The Physio Pulse Podcast

We've had loads of new followers and we thought this week it would be great to revisit one of our first ever episodes looking at the RESTORE trial. CFT treatment for chronic lower back painWe hope you enjoy!

Today we discuss an interesting 2026 paper looking at long term outcomes for Cross Bracing ACL ruptures. DOI: 10.1097/JSM.0000000000001416What is cross bracing?Where did it come from?How does it compare to surgery in an athletic population?

Jeff has been waiting a while to discuss this paper that has been widely shared by a high impact journal (BJSM) and appears to have gained a lot of attention since its publication.Are we justified in heavily critiquing this paper? Are we taking crazy pills?! Is the spin in the abstract a cause for concern and something we should rightly be angry about?Have a read for yourself and let us know your thoughts: https://bjsm.bmj.com/content/55/9/501

In this episode, we speak with Jack Chew. A huge figure in the world of Physiotherapy Jack reflects on his rapid early career, including becoming the youngest Band 8a Physiotherapist.We then explore the origins of the MSK Reform Movement. Why it emerged, what it set out to challenge, and the resistance it encountered, before discussing Jack's subsequent move into the CSP, and what he learned trying to enact change from within the system.The conversation finishes by looking forward: what physiotherapy needs to confront, what must change, and how the profession can remain relevant, credible, and fit for the future.This is an honest discussion about professional power, evidence, scope of practice, and leadership, and it's essential listening for MSK physios, educators, managers, and anyone invested in the future of physiotherapy.We hope you enjoy!Jacks Own Words From Inside the CSPhttps://mskmag.substack.com/p/how-the-sausage-is-made-insights

This week we host the amazing S+C professor, author and coach Dan Cleather to discuss concepts from his lesser talked about books 'The Little Black Book of Training Wisdom' and 'Subvert' (Jeff and James' favourite).Topics include philosophy of science through an anarchist lens, fundamental concepts in coaching people and why Dan is cautious when it comes to adopting language associated with Dynamic Systems Theory.We hope you enjoy this episode as much as we did!You can find Dan at @dancleather on IG and most definitely search for his books on Amazon!

This week....Jeff causes a PR nightmare for Physio Pulse on social media...How should Physio courses better prepare students for MSK work?We discuss ACL limb symmetry index, is there a better way we can be testing this? or WHEN we test this - https://www.jospt.org/doi/10.2519/jospt.2017.7285

This week we have an honest discussion about the importance of NOT using some words when chatting with patients, alongside some discussion on how to balance empathy and understanding without losing the clarity of our messages.Please note, this episode is not intended to provide medical advice.

First episode of 2026 - Jeff celebrates reading the right paper - James reminisces about turkey sandwiches We are looking at the 2025 paper - Sprint running mechanics are associated with hamstring strain injury: a 6-month prospective cohort study of 126 elite male footballers

It's the end of the year, and as is tradition (i.e. it's what we did last year) we answer some listener questions, discuss different topics around the MSK world and James drinks some wine.

Our last episode before christmas! Hot off the press and only a month old, published in November 2025 What can we learn about the types of sport people try to return to after rotator cuff repairs. Do overhead athletes struggle more? and what are the risk factors for failure to return to sport?

This weeks guest is Dr. Jarred Boyd, head of physical therapy at the Memphis Grizzlies and an expert in critical thinking when it comes to reasoning out rehabilitation.In this episode, we dive straight into how Jarred uses dynamic systems theory, the theory of affordances and attractor states in his clinical reasoning. We have a post on our instagram page to explain these terms a little more however if you don't have the time and are unfamiliar, ask chatGPT to give you a rundown!This is an incredible episode that we guarantee you will pick new things up from if you listen back.Make sure to give Jarred a follow on social media and check out his episodes on other podcast platforms as there is a lot of topics we didn't even attempt to discuss with him already doing such a great job on those! (Forward Physio, E3 Rehab, Rethinking Rehab)

This week James and Jeff tread the tightrope of Physiotherapy...Plenty of clowning about...A circus acrobat with 8 months of worsening big toe painWhat are your differentials? Would you investigate?How would you treat this?When does surgery become the right option?

We dive into a placebo comparison paper for the GLAD programme which has been growing over the past few years as a structured exercise approach to manage osteoarthritis.How does it shape up to open label placebo injections? What are our thoughts on the nuances of the study, and the positives / negatives of the GLAD programme?Please note, nothing in this episode is intended to be medical advice.

We know that a most conditions will improve or fluctuate with time, but how much does that effect research outcomes?To help answer this we are looking at the 2024 paper - Regression to the mean for physical function and quality of life in clinical trials for symptomatic knee osteoarthritis - Martin Englund and Aleksandra Turkiewicz- What is regression to the mean?- How can we measure it?- How does this effect research outcomes?- What does this mean for us and our patients?

A little bit of a different episode this week! Instead of talking through a paper we sit down to discuss our thoughts on Ben Patrick, otherwise known online as 'Knees Over Toes Guy'; a hugely successful movement with the aim to help people get out of pain.Athletic Truth Group is the name of Ben Patrick's business that has emerged from this training philosophy that appears to be doing really well based off a simple message of de-threatening knees going over toes in exercise for people with knee pain.We ask: Who is Ben Patrick?How has he become so influential?What are the strengths of his approach?What are the drawbacks of his approach?How could his approach be improved?What are we doing differently now as a result of our deep dive into this approach?This was a great discussion, and one we hope you will find useful if you are unsure on your feelings about the ATG movement!

