The Physio Pulse Podcast

This week we are re-releasing our first ever proper episode on two RCT's exploring the question of whether there is a difference between ACL reconstruction and non-operative management!Please note, this epidsode does not constitute medical advice.

We're always told to avoid dorsiflexion with insertional Achilles tendinopathies, but is this accurate?We discuss the 2025 paper - Effectiveness of reducing tendon compression in the rehabilitation of insertional Achilles tendinopathy: a randomised clinical trialhttps://bjsm.bmj.com/content/59/9/640.long

Jeff discusses a rationale he can see to justify the use of a bosu ball, despite not actually using them himself!Paper for affordances and chronic pain HERE Embodied pain HEREEnactive biopsychosocial model HEREPlease note, this episode does not constitute medical advice.

James presents a case study of a patient who came to see him with bilateral knee pains, but all is not as it seems...

Jeff shares his most successful prank on James, and we talk about injections for tennis elbow with some good talking points around placebo / contextual effects and open science.Please note, this episode does not constitute medical advice.

Today on Physio pulse James has some beefJeff ruins a shirt We dive into the world of blood flow restriction training for knee OA with the very recent Jacobs et al 2025 paper making the rounds on social media.

This week we dip our toe into the political space and accompany this with the first meta-analysis investigating socioeconomic status and chronic pain.Jeff has an apology to make for the listeners and gets excited about a funnel plot (he's not got much going on right now).James keeps conversation on track as the more politically aware of the two of us and makes this a passable episode.Please note, this episode does not constitute medical advice.

Struggle to get your head around the ascending and descending pathways? And what even is pain gate?? Well in our clinical pearl episode this week James gives a quick overview in 6 minutesHope you enjoy!

Today on the Physio Pulse we had the pleasure of speaking with Joe Palmer who is a lecturer and researcher working in Sheffield and was in the first cohort of clinicians who moved into the First Contact Physiotherapy roles. We speak about the realities of lecturing and research, the trials and tribulations of FCP and how to get clinicians to fall in love with stats. Hope you enjoy!Click here for a link to the statistics book Joe mentioned!

We sit down and read the Kim Herbert-Losier paper on updated normative values and reliability of the calf raise test. What does the average actually show, how should it be completed to have comparative values and what does it inform?Also, James confesses to having very skinny calves.Apologies as Jeff's audio is a little bit low on this one!Please note, this episode does not constitute medical advice.

In this episode, we're joined by Paul Houghoughi, better known as The Climbing Physio, to dive deep into the world of climbing injuries, rehab, and performance. Paul shares his insights on the most common climbing-related injuries, the unique demands of the sport and the best strategies for rehab and prevention. Tune in and learn how to take your hand rehab game—to the next level!

This week James and Jeff delve into one (...of the many) subgroup analyses of the DREAM study. What is better surgery or Physiotherapy for meniscal tears?How can we predict which patients will do well in each group? Why does Jeff hate the world of research?

This week we have a great discussion with Dr. Jared Powell on all things relating to dispositional causation and how this relates to positive clinical improvements in people with shoulder pain (but this could be extended to most MSK pain really!) These complex topics are broken down into very digestible soundbites and we think this episode is a must listen, and probably one to revisit in the future! Please note, this episode does not constitute medical advice.

Would you have ever considered injection someone with mid-portion achilles tendinopathy 3 times in the space of 12 weeks? Johanssen et al (2022) did in todays paper and the results might surprise you! This is the closest we have come on having genuinely different views on a paper and was a fun conversation! Please note, this episode does not constitute medical advice.

A quick overview of RCRSP - What is the literature around diagnosis? - Are special tests useful for this condition? - Brief overview of the history of this condition - What is the evidence around strengthening exercises for this condition? Hope you enjoy!

