The Shoulder Physio Podcast

In this episode of The Shoulder Physio Podcast, Dr Jared Powell sits down with Dr Mervyn Travers, physiotherapist, S&C coach, and researcher, to explore one of the most compelling frameworks in contemporary pain science: active inference. They discuss how this predictive brain model helps explain persistent musculoskeletal pain, why traditional exercise-based interventions might miss the mark, and how clinicians can use movement and context to shift a patient’s pain experience. Merv blends philosophy, neuroscience, and clinical pragmatism in a way that's accessible, challenging, and highly relevant. Key talking points: What is active inference and how does it relate to predictive processing? The role of prior beliefs, culture, and clinical language in shaping pain Movement experimentation as a tool for model updating and recovery Why it’s time to rethink how we prescribe exercise in pain rehab Clinical implications from landmark studies within the field that lend themselves to active inference A call for compassion, curiosity, and nuance in patient care Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 Merv website:  Home - Optimise Rehab Merv X: @‌mervtravers Merv Instagram: @‌optimise_rehab See our Disclaimer here: The Shoulder Physio - Disclaimer

 In this episode, Jared Powell sits down with Professor Gordon Guyatt, the physician and researcher who coined the term evidence-based medicine (EBM). They unpack the origins of EBM, why it’s often misunderstood, and how it continues to shape modern healthcare. Rather than being rigid or formulaic, EBM is about integrating the best evidence with clinical expertise and—crucially—patient values and preferences. 🎙 Key talking points: The surprising history behind the creation of EBM Why randomised trials matter—and when they’re not enough How to practice medicine in the face of low-certainty evidence The role of shared decision-making in everyday care Why acknowledging uncertainty is a sign of strength, not weakness How EBM is sometimes misunderstood or misused What the future holds for EBM—including education in schools 🎧 A must-listen for anyone navigating the grey zones of clinical care. Key Papers: Professor Guyatt has too many high impact papers to mention and he has one of the highest H-Index scores in the world (number 13 worldwide and number 1 in Canada). Here is his Google Scholar profile.  Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 Gordon on X:@GuyattGH See our Disclaimer here: The Shoulder Physio - Disclaimer

In this episode of The Shoulder Physio Podcast, Dr. Jared Powell sits down with Dr. Charlotte Ganderton, a physiotherapist, researcher, and senior lecturer at RMIT University. Charlotte shares insights from her latest research on gluteal tendinopathy, breaking down common misconceptions about imaging, corticosteroid injections, and the infamous clam exercise. From understanding the role of compression in tendinopathy to discussing effective treatment strategies, this episode is packed with clinically relevant takeaways for musculoskeletal healthcare professionals. Tune in to hear Charlotte’s perspective on how education, exercise, and progressive loading can make all the difference in patient outcomes. 🔹 What is gluteal tendinopathy and how does it differ from other tendon issues? 🔹 Should we rethink the role of imaging and injections? 🔹 Is it finally time to ban the clam? 🔹 Practical treatment strategies for improving patient care. If you're looking to refine your approach to gluteal tendinopathy, this is an episode you don’t want to miss! Key Papers:   Grimaldi A, Ganderton C, Nasser A. Gluteal tendinopathy masterclass: Refuting the myths and engaging with the evidence. Musculoskelet Sci Pract. 2025 Apr;76:103253. doi: 10.1016/j.msksp.2025.103253. Epub 2025 Jan 3. PMID: 39854929. Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 Charlotte on X:@C_Ganderton Cliniko free trial, click here! See our Disclaimer here: The Shoulder Physio - Disclaimer