This week we discuss the 2022 Van Der Graff paper Arthroscopic partial meniscectomy versus physical therapy for traumatic meniscal tears in a young study population: a randomised controlled trialWhat are the long term outcomes for these patients between the two groups and what can we take forward to help our patients make the best choice for them?https://pmc.ncbi.nlm.nih.gov/articles/PMC9304087/#s4

This week we chat through a paper that looked at surgeons answers to questions on knee osteoarthritis compared to ChatGPT. Who comes out on top?How can AI be used in healthcare?How would you fare against AI at the end of a long day?Are James and Jeff progressive thinkers or old at heart in their early 30's?Find the paper here: https://www.thekneejournal.com/article/S0968-0160(25)00065-1/abstractPlease note, nothing in this episode is intended to be medical advice.

We review a paper with 5200 participants that tried to answer how best to analyse someones risk of injury with training load.It's been making the rounds on social media, what does it actually show and how can we use this information clinically?Please note, this episode does not constitute medical advice.https://bjsm.bmj.com/content/bjsports/59/17/1203.full.pdf

This week we look at the new paper "The effect of exercise time and frequency on the development of cam morphology" by M. Baldawi et al 2025 https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-025-08603-1What do we know about the development of CAM morphology?How do we define it?Could they be useful to athletes?

In this episode we sit down to discuss a really interesting paper all about how stability is produced in the glenohumeral joint. Concavity compression or Intrinsic muscle stiffness? Rotator cuff or larger muscle groups?We go through the mechanisms and basic biomechanical considerations of this before discussing what we think this papers findings mean in clinical practice.Use the comment function below to engage and ask any questions!Please note, this episode does not constitute medical advice.https://link.springer.com/article/10.1007/s10439-025-03683-5

We're back for series 2!! New logo but unfortunately for you, same hosts... This week we're running through the brand new CALMER Cuff pathway from Fayh et al 2025. - How should we manage cuff tears?- How does surgery compare to conservative management?- How do we discuss this with our patients?https://www.jospt.org/doi/10.2519/jospt.2025.13342?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

This is a special episode to introduce you a fantastic resource created by friend of the show, Fin Murphy, who is an expert in ACL rehabilitation. If you haven't already, make sure to go back and listen to his episodes on solving patellofemoral pain after ACL rehab, and the influence of graft site on post-surgical rehab!This will be an amazing source of information on everything (and we mean everything) to do with ACL rehab for both patients AND clinicians, so please make sure to give him a follow both on your podcast platform AND on social media.This is the first episode Fin has released, so if you want to help him out, go listen to it through his podcast channel now... or kick back and press play here and we will deliver it to you! Enjoy!Find Fins podcast page on Spotify HERE- Find Fin on instagram HERE

That's us for the first half of 2025... holidays, babies and house moves keeping us busy over the next couple of months. James and Jeff crack a few beers, have a few rants, offend a few nations and answer listener questions.

We answer a question from a listener about the benefit of NHS versus private practice as a new graduate before going on discuss a recent randomised controlled trial comparing manual therapy to exercise therapy in the management of persistent neck pain.Finally we go on to discuss some of our considerations with managing people with neck pain.Please note, this episode does not constitute medical advice.

We run through a presentation of shin pain that seems to evade any usual diagnosis. Please note, nothing in this episode is intended as medical advice.

We had the pleasure of sitting down with Ben Whybrow the host of the Clinical Communication Podcast to discuss...- Communication tips- Difficult conversations - How to handle conflict ... and cake...Hope you enjoy!

James is back and reminding Jeff this isn't an ACL podcast... Today we are discussing the famous GRASP trial looking at Education, Progressive Exercise and Steroid injections for RCRSP. What are the true take aways from this study? Don't forget to check out Jeff's upcoming live webinar on his Instagram page

James was off climbing in the Alps this week so Jeff seized the opportunity to talk more ACL with Mr. ACL himself, Fin Murphy, without the usual judgement from James about how this might be becoming a lower limb podcast!We cover everything to do with rehab considerations of the big 3 donor sites for ACL rehab. Great practical takeaways throughout this one!Please note, this episode does not constitute medical advice.

Dylan Carmody joins us this week to talk to us about: Anatomical and Functional considerations we need to understand when rehabilitating the calf complexWhat objective tests we can use to help guide our rehabilitation and adviceRehabilitation tips and tricksJames' cross sectionally challenged calves.Check out his amazing value calf force profiling book here!

This week we are discussing the new secondary analysis of the KANON study from this year...Do conservatively managed ACL's that show healing actually get better outcomes long term?https://journals.sagepub.com/doi/full/10.1177/03635465251339061?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org

This week we discuss one of Jeff's go-to papers on everything to do with meniscectomy. We also touch on high tibial osteotomy and chondral cartilage surgery!This is the last week of Jeff's launch sale for 'The Force Awakens: How to REALLY use biomechanics in clinical practice' - enter code LAUNCH20 at the checkout through the link in his instagram bio!Find the paper we discussed on this episode HEREPlease note, this episode does not constitute medical advice.

Apologies for missing last week...But we are back with one of James' favourite ever studies looking at sham exercise vs strengthening for GTPSDefinitely a study that raises a lot of talking points, hope you enjoy!

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.