All the data point to a growing burden of chronic musculoskeletal pain for populations around the world. Clearly, there is a need to innovate in the way that musculoskeletal care is delivered.

In today's episode, Dr Luc Hébert shares his wealth of experience in musculoskeletal rehabilitation care - as a clinician and as a researcher leading clinical trials of different care models. We explore new models of care and the data supporting them.

Dr Hébert is Professor at Laval University in Quebec City, Canada, and researcher at the Interdisciplinary Research Centre on Rehabilitation and Social Integration.

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RESOURCES

Group-based rehabilitation vs. individual programs: https://www.jospt.org/doi/10.2519/jospt.2024.12342

Benefits of primary contact emergency department physical therapy: https://www.jospt.org/doi/10.2519/jospt.2025.13429

There are many outstanding leaders in the sports medicine and musculoskeletal rehabilitation world. How did they get there? What decisions did they make that have got them to where they are today?

In today's episode, Dr Amber Donaldson shares what she is looking for in the next generation of sports medicine leaders, how she has approached developing her own career, and her advice for early-career clinicians looking to establish themselves in elite sports medicine.

Dr Donaldson is the Vice President - Sports Medicine at the United States Olympic and Paralympic Committee.

How often do you think about the air quality in the clinic or outside when you're exercising? Perhaps you live and work in a part of the world where you're fortunate to have good air quality most of the time. For many people though, that's not the case.

Air pollution from wildfires in increasing, and it has serious implications for everyone's health. Today, Dr Débora Petry Moecke (Centre for Heart Lung Innovation, University of British Columbia) explains how to support clean air in the clinic to protect patients' health.

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RESOURCES

Wildfire smoke and its impact on physical therapy practice: https://www.jospt.org/doi/10.2519/jospt.2025.13546

IQAir (real-time air quality data from around the world): www.iqair.com

Today, Dr Federico Pozzi (University of Florida), walks Dan and Marquis through his recent paper titled “Addressing Shoulder Weakness in Individuals With Rotator Cuff–Related Shoulder Pain: A Systematic Review With Meta-analysis”

In this discussion, Dr Pozzi, Dan & Marquis look at the research regarding rotator cuff-related shoulder pain, asking the question: what type of strengthening interventions help best? Dr Pozzi shares his advice for clinicians on how to design and implement effective shoulder rehabilitation programs.

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RESOURCES

Addressing shoulder weakness systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13445

Rugby is seeing consistent growth in popularity and participation. It's also no secret that women's sport is also growing rapidly. Put those together and you enter the exciting and rapidly developing area of women's and girl's rugby.

Today, Dr Isla Shill (University of Victoria) discusses her research work in preventing injuries (including concussion) in girl's rugby. She shares the key components, and what it takes to implement an effective injury prevention program.

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RESOURCES

Effects of neuromuscular training warm-up for preventing injury and concussion in girl's rugby: https://www.jospt.org/doi/10.2519/jospt.2026.13373

SHRED injuries neuromuscular training warm-up programs: https://www.ucalgary.ca/shred-injuries

Tips for supporting athletes to return to sport after concussion, with Dr Kathryn Schneider: https://pod.link/1522929437/episode/YTA0ZWY0NDgtYzNmZi00ODlmLTg5ZWQtMTAyMDE3ZTUxNjhk

Female, woman, and/or girl Athlete Injury pRevention: https://fairconsensus.com/

FAIR practical recommendations: https://pubmed.ncbi.nlm.nih.gov/41330629/

Today’s guest—Dr Thomas Ibounig—who led the paper, “Rotator Cuff Imaging Abnormalities in Asymptomatic Shoulders: A systematic review” explores how prevalent abnormal MRI findings are in asymptomatic shoulders, and how the prevalence changes by population.

The systematic review is an exemplar of what musculoskeletal rehabilitation clinicians can learn from accepting what we don’t know!

Chelsea and Marquis wrap up the chat by thinking about how physical therapists can take the systematic review findings into account when educating and referring patients with shoulder pain.

