JOSPT Insights

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

Clinical Practice Guidelines (CPGs) are an incredible resource for clinicians of all experience levels—synthesizing all the research on a topic and packaging it into bite-sized recommendations and flow charts. But how often are clinicians adhering to these guidelines? In today’s episode, Dr Maggie Horn (Duke University) walks us through her research team’s work to assess if, how, and when clinicians follow CPG recommendations. The team worked with clinicians in their hospital system to embed templates in the EMR, and used self-report strategies to answer these questions, specifically for the neck pain CPG. Dr Horn reviews the neck pain CPG, how the research team evaluated adherence, and what the findings mean for CPGs and clinicians. ------------------------------ RESOURCES Neck pain clinical practice guideline (revised in 2017): https://www.jospt.org/doi/10.2519/jospt.2017.0302 Translating the neck pain CPG into practice framework: https://www.jospt.org/doi/10.2519/josptopen.2025.0101

No doubt you've come across people using the analogy of a broken down machine to describe an osteoarthritic joint. Or perhaps that too much loading on the joint is responsible for wearing it out - assuming that each joint has a finite number of movements in its lifetime. You've probably also heard from patients who are concerned that the exercise therapy you prescribe might do more harm to their already worn-out joint. But is that true? Today, Dr Alessio Bricca (Centre for Muscle and Joint Health, University of Southern Denmark) explores the evidence and refutes these beliefs. ------------------------------ RESOURCES Exercise Therapy "Wears Down" My Knee Joint: Myth or Reality?: https://www.jospt.org/doi/10.2519/jospt.2025.13069

Today is part 2 of a 2-part chat about hip health and training load for the youth athlete. Last episode, Dr Sara Lyn Terrell (Florida Southern College) discussed the developing hip, and the important distinction between primary cam morphology and femoroacetabular impingement syndrome. Many athletes have a bony bump on their hip that doesn't cause any problems - it's the morphology in combination with symptoms that clinicians might worry about. Today's episode builds on the foundation of the developing hip, and covers appropriate loads for youth athletes. Dr Terrell discusses how to plan, monitor and progress a loading programs, and how you might incorporate strength & conditioning principles into your practice. ------------------------------ RESOURCES Strategies to deter primary cam morphology in youth athletes: https://www.jospt.org/doi/10.2519/josptopen.2025.0128 Can we reduce injury risk during the adolescent growth spurt?: https://pubmed.ncbi.nlm.nih.gov/37823577/ “My kid is going through a growth spurt – what should I do?”: https://shorturl.at/FqqCM

The hip health of youth athletes as their skeletons grow and mature while the athlete copes with the physical and mental stressors of sport and life, has been receiving renewed attention. Today's episode of JOSPT Insights is part 1 of a 2-part chat about training load and the youth athlete's hip. We discuss how primary cam morphology and femoroacetabular impingement syndrome might develop. Dr Sara Lynn Terrell (Florida Southern College) shares her >20 years of experience in exercise science and strength & conditioning, and walks listeners through the complexity of working with youth athletes to support their best sports performance. ------------------------------ RESOURCES Strategies to deter primary cam morphology in youth athletes: https://www.jospt.org/doi/10.2519/josptopen.2025.0128 Oxford consensus on primary cam morphology and FAI (part 1): https://pubmed.ncbi.nlm.nih.gov/36588401/ Oxford consensus on primary cam morphology and FAI (part 2): https://pubmed.ncbi.nlm.nih.gov/36588402/

In this discussion, Dr. Brad Neal, an Advanced Clinical Academic Fellow at Queen Mary University, shares his expertise on managing patellofemoral pain, a common issue across various demographics. He highlights the importance of individualized treatment approaches, emphasizing education and targeted exercises. The conversation also explores the significance of running retraining for athletes, focusing on biomechanics and symptom management. Dr. Neal underscores the need for effective patient education and tailored strategies, especially for young athletes facing long-term implications.

Pain is often what prompts patients to seek the care of a musculoskeletal rehabilitation clinician. In today's episode, Dr Paul Mintken guides listeners through different ways to work with a person to help make sense of, and explain, unexplained pain. Dr Mintken (Hawai'i Pacific University) is a board-certified Orthopaedic Clinical Specialist and a Fellow of the American Academy of Orthopaedic and Manual Physical Therapists. ------------------------------ RESOURCES JOSPT Viewpoint article - The Worst Pain is an Unexplained Pain: https://www.jospt.org/doi/10.2519/jospt.2025.13167

In Part 2 of our conversation with Dr Olivia Abdoo (Ultimate Fighting Championship), we dive deeper into one of the most common injuries in mixed martial arts (MMA) - concussion. Dr Abdoo's experience treating UFC athletes provides an insight into working with athletes for whom skills including wrestling, striking, and grappling are crucial to performing well. How to approach educating the athlete and everyone involved with them about concussion, ensuring the athlete can participate safely while recovering from concussion, what an MMA-specific concussion evaluation looks like, and the importance of sport-specificity in concussion rehabilitation - we hit on it all!

Given how common rotator cuff tears are, chances are you will work with someone who has a tear at some point in your career. Do you know what patients will want from their rehabilitation? Are you confident with your approach to managing rotator cuff tears? Today, Dr Kathryn Fahy, physiotherapist and researcher from Aspetar Orthopaedic & Sports Medicine Hospital, Doha discusses the CALMeR Cuff pathway. Dr Fahy developed CALMeR Cuff with patients, clinicians and researchers to guide care for people with large to massive rotator cuff tears. ------------------------------ RESOURCES Co-design of the CALMeR Cuff pathway: https://www.jospt.org/doi/10.2519/jospt.2025.13342

A mention of pre-professional or professional dance might conjure thoughts of relentless, gruelling training hours, incredible performances and bodies pushed through high musculoskeletal demands. Dr Melanie Fuller (University of Southern Queensland) has devoted her clinical career of almost 20 years to working with dancers - helping them stay healthy and performing well - and she has a similar focus in her research work. Today we discuss the prevalence of musculoskeletal injury, specifically focusing on osteoarthritis. ------------------------------ RESOURCES Osteoarthritis in dancers (systematic review with meta-analysis): https://www.jospt.org/doi/10.2519/jospt.2025.12918