The Shoulder Physio Podcast

In this episode of The Shoulder Physio Podcast, I am joined by  Rachelle Buchbinder and Ian Harris. Rachelle and Ian are academic doctors who still see and treat patients whilst also conducting high quality research. This conversation centres around the concept that modern medical care is sick. Over-treatment, over-diagnosis, junk science, and perverse incentives are just some of the iss...

In this episode of The Shoulder Physio podcast, I am joined by  Kim Bennell, a professor and research physiotherapist from the University of Melbourne. Kim has been involved in designing and implementing dozens of clinical trials over her many years of research and is a true giant of the physiotherapy profession.  In this episode we discuss something novel. We venture into...

In this episode of The Shoulder Physio podcast, I am joined by  Amy McDevitt, an associate professor and clinician  at the University of Colorado. Amy shared her perspective on manual  therapy and the importance of unraveling the mechanisms behind this  treatment approach. We discussed the evolving causal explanations of manual therapy, moving  bey...

Patello-femoral pain is a common, and at times, debilitating condition of the knee that can impact people across the lifespan. Professor Bill Vicenzino is a world leading expert on this topic and to that end I've enticed him onto the show to give us the ins and outs of this tricky condition. This is truly a must listen episode with a real pioneer of physiotherapy about a very common...

When a patient comes to see a physiotherapist, or any health care professional, how much better does that patient need to get to make a treatment worthwhile? This is an important question because we're constantly making treatment recommendations to patients, day in-day-out, but based on what? My guest for this podcast, Harrison Hansford, reckons a lot of our treatment decisions...

We're constantly told, even lectured, about the importance of exercise for most non-traumatic musculoskeletal pain presentations, shoulder pain included. We assume it works for all people across time and space, but is this true? Are there factors that might influence whether exercise will help an individual with shoulder pain or not? What are these factors and can we influence them? Listen on to h...

Every iconic scientist has a quote emphasising the importance of uncertainty and doubt that underpins the scientific attitude. This holds true as much for fundamental physics and biological science as it does for health science, probably far more so in the case of health science. For we are complex, non-linear creatures, each with different stories, backgrounds, contexts and circums...

Pilates exercise seems to help people with chronic low back pain...but how? What are the causal mechanisms underpinning the apparent effectiveness of Pilates? Does it activate the multifidus and transeversus abdominis muscles? Does it reduce fear and improve confidence? Both or neither? To shed some light on this question I have invited Lianne Wood on to the show, who, incidentally, has a paper on...

What exactly is a placebo effect? When you try and pin it down, it's confusing. Technically, it's something inert that produces an effect...how can there be an effect without a mechanism? Prof. Steve Kamper is here to help bring clarity to the issue.  Key Papers: Kamper 2013: The placebo effect: powerful, powerless or redundant? Testa and Rossettini 2016:  Enhance placebo, avoid nocebo:...

Science is ubiquitous. But what is it? Everyone talks about science and the significance of being scientific but nailing down just what this means for clinical practice in physical therapy is somewhat elusive. To clear all this up, I’m joined by the Science Pt, Erik Meira. Erik is a sharp and eloquent communicator about science and its application to physical therapy. You don’t want to miss this o...

Exercise for knee osteoarthritis is a non-negotiable and effective intervention, right? Well, maybe it’s not so clear. Evidence seems to be dropping every month challenging the privileged position that exercise occupies for managing knee osteoarthritis. Front and centre is the infamous DICSO trial, published in 2022, and this study will serve as the foundation for this debate. The debate feat...

Tendinopathy: Is it a simple case of tendon overload that can be fixed with eccentric exercise or friction massage? What's the deal with inflammation? Is there a role for adjunct therapies such as biologics and medications? Can physios, surgeons and sports physicians ever get along when it comes to managing tendinopathy? My guest, Professor Neal Millar is here to let you know.  Key papers: Mi...

Strengthening exercise is a popular and effective treatment for shoulder pain. But...is the benefit of strengthening exercise derived from getting stronger or are there other causal mechanisms underpinning the effect? Listen to find out! Key papers: Powell and Lewis 2021:   Rotator Cuff–Related Shoulder Pain: Is It Time to Reframe the Advice, “You Need to Strengthen Your Shoulder”? Lewis and...

