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

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

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

Dr. Simon Lafrance, a physiotherapist and researcher at the University of Montreal, dives into the pressing challenges in our healthcare system, particularly the growing wait times for musculoskeletal care. He discusses innovative models where physiotherapists lead as the first point of contact, enhancing patient access and reducing costs. Simon also explores the evolution of physiotherapists' roles in rehabilitation, the effectiveness of treatment approaches for spine pain, and how personalized care can transform patient satisfaction and outcomes.

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

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

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

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

Dr. Giovanni Ferreira, an Emerging Leader Research Fellow at the University of Sydney, dives into the pressing concerns of people suffering from acute low back pain. He critiques clinical practice guidelines, arguing they often miss the mark on addressing patient worries. The conversation highlights the need for personalized education over generic advice and emphasizes the role of effective communication in improving treatment outcomes. Ferreira also discusses the potential for AI chatbots to help patients find reliable information, navigating the complexities of back pain management.

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