In this episode of The Shoulder Physio Podcast, I am interviewed by my wife, Tara, about my recently completed PhD. For the past 7 years of my life I have been engaged in a research based PhD investigating the causal mechanisms underpinning the effectiveness of exercise therapy for rotator cuff related shoulder pain. This research program has produced 6 published pieces of research that is contained with the thesis. In this episode I briefly discuss the premise of the thesis, its main findings, and recommendations for future research. I also gives some tips and tricks and to prospective PhD or current PhD students which may help their journey.  Don't miss this episode with myself, Dr Jared Powell, and my wife, the amazing Tara Powell. Buckle up! Key Papers: Powell JK, Lewis JS. Rotator Cuff-Related Shoulder Pain: Is It Time to Reframe the Advice, "You Need to Strengthen Your Shoulder"? J Orthop Sports Phys Ther. 2021 Apr;51(4):156-158. doi: 10.2519/jospt.2021.10199. PMID: 33789431. Powell JK, Schram B, Lewis J, Hing W. "You have (rotator cuff related) shoulder pain, and to treat it, I recommend exercise." A scoping review of the possible mechanisms underpinning exercise therapy. Musculoskelet Sci Pract. 2022 Dec;62:102646. doi: 10.1016/j.msksp.2022.102646. Epub 2022 Aug 8. PMID: 35964499. Powell JK, Schram B, Lewis J, Hing W. Physiotherapists nearly always prescribe exercise for rotator cuff-related shoulder pain; but why? A cross-sectional international survey of physiotherapists. Musculoskeletal Care. 2023 Mar;21(1):253-263. doi: 10.1002/msc.1699. Epub 2022 Sep 11. PMID: 36089802. Powell JK, Costa N, Schram B, Hing W, Lewis J. "Restoring That Faith in My Shoulder": A Qualitative Investigation of How and Why Exercise Therapy Influenced the Clinical Outcomes of Individuals With Rotator Cuff-Related Shoulder Pain. Phys Ther. 2023 Dec 6;103(12):pzad088. doi: 10.1093/ptj/pzad088. PMID: 37440455; PMCID: PMC10733131. Powell JK, Lewis J, Schram B, Hing W. Is exercise therapy the right treatment for rotator cuff-related shoulder pain? Uncertainties, theory, and practice. Musculoskeletal Care. 2024 Jun;22(2):e1879. doi: 10.1002/msc.1879. PMID: 38563603. READ THE WHOLE THESIS! Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer Cliniko free trial, click here!

In this episode of The Shoulder Physio Podcast, I am joined by Rich Willy, PhD to discuss bone stress injuries. Rich is one of the foremost experts in the world on bone stress injuries, and it was a real pleasure to sit down with him for an hour to chat all things bone. Bone stress injuries can be quite common in athletic populations and the consequences of a poorly managed bone stress injury can be severe. As such, it is so important to be able to accurately detect a bone stress injury, know how to manage it, and give appropriate advice and education around what causes it and what is their probably prognosis. Rich gives us a masterclass on all of this and much more.  Don't miss this wonderful episode with Rich Willy, PhD. Key Papers: Nunns M et al. Four biomechanical and anthropometric measures predict tibial stress fracture: a prospective study of 1065 Royal Marines. Br J Sports Med. 2016 Oct;50(19):1206-10. doi: 10.1136/bjsports-2015-095394. Epub 2016 Jan 8. PMID: 26746906. Warden SJ, Edwards WB, Willy RW. Preventing Bone Stress Injuries in Runners with Optimal Workload. Curr Osteoporos Rep. 2021 Jun;19(3):298-307. doi: 10.1007/s11914-021-00666-y. Epub 2021 Feb 26. PMID: 33635519; PMCID: PMC8316280. McLellan M, Allahabadi S, Pandya NK. Youth Sports Specialization and Its Effect on Professional, Elite, and Olympic Athlete Performance, Career Longevity, and Injury Rates: A Systematic Review. Orthop J Sports Med. 2022 Nov 4;10(11):23259671221129594. doi: 10.1177/23259671221129594. PMID: 36353394; PMCID: PMC9638532. Tenforde AS, Outerleys J, Bouxsein ML, Buckless CG, Besier T, Davis IS, Bredella MA. Metatarsal Bone Marrow Edema on Magnetic Resonance Imaging and Its Correlation to Bone Stress Injuries in Male Collegiate Basketball Players. Orthop J Sports Med. 2022 Jan 17;10(1):23259671211063505. doi: 10.1177/23259671211063505. PMID: 35071655; PMCID: PMC8777350. Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 Rich on Twitter: @rwilly2003 Rich on Instagram: @montanarunninglab Rich's website: www.montanarunninglab.com See our Disclaimer here: The Shoulder Physio - Disclaimer Cliniko free trial, click here!

In this episode of The Shoulder Physio podcast, I am joined by Chris Neason and Claire Samanna to discuss their recently published randomised controlled trial exploring running as a treatment for chronic low back pain.  Chronic low back pain is widely believed to be one of the biggest contributors to years lived with disability. As such, it is a problem that needs attention, and part of this is identifying effective treatments. Typically, exercise is a recommended and effective treatment for persistent low back pain, and this can include resistance exercise, pilates, yoga and many other movement based approaches. But what about good old fashioned jogging, could this work? Listen to find out! Don't miss this wonderful episode with Chris Neason and Claire Samanna. Key Papers: Neason C, Samanna CL, et al. Running is acceptable and efficacious in adults with non-specific chronic low back pain: the ASTEROID randomised controlled trial. Br J Sports Med. 2024 Oct 7:bjsports-2024-108245. doi: 10.1136/bjsports-2024-108245. Epub ahead of print. PMID: 39375007. Natoli A, Jones MD, Long V, Mouatt B, Walker ED, Gibbs MT. How do people with chronic low back pain perceive specific and general exercise? A mixed methods survey. Pain Pract. 2024 Jun;24(5):739-748. doi: 10.1111/papr.13354. Epub 2024 Feb 20. PMID: 38379359. Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 Chris on Twitter: @chris_neason Claire on Instagram: @claire_thelowbackpain_ep Claire on Twitter: @claireLsamanna  See our Disclaimer here: The Shoulder Physio - Disclaimer Cliniko free trial, click here!