Should we be ordering imaging for patients when it won't change management, but it is perceived (sometimes wrongly?) that it could help their health anxiety? This is a clinically grey area, and one we have tried to tackle in the absence of any strong direction from the literature. Jeff and James take opposite sides in the debate initially before settling into what we think good practice looks like. This was a difficult topic to use as our first debate format, but we hope it is interesting! Please use the comment section to add any thoughts you have on this!

We're back for 2025! Looking at the recent Heide et al 2024 paper comparing Shockwave, Sham Shockwave, Exercise and Education + Custom Insoles. https://pmc.ncbi.nlm.nih.gov/articles/PMC11347971/ Jeff reads the wrong paper James has a bee in his bonnet

This week we chat around James' injection skills, what we have found doing a podcast is like and recommendations for 2025. James also provides an update to a case study he raised a few episodes back. See you in 2025!

If you want to skip past the discussion on the recent assisted dying bill in the UK then head to 09:20. We take a deep dive into movement science, ecological dynamics and a research paper looking at different ways to 'teach movement' Please note, this episode does not constitute medical advice.

This week we dive into a qualitative paper for the first time all around perceptions of sciatica from the patients perspective! James talks about wearing high heels. Please note, this episode does not constitute medical advice.

In the intro to this episode we discuss our thoughts on the HCPC hearing Adam Meakins is currently going through, Jeff makes a bet that he won't swear for the remainder of the episode and James leads a conversation on a patient with shoulder pain that wasn't improving with rehabilitation! Please note, this episode does not constitute medical advice.

This paper has made a huge splash and influenced so many physios treatments. So naturally we need to dive into it a bit deeper to see what it actually shows. Jeff has beef (surprise), James googles more things. Please note, this episode does not constitute medical advice.

You may have seen all the recent hype around Ozempic and other "miracle" Semaglutide medications for weight loss in the recent months... But what is the clinical utility of these for OA?? We explore the new 2024 paper "Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis by Bliddal et al" James tries not to get sued Jeff mobs a hip

It's time for another case study! This week we run through a complex presentation of bilateral buttock pain. James scored 9/10 on the possible differentials. Jeff talks about his upcoming course. If you would like to show support for the show, it would be much appreciated and you can explore this more here Please note, this episode does not constitute medical advice.

James compliments Jeff. Also, we discuss Messier et al (2021) which compared an 18 month long high and low intensity exercise compared to an attention control in people with knee osteoarthritis... the results of which may surprise you! *Regarding discussion on strength, the 3Nm/kg statistic we talked about is for isometric testing so strictly is not right to compare to 30 degrees/second isokinetic... but the message still stands! Please note, this episode does not constitute medical advice.

We sit down to discuss a golden oldie from the research base. The study that gave us the straight leg raise and an insight into how the thinking around radicular pain developed!We use this as a jumping off point before discussing different types of nerve root problems and how we think about them clinically.Please note this episode does not constitute medical advice.

We sat down with the legend that is Erik Meira to get his views on A.I. and it's potential role in healthcare and of course, some lower limb biomechanics and application to rehabilitation! If you want to skip to the main discussion - head to around the 16 minute mark, kick back and enjoy! Please go and check out www.thesciencept.com and PT Inquest to learn more from Erik! This show does not constitute medical advice.

James and Jeff are ahead of the game with this one! Looking at the very recent Hancock study diving into what moderates how people respond to treatment for Chronic LBP. James wears a shirt and tie Jeff gets nervous about our next guest...

Patellofemoral pain after an ACL reconstruction or injury can be a huge problem if you don't know how to manage it and can at times grind rehab to a crawl. In this episode we sit down with a good friend Fin Murphy (@finmurphyphysio), who is an expert in ACL rehabilitation, to discuss how we can reduce the likelihood of patients experiencing PFP after ACL-R and what to do about it if you find yourself trying to manage it! This was a fantastic episode to record with loads of practical advice that you can implement straight away into your treatments. Along with (mostly) good analogies / metaphors to help with your communication. Fin can be found online on Instagram @finmurphyphysio and is well worth a follow for information around ACL rehab! Please note, this episode does not constitute medical advice.

