JOSPT Insights

Does the ACL have the capacity to heal following injury? And if it does, what might that mean for how clinicians approach ACL rehabilitation? The prevailing assumption has been that a ruptured ACL has limited capacity to heal and restore structural continuity without reconstruction. Now, a growing body of research is challenging that assumption.In today's episode, Professor Joanna Kvist (Linköping University, Sweden) discusses new findings from the NACOX cohort examining how ACL structure changes on MRI during the first 2 years following acute ACL injury. Dr Kvist and her team found that ACL structure and fiber continuity improved over time in many participants managed without ACL reconstruction, and greater ACL continuity was associated with less knee laxity on objective measurement.Dr Kvist explains what the ACL looked like on MRI over those 2 years, the changes in ligament thickness and fiber continuity, how those structural findings related to clinical outcomes, and what clinicians should (and shouldn't) take from these findings when discussing rehabilitation and treatment options with patients.------------------------------RESOURCESStructural changes of the ACL, evaluated by MRI, and their relation to clinical outcomes within 2 years after ACL injury

How many patients describe receiving what sounds like inadequate care for osteoarthritis before they reached your clinic? Osteoarthritis is one of the most common chronic musculoskeletal conditions. When there are many trustworthy, international clinical guidelines that clearly outline what best-practice osteoarthritis care should entail, why are so many patients missing out on high-value care?Today's guest, Dr Jodi Young, discusses her team's analysis of data from nearly 25,000 patients who received osteoarthritis care in the United States, and what these data say about osteoarthritis care. Dr Young is the Director of Research for the Doctor of Science in Physical Therapy program at Bellin College in Green Bay, Wisconsin. She is also a fellow of the American Academy of Orthopaedic Manual Physical Therapists.------------------------------RESOURCESReal-world use of exercise and manual therapy for managing knee osteoarthritis: https://www.jospt.org/doi/10.2519/josptopen.2026.0221Opioid prescribing to active duty US military personnel: https://pubmed.ncbi.nlm.nih.gov/37507224/Opioid vs. non-opioid medications for people with chronic back pain or hip or knee OA (SPACE Trial): https://pubmed.ncbi.nlm.nih.gov/29509867/Opioid use patterns among active duty service members and civilians: https://pubmed.ncbi.nlm.nih.gov/29514335/ JOSPT Insights episode 257 - Reflecting on contemporary manual therapy: https://pod.link/1522929437/episode/NzM4ZjYwY2EtMzNhYi00OTI5LWE5OTAtZmUwY2ZkM2QxMDA0

Psychological factors like a person's thoughts, beliefs and emotions can exert a strong influence on rehabilitation outcomes for people with chronic musculoskeletal conditions. When a person has pain, they might feel scared to move or convinced that moving in a certain way will damage their body. Today's discussion focuses on how a person's thoughts about shoulder pain can change over an 8-week exercise-based rehabilitation program, and the implications for how musculoskeletal rehabilitation clinicians approach discussions about fear and moving with the patients you work with. Dr Courtney Mears and Dr Matthew Heindel discuss their recent JOSPT publication (linked below).Dr Mears is a physical therapist at the University of Southern California, and a researcher in the Clinical Biomechanics Orthopedic and Sports Outcomes Research Lab. Her research focuses on understanding the relationship between psychosocial factors, shoulder pain, and functional outcomes.Dr Heindel is a physical therapist, and a postdoctoral associate at Duke University’s School of Medicine, where he studies the neuroimmune mechanisms of chronic musculoskeletal pain. Dr Heindel completed his PhD on the mechanics of pain and muscle dysfunction in rotator cuff tendinopathy in 2025 at the Clinical Biomechanics Orthopedic and Sports Outcomes Research Lab at the University of Southern California.------------------------------RESOURCESChanges in pain-related fear: https://www.jospt.org/doi/10.2519/jospt.2026.13563OSPRO yellow flag assessment tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487

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. ------------------------------ RESOURCES Evoolve Pain Care Academy: https://evoolvepaincare.academy/ Videos, infographics and written resources for clinicians: https://evoolvepaincare.academy/clinician-resources