoulder pain (RCRSP) has gained traction as a more accurate, patient-centered way to describe shoulder pain. In this episode, Dr Amy McDevitt (Physical Medicine and Rehabilitation Department, University of Colorado) joins Dan Chapman and Marquis Sanabrais to unpack why shifting from structural labels like impingement or tendinopathy toward RCRSP can improve both communication and care. They discuss how imaging often fails to match symptoms, why language matters for patient engagement, and how clinicians can explain shoulder pain without over-pathologizing. Take home messages: 1. RCRSP reflects the multifactorial nature of shoulder pain, biological, mechanical, and psychosocial. 2. Clear and non-anatomic terminology helps patients understand and buy into treatment. 3. Future research should clarify mechanisms behind exercise and refine subgroups within RCRSP. ------------------------------ RESOURCES The case for using "rotator cuff-related shoulder pain" in practice: https://www.jospt.org/doi/10.2519/jospt.2025.13405

Some of the most powerful drivers of change in musculoskeletal rehabilitation aren’t researchers or administrators—but clinicians working shoulder-to-shoulder with their peers. These so-called "local opinion leaders" often shape practice more effectively than top-down mandates or distant guidelines. And they're more than simply influencers or savvy social media marketers. In today's episode, Dr Seth Peterson explores how local opinion leaders—those trusted voices within clinical settings—can play a pivotal role in translating research into practice. Dr Peterson shares practical strategies for fostering cultures of learning and supporting clinicians to lead. Dr Peterson is a clinician-researcher based in Tucson, Arizona. He leads care at his clinic, The Motive, and teaches nationally with The Movement Brainery. ------------------------------ RESOURCES Empowering local opinion leaders in physical therapy systems: https://www.jospt.org/doi/10.2519/jospt.2025.13508 Why higher standards are needed in physical therapist professional development: https://www.jospt.org/doi/10.2519/jospt.2022.11377 2025 hip osteoarthritis clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2025.0301

Pain near the posteromedial tibia is common in running and jumping athletes. Laura Anderson, physiotherapist and PhD candidate, is challenging the diagnostic labels "shin splits" and "medial tibial stress syndrome", and suggesting a new term: "load-induced medial leg pain" (LIMP). In today's episode, Laura explores ways to improve how you diagnose and manage shin pain in athletes, including how you talk with athletes about their condition. She discusses loading, red flags and the role of running retraining. ------------------------------ RESOURCES Diagnosing medial tibial stress syndrome (including flow diagram): https://pubmed.ncbi.nlm.nih.gov/28179260/ Re-naming MTSS as Load Induced Medial Leg Pain (LIMP): https://www.jospt.org/doi/10.2519/jospt.2025.13411 Effectiveness of running gait retraining - systematic review: https://www.jospt.org/doi/10.2519/jospt.2022.10585

Over half of performing artists and artistic athletes report pelvic floor symptoms. Up to 80% of female artistic athletes report pelvic floor symptoms, yet many believe these issues—like urinary leakage during performance—are par for the course, part of the job. Today, Jessica Frydenberg explains who performing artists are, why they are particularly susceptible to pelvic floor symptoms, and what this means for your clinical practice. Jess is an experienced pelvic health physiotherapist and PhD candidate at La Trobe University in Melbourne, Australia. She has extensive experience working with performing artists, and recently led a systematic review investigating the epidemiology of pelvic floor symptoms in performing artists. ------------------------------ RESOURCES Prevalence and impact of pelvic floor symptoms systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13452