This week we sit down to discuss another case study, this time taking an approach from a traige setting for someone with progressive neck weakness! Please note, this episode does not constitute medical advice.

We sit down to discuss a patient Jeff has previously treated (with some details altered) with an emphasis on the psychological aspects of the story. This serves as an introductory episode to the concepts we will be exploring with Dr. Carl Bescoby (@theinjurypsychologist) on the podcast next week which will be one to make sure you don't miss!Please note, this episode does not constitute medical advice.

We discuss the CHECK prospective cohort study - the first of its kind looking at symptoms alongside radiographic findings in FAIS and its relationship with future hip osteoarthritis! Please note, this episode does not constitute medical advice.

This week we delve into a fascinating study looking at the effects of nerve blocks into the gluteal muscles and how that effects (or more interestingly, doesn't effect) peoples squatting kinetics and kinematics.

James does a brief rundown on the 3 most common Spondyloarthropathies. What should we be asking subjectively and what tools do we have to aid diagnosis as Physio's? Terrible jokes and a bit of myth busting along the way

Misinformation is everywhere, and relating to science is no different. We discuss how science is a social construct and how this opens it up to being primary sources of misinformation. Importantly, we discuss how to try and protect yourself from these traps. "When genuine benefit exists for an intervention, it easily withstands critical appraisal. No one debates the value of antibiotics for bacterial infection" (Mandrola et al, 2019) Please note, this podcast does not constitute medical advice.

Quadriceps peak torque is an important metric to track in ACL rehabilitation. But is it valued too highly for return to run decisions? In this episode, Jeff breaks down some of the literature that looks at this question to understand what we know so far about the value of this metric when making return to run decisions. Please note, this episode does not constitute medical advice.

We sit down to chat with the legend that is @skepticalphysio - a friend of ours for many years, to delve into the realms of anatomical possibilism, pseudoscience and how to shield yourself from it! Diego shares great insight informed by his history in journalism, physiotherapy and philosophy of science. This was a great episode, with a great guest! Please note, this show does not constitute medical advice.

Does following simple decision rules reduce the risk of re-injury after ACL-R by 84%? We discuss this strong claim by Grindem et al (2016) and look at the specifics of this widely cited and quoted research! As always, it's not as straight forward as it seems! Please note, this show does not constitute medical advice.

We run through everything from assessment, radiographic features, surgery and rehabilitation in patella instability using an example of a patient similar to people Jeff has worked with in the past. Please note, this episode does not constitute medical advice.

We have a brief discussion on the importance and challenges of informing patient expectations before sitting down to discuss a challenging case that James has experienced recently (This section starts at 14:15). Please note, this podcast does not constitute medical advice.

Physio, MUA or Surgery for Frozen Shoulder? We discuss the findings of this landmark paper as well as how we think it fits into our current understanding and treatment of patients with a frozen shoulder. Please note, this episode does not constitute medical advice.

Jeff sits down to discuss one of the most important distinguishing questions to ask someone to help decipher between a bone stress injury or a tendinopathy. Does his one question match up with what yours would be? Please note, this episode does not constitute medical advice.

We sit down to run through a case study! There is something for everyone in this episode; from planning and executing history taking and a clinical exam, through to the operative and non-operative management discussions and the reasoning behind this. Please note, this podcast does not constitute medical advice.

We sit down to discuss the RESTORE trial, the biggest RCT to date looking at cognitive functional therapy for back pain! Please note, this podcast does not constitute medical advice.

We sit down to discuss well known and well cited randomised controlled trials looking at primary management of ACL rupture, KANON and ACL SNNAP. Which treatment appears to be superior in the management of ACL rupture? What are our takeaways to clinical practice? For links to the papers discussed, access our open Dropbox through @physiopulsepodcast on Instagram. Please note, this podcast does not constitute medical advice.

Introducing who we are, and what we hope to do with the podcast moving forwards!