Can we prevent injuries from happening? All of them? If we can't prevent ALL injuries should we move away from using the term prevention? Or is all this boring and irrelevant linguistic games that don't move the needle for clinical practice? I for one am fascinated by this discussion and I reckon you will enjoy it too. Franco, as always, has the ability to cut through fluffy opinions and stat...

In this solo episode I discuss the evidence underpinning the use of platelet rich plasma injections for shoulder pain. Platelet rich plasma makes total sense on the surface, but do empirical findings support this? Should we continue down the pathway of research for platelet rich plasma, or move on? Should you recommend it in your practice? What do you say if a patient asks you about it? These are...

In this episode I speak with eminent sport scientist and coach, John Kiely. John is infamous for challenging dogmatic training principles in sport science, chiefly periodisation theory. Our conversation starts with periodisation theory and then goes to some interesting locations, stopping momentarily at homeostasis, allostasis, general adaptation syndrome (GAS), predictive processing, the biomedic...

An entrenched assumption in sport and exercise medicine/physiotherapy, going back decades, has been that ACL (anterior cruciate ligament) injuries DO NOT heal. Not ever. However, like many dogmatic beliefs in the health and fitness sector, this assumption appears to have been seriously wrong. Dr Stephanie Filbay joins me to discuss her latest paper about the healing capacity of the...

Osteoarthritis (OA) is a leading cause of pain and disability. OA is also seems to be associated with several myths and misconceptions about how it is caused and how it might be managed. To cut through some of this mythology, I invited Professor David Hunter on the show for a 'no holds barred' conversation. David is the number 1 ranked expert in the world on OA, so it should come as no surprise he...

In this podcast, I discuss the scapula with Filip Struyf, PhD. Filip is a former guest on the show (episode 2) and I've pulled him back on the podcast to tackle the hard problems as they relate to the scapula. Specifically, in this episode we consider the question: "If we identify a scapula dyskinesis in our physical examination, should we attempt to rectify it?".  Key Resources: Filip's fabu...

Feeling stiff is a familiar feeling for all of us. But does feeling stiff mean our joints are actually stiff? Or is there more to it. Tasha Stanton PhD is a clinical neuroscientist who has performed research directly addressing this question. This is a fascinating conversation and I hope you enjoy.  Key resources: Tasha's paper here   Connect with Jared and Tasha: Jared on Instagram: &nb...

The Nordic hamstring exercise has enjoyed mostly good press with respect to injury prevention effectiveness. That is until recently. Professor's Franco Impellizzeri and Kristian Thorborg kindly and clearly join me in conversation to help us understand the evidence for and against this exercise. Key resources: Impellizzeri Meta analysis: HERE I shoi and Thorborg response: HERE Van Dyk systematic re...

I am joined by Connor Gleadhill to discuss causal inference. Connor is a PhD candidate exploring causal inference and is someone who speaks fluently about complex topics (must be the smooth Irish accent!). Causal inference is basically the pursuit of estimating how and why things happen. How do we determine causation - strictly through the randomised controlled trial or can we use o...

The biopsychosocial model is ubiquitous in modern health care but what is it at its core? Is it accurately described and used in research and clinical practice? To help make headway into these questions and more, I'm joined by Ben Cormack. Ben is a MSK therapist from England who has developed a special interest in the philosophy and implementation of the biopsychosocial in MSK health car...

Cognitive biases are as much of a problem as they are fundamental to the human condition. They exist, but can we mitigate them? What common cognitive biases afflict health care? Jarod and Jared shoot the s**t around these interesting questions. Melbourne workshop details:   Melbourne Workshop, June 4, The Performance Centre Jared Powell on Instagram:   @shoulder_physio Jared Powell on Tw...

In this episode I am joined by Scot Morrison to discuss the envelope of function model, as proposed by Scott Dye in the 1990s. The envelope of function has gained increasing acceptance over the past decade and I thought a deep dive into this concept was needed to highlight the potential pro's and con's of implementing this into clinical practice.   Key resources:  Scott Dye 1996 pap...