Who pays you, and how, for your work as a physical therapist? How health care is funded has implications for the way you work, and for the care that you can provide for patients. Societies all around the world are grappling with complex decisions about health care and how it is funded. Even more so as changing populations place different demands on health care systems, and as the health work force changes. Today, Dr Chris Bise (Assistant Professor, University of Pittsburgh) explains the changing face of health care funding, and what it means for the physical therapist. Chris has 25 years of experience as a physical therapist and health system analyst who studies value-based health care and physical therapy practice - trying to find better ways of funding health care to deliver outcomes that satisfy patients, clinicians and payers. ------------------------------ RESOURCES Building the foundation for value-based physical therapy: https://www.jospt.org/doi/10.2519/jospt.2025.13586 Perspectives for Payers - Heel pain/plantarfasciopathy: https://www.jospt.org/doi/10.2519/jospt.2025.0502 Perspectives for Payers - Achilles tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2025.0503

Welcome back to this explainer on health economics analyses in musculoskeletal rehabilitation. In part 1, Dr Codie Primeau explained the things you're looking for when reading a health economics analysis, to decide whether it's a good quality analysis. That's important because a good quality analysis can help you make decisions about whether the intervention being studied is worth considering. Today in part 2, we take things a step further to explore how you decide what "worthwhile" really means. Worth it for whom? The patient, your clinic, the health system, or even society? ------------------------------ RESOURCES From whose perspective is cost-effectiveness judged?: https://pmc.ncbi.nlm.nih.gov/articles/PMC6351264/ Review of health economics evaluations in hip and knee orthopaedics: https://pubmed.ncbi.nlm.nih.gov/34262974/

Whether you work in a solo private practice, or a large health network, no doubt you're considering costs when it comes to deciding what to change and perhaps what to implement - or de-implement - in your practice. Perhaps you're in the position of making decisions on behalf of a health service or you are trying to quantify and communicate the costs and benefits of treatments you study in a research setting? Today is part 1 of a 2-part chat with Dr Codie Primeau about health economics in musculoskeletal rehabilitation, which has something for everyone working in health care. We're covering how to read a health economics analysis to decide whether the analysis can help you navigate the complex decisions you're grappling with. Dr Primeau is a physiotherapist and Assistant Professor in the School of Physical Therapy at Western University in London, Canada, and an Affiliate Scientist with Arthritis Research Canada. His research focuses on arthritis, chronic pain, and pelvic health, using a blend of qualitative and quantitative methods to improve patient care and outcomes, including health economics evaluation. ------------------------------ RESOURCES From whose perspective is cost-effectiveness judged?: https://pmc.ncbi.nlm.nih.gov/articles/PMC6351264/ Review of health economics evaluations in hip and knee orthopaedics: https://pubmed.ncbi.nlm.nih.gov/34262974/

Wondering about whether large language models (generative AI) like ChatGPT, Co-Pilot or Claude, to name just a few, could add value to your clinical practice? Drs Mark Vorensky and Daniel Peredo (Rutgers University; NYU Langone Health) discuss the field of 'prompt engineering' - the approach to structuring and crafting the instructions (a.k.a. prompt) given to a generative AI model, to describe the task that the AI should perform. The quality of the output from generative AI is highly dependent on how the model is prompted. So, if you're looking to get the best out of generative AI, tune in! ------------------------------ RESOURCES Improving ChatGPT's performance using the CRISPE framework: https://www.jospt.org/doi/10.2519/josptmethods.2025.0151 Neck pain clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2017.0302

How do you think about supporting athletes to return to running after injury? Andrew Mitchell is someone who has thought about it a lot, and refined his approach over years of practice in top football/soccer. In today's episode, Andrew outlines the 5 elements of his criteria-based approach. Andrew is a sports physiotherapist and strength & conditioning practitioner with experience working in the hospital, private practice and professional sport arenas, including in the English Premier League, the German Bundesliga and the European Champions League. ------------------------------ RESOURCES Evidence-informed return-to-running framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0115 Criteria-based return-to-performance pathway: https://www.jospt.org/doi/10.2519/josptopen.2024.1240 On the path to perfoming after injury (ep 193): https://pod.link/1522929437/episode/NmEzODliMjAtYmIyZi00YzkwLWIwMzctNjU3NzI4NTY3ZWUz