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RESOURCES

Rotator cuff imaging abnormalities in asymptomatic shoulders systematic review: https://www.jospt.org/doi/10.2519/jospt.2025.13611

More on the SCRUTINY (Systematic Review of Shoulder Imaging Abnormalities in Asymptomatic Adults) project: https://www.ficebo.com/project/scrutiny

Psychological factors can be prominent for people with tendinopathy–so how do you pick up on them? How might psychological factors guide your plan of care? Today, physiotherapist Jack Mest (University of Canberra), is your guide to understanding how best to screen for important psychological factors, and how to address them in the clinic.

Jack Mest is a PhD candidate, studying psychological factors associated with persistent tendinopathy and psychologically informed approaches in Achilles tendinopathy rehabilitation.

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RESOURCES

Psychological factors in people with and without persistent tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2025.13307

Scoping review of psychological factors in tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2022.11005

JOSPT Insights ep 255: what if clinicians trusted people in pain? With Joletta Belton & Ben Darlow: https://pod.link/1522929437/episode/ZjcwNTljYzMtMjI5Ny00NWI2LWJjNzMtYzlkZTA3ZjVhODcz

The Covid pandemic was an inflection point for many aspects of health care, including turbocharging uptake of virtual models of care.

Telerehabilitation was around before Covid, of course, but the past few years has seen it in a far more prominent place in health care systems. There's also increasing research evaluating different telerehabilitation interventions.

Dr Bruno Saragiotto (University of Technology Sydney) studies telehealth for chronic pain conditions, artificial intelligence and implementing digital solutions in health care. Today he joins JOSPT Insights to discuss the present and future of technology for improving outcomes in musculoskeletal rehabilitation.

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RESOURCES

Internet-based self-management for chronic pain (ReabilitaDOR Trial): https://www.jospt.org/doi/10.2519/jospt.2025.13418

Effectiveness of activity trackers and smartphone apps for increasing physical activity: https://www.jospt.org/doi/10.2519/jospt.2026.13825

Physiotherapy Evidence Database (PEDro): https://pedro.org.au/

In episode 258, Drs Ruth Chang and JP Caneiro explain the results of trials testing cognitive functional therapy (CFT). They explored what CFT is and how it might help people in pain.

In today's episode, Dr Caneiro (Curtin University; Evoolve Pain Care Academy) joins the JOSPT Insights community again to explain what is involved in learning the patient-centred CFT approach.

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RESOURCES

Evoolve Pain Care Academy: https://evoolvepaincare.academy/

Videos, infographics and written resources for clinicians: https://evoolvepaincare.academy/clinician-resources

All clinicians know the challenge and opportunity that comes with tailoring clinical decisions to the person in front of you. While it's helpful to have clinical practice guidelines to give you a starting point and to reduce unwarranted variation in practice, of course every patient is different!

Today, Dr Trevor Lentz (Duke University) explains the concept of clinical phenotyping, which is another way of identifying patterns in your clinical practice, and guiding your clinical decisions.

Clinical phenotyping has been suggested as a way of tailoring musculoskeletal care in practice, although its implementation in practice has been patchy - Dr Lentz explains some of the reasons why.

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RESOURCES

Psychological phenotyping in osteoarthritis: https://www.jospt.org/doi/10.2519/josptopen.2025.0177

OSPRO yellow flags tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487

Clinical framework for screening yellow flags: https://www.jospt.org/doi/10.2519/jospt.2021.10570

STarT MSK research programme review: https://pubmed.ncbi.nlm.nih.gov/37490570/

Last week we explored how people with pain move. Drs Ruth Chang and JP Caneiro explained cognitive functional therapy, or CFT, as an approach to helping people in pain explore their beliefs with curiosity. Today, we take the discussion further, exploring what CFT could do for your practice.

Dr Chang is a postdoctoral research fellow at Curtin University in Perth, Australia, and a specialist musculoskeletal physiotherapist. Dr Caneiro is a specialist physiotherapist, Adjunct Senior Clinical Researcher at Curtin University, and Director and Educator at Evoolve Pain Care Academy.

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RESOURCES

RESTORE trial: https://pubmed.ncbi.nlm.nih.gov/37146623/

Patterns of change in forward bending, and pain self-efficacy during CFT: https://www.jospt.org/doi/10.2519/jospt.2025.13114

Relationship between forward bending and improvement in pain and disability during CFT: https://www.jospt.org/doi/10.2519/jospt.2024.12727

Network meta-analysis of tailored exercise therapies with or without psychological interventions: https://www.jospt.org/doi/10.2519/jospt.2025.13281