JOSPT Insights

The anterior talofibular ligament (ATFL) and the Achilles tendon captures much of our ankle attention. As JOSPT Insights listeners know, there's plenty more to the ankle than the ATFL. Today, Liz Bayley shares her approach to diagnosing, managing and ideally, preventing ankle pain in active people. Liz covers diagnosing the problem, where imaging fits, and how to support return to function, including high-level sport. Liz is a former professional dancer, who now works as a dance-specialist physiotherapist. Her clinic is in London's West End, in close proximity to the freelance professional and student dancers she works with, at Trinity Laban Conservatoire of Music and Dance, and on 'Matilda The Musical' in Covent Garden. ------------------------------ RESOURCES Lateral ankle ligament sprains clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2021.0302 Updated model of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/31162943/ Predictors of chronic ankle instability: https://pubmed.ncbi.nlm.nih.gov/26912285/ Intrinsic foot muscle training systematic review: https://pubmed.ncbi.nlm.nih.gov/35724360/ Neuromuscular electrical stimulation for foot intrinsic muscles: https://pubmed.ncbi.nlm.nih.gov/35142810/

Dr. Matthew King, a physiotherapist and Senior Lecturer at La Trobe University, dives into the complexities of hip arthroscopy recovery. He discusses the significant sex differences in athletes' return to sport post-surgery, with women facing greater challenges. The conversation emphasizes the importance of clearly defining 'return to sport' and understanding the biological and social factors at play. Dr. King also highlights the need for personalized recovery approaches and better communication of outcomes to improve clinical practices.

Myofascial pain syndrome is common - affecting somewhere around 1 in every 5 people. Yet there is plenty of debate about what causes myofascial pain syndrome, how to diagnose it, and even whether myofascial pain syndrome is a primary condition. Today, Professor Chad Cook (Duke University) discusses whether it is even possible to differentiate myofascial pain syndrome from other pain conditions, and the implications for you, the clinician. ------------------------------ RESOURCES Myofascial pain syndromes - controversies and suggestions for improving diagnosis and treatment: https://www.jospt.org/doi/10.2519/jospt.2025.13072 International Association for the Study of Pain - Myofascial pain fact sheet 14: https://www.iasp-pain.org/wp-content/uploads/2022/10/14.-Myofascial-Pain-Fact-Sheet-Revised-2017.pdf

Discover how postmenopausal women can enhance their bone density and strength with the right exercises. Dr. Belinda Beck reveals insights from the LIFTMOR trial, showcasing safe lifting techniques and emphasizing the importance of high-intensity training. Learn about the surprising benefits of customized mechanical loading on bone health and how tailored exercise can significantly improve quality of life. Plus, find out key strategies for fall prevention and maintaining balance in older adults.

Clinicians appreciate the value of a trustworthy clinical practice guideline for helping guide decisions in practice. Professor François Desmeules (University of Montréal) led an international team of shoulder experts who synthesised the latest evidence on diagnosing and non-surgically managing rotator cuff tendinopathy. Today he shares the headlines of the CPG and explains how the guideline group made sense of all the evidence to come up with recommendations for assessment, diagnosis, treatment and prognosis, including return to sport. ------------------------------ RESOURCES Rotator cuff tendinopathy diagnosis, non-surgical medical care and rehabilitation CPG: https://www.jospt.org/doi/10.2519/jospt.2025.13182

Ciarán Purcell is a sports physiotherapist and researcher from the University of Limerick, focusing on refining pain assessment in athletes. He explains the limitations of traditional pain assessment tools and advocates for a holistic approach that accounts for psychological and socio-environmental factors. Ciarán discusses a collaborative project aimed at developing consensus guidelines in pain assessment, emphasizing the need for comprehensive tools in sports medicine. He also invites listeners to engage with this important research initiative.

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. ------------------------------ 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/

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. ------------------------------ 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

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. ------------------------------ 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/

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. ------------------------------ 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