In this episode of The Shoulder Physio podcast, I am joined by Dr John Kuhn, who is an orthopaedic surgeon and researcher from the United States. Doctor Kuhn and his colleagues, through the MOON shoulder group, have published several high impact studies investigating the management of individuals with rotator cuff tears and the results of these studies have caused some controversy (good controversy, that is).  Rotator cuff tears are ubiquitous in musculoskeletal health care. They are both common and often burdensome, so it is important that shoulder surgeons and physiotherapists can agree on best practice management, for the betterment of the individual with the rotator cuff tear. So do John and I agree or not? Listen to find out.  Don't miss this wonderful episode with Doctor John Kuhn. Key Papers: Kuhn et al; MOON Shoulder Group. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg. 2013 Oct;22(10):1371-9. doi: 10.1016/j.jse.2013.01.026. Epub 2013 Mar 27. PMID: 23540577; PMCID: PMC3748251. Dunn WR et al; MOON Shoulder Group. 2013 Neer Award: predictors of failure of nonoperative treatment of chronic, symptomatic, full-thickness rotator cuff tears. J Shoulder Elbow Surg. 2016 Aug;25(8):1303-11. doi: 10.1016/j.jse.2016.04.030. PMID: 27422460. Kuhn JE et al. The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort. J Bone Joint Surg Am. 2024 Sep 4;106(17):1563-1572. doi: 10.2106/JBJS.23.00978. Epub 2024 Jul 9. PMID: 38980920. Kuhn, 2023. Prevalence, Natural History, and Nonoperative Treatment of Rotator Cuff Disease Check out the Shoulder Physio Online Course here - 40% off for a limited time! Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 John's Research Gate profile See our Disclaimer here: The Shoulder Physio - Disclaimer Cliniko free trial, click here!

In this episode of The Shoulder Physio podcast, I am joined by Leanne Bisset, who is the queen of tennis elbow, seriously. Leanne is an associate professor at Griffith University on the Gold Coast, Australia with a keen interest in upper limb tendinopathy. Leanne also has extensive experience as a clinician, which makes Leanne a balanced voice of reason.  Tennis elbow is a common and often debilitating musculoskeletal condition however it often receives insufficient attention compared to other, more sexy, tendinopathies. This episode will change that as we explore all dimensions of tennis elbow, from diagnosis to differential diagnosis to pain mechanisms and of course treatment. Don't miss this wonderful episode with Leanne Bisset. Key Papers: Leanne's google scholar profile  Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 Leanne on Twitter: @leannebisset Cliniko free trial, click here! See our Disclaimer here: The Shoulder Physio - Disclaimer

In a captivating discussion, Tim Gabbett, renowned as the training load master, dives into the critical role of load management in sports. He shares insights on the evolution of sports science and the journey from average athlete to expert. Tim explains the acute chronic workload ratio and its significance in balancing training stress and recovery to prevent injuries. He addresses the complexities of load management and emphasizes the need for individualized approaches, encouraging resilience and adaptability in athletes.

In this episode of The Shoulder Physio podcast, I am joined by Caitlin Jones, who has recently published a world first randomised placebo controlled trial in the Lancet journal on opioids for acute neck and low back pain. In this episode Caitlin discusses why they chose to do this trial, the results and their possible clinical implications. Caitlin also responds to various critiques of the trial with aplomb.  Don't miss this enlightening episode with Caitlin Jones. Key Papers: Jones CMP et al. OPAL Investigators Coordinators. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet. 2023 Jul 22;402(10398):304-312. doi: 10.1016/S0140-6736(23)00404-X. Epub 2023 Jun 28. Erratum in: Lancet. 2023 Aug 19;402(10402):612. doi: 10.1016/S0140-6736(23)01681-1. PMID: 37392748. Check out the Shoulder Physio Online Course here Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on Twitter: @‌jaredpowell12 Caitlin on Twitter: @caitlin_jones See our Disclaimer here: The Shoulder Physio - Disclaimer Cliniko free trial, click here!