The Shoulder Physio Podcast

The question of allowing pain, or avoiding it, during exercise based rehab remains contentious and uncertain. So, like any good scientist, we (led by Ivy Tran) studied the evidence-base and sought an answer to this clinical conundrum to help not just you, but us too! What did we find? Listen to the episode to find out.  Key resources Tran I et al. Effectiveness of Painful Versus Non...

What is a physiotherapist? Strip away the hands, the exercises, the modalities, what's left? In this episode I argue that the "fixer" identity, the clinician who finds what's broken and corrects it, isn't where our profession came from. It's something that was selected into us through a century of professional politics and reductionist thinking. Drawing on the history of physiotherapy, Newell's co...

Burnout in our profession is widespread, with most studies reporting prevalence between 8 and 23 per cent, and up to 65 per cent of recent graduates planning to leave physiotherapy within ten years. In this episode, drawing on a recent editorial in the Journal of Physiotherapy by Ky Wynne, I lay out the empirical picture and challenge the dominant framing that burnout is a problem of individu...

Is more always better? Is there a dose response effect of exercise for musculoskeletal pain? Should exercise be just like a medication, where the dose has to be sufficient in order for it to elicit a therapeutic effect?  These are the questions we contend with on this episode of The Shoulder Physio Podcast.  Key resources Lawford BJ, Hinman RS, Spiers L, Kimp AJ, Dell'Isola A, Harme...

The FIMAGE study scanned both shoulders of 602 adults from the general population using high-resolution 3-Tesla MRI. Only 7 had a structurally normal rotator cuff. In this episode, I walk through what the study found, why 78% of full-thickness tears were in people with no shoulder pain, and what happens to the diagnostic value of a scan when the finding it detects is near-universal. I challenge th...

In this episode, I walk through my recent JOSPT paper arguing that no single treatment modality has proven itself superior for musculoskeletal pain and that the profession should stop pretending otherwise. Drawing on Isaiah Berlin's distinction between the hedgehog and the fox, I make the case for treatment pluralism: the idea that multiple interventions can lead to recovery, and that rigid allegi...

I posted a meta-analysis showing PRP doesn't beat saline for tennis elbow. The regenerative medicine community came for me, hard. This episode walks through the incident, what the evidence states, why the comparator you choose determines the conclusion you reach, and what the pushback reveals about incentives in musculoskeletal medicine. References Antunes Júnior et al. (2026). Platelet-rich...

The argument that AI replaces "the science" while clinicians should "lean into the art" has become common across healthcare. In this episode, I explain why I think both sides of that framing get it wrong, and why the art vs. science debate was always a false dichotomy that AI has simply made harder to ignore. I draw on four thinkers to make the case: Michael Polanyi on tacit knowledge, Donald Schö...

In this episode of The Shoulder Physio Podcast, we discuss why musculoskeletal clinicians are, at their core, knowledge workers. Not in the corporate buzzword sense, but in the truest sense: professionals whose value comes from the quality of their thinking, not the techniques in their toolkit. We explore why knowledge compounds but repetition doesn't, why information alone fails to change behavio...

Physiotherapist and PhD researcher Laura Anderson just published a paper arguing that "medial tibial stress syndrome" is a 'garbage' name that's been freaking runners out and leading to terrible treatment for decades. Her proposed replacement? Load-Induced Medial Leg Pain (LIMP). Yes, LIMP, pun not intended. The Problem: "Tibial stress" makes everyone think bone stress injury → stress fracture → p...

In this episode, I discuss our recently published BJSM editorial “It’s Not All About Strength”  ; what the paper argues, why we wrote it, and what the evidence says about mechanisms of exercise-related pain relief in musculoskeletal conditions. I then turn to the reaction. Not to name names or settle scores, but to examine what the response reveals about how we handle criticism, uncertainty,...

In this episode, Jared Powell is joined by Dr. Jackson Fyfe, exercise scientist and Senior Lecturer at Deakin University, to explore the science and practicality of resistance training across the lifespan . They unpack everything from how kids can safely lift weights to how older adults can maintain muscle health and longevity. Jackson also shares insights from his research on training dosage, hyp...

In this episode, Jared announces the launch of The Complete Clinician,  a new mentorship and education community for MSK professionals who want more than recycled CPD. He explains why this platform exists, what’s inside, and who it’s designed for. From monthly PhD-level lectures to the Brew & Review journal club, structured learning modules, and The Clinician’s Compass, this is a second e...

In this candid and wide-ranging conversation, Dr Jared Powell is joined once again by Professor Peter O’Sullivan, one of the most influential voices in musculoskeletal care.  Pete unpacks the rationale and findings of the landmark RESTORE trial published in The Lancet , which provides some of the most compelling evidence to date for cognitive functional therapy (CFT) in people with chronic lo...

In this solo episode of The Shoulder Physio Podcast , Dr Jared Powell explores a deceptively simple question: How much benefit does rotator cuff surgery need to provide to be considered worthwhile?   Jared explores a new 2025 study by Harrison Hansford and colleagues, which uses a clever benefit–harm trade-off approach to quantify what patients actually want from surgery. This episode ch...

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 mar...

 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...

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 compre...

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...

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 st...

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 attenti...

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...

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 elbo...

In this episode of The Shoulder Physio podcast, I am joined by  Tim Gabbett, who is the training load master. Tim has an incredible resume as both a coach and scientist and recently featured in the top 10 of a list ranking sports scientists from around the world.  In this episode, we go deep into the training load literature and what it may mean for the clinician and coach...

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 re...