JOSPT Insights

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

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. ------------------------------ 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

Manual therapy is one of those topics that seems to quickly descend to polarised debates in musculoskeletal rehabilitation. Today, we're talking about what manual therapy looks like and does in the 2020s. Dr Jodi Young explains the mechanisms of manual therapy, the typical effects and why you might think about adding manual therapy as another tool in your physical therapy toolkit. Dr Young is the Director of Research for the Doctor of Science in Physical Therapy program at Bellin College in Green Bay, Wisconsin, where she mentors doctoral clinicians and helps turn clinical and educational research questions into meaningful, publishable research. She is also a fellow of the American Academy of Orthopaedic Manual Physical Therapists. ------------------------------ RESOURCES Modern definition and description of manual therapy: https://pubmed.ncbi.nlm.nih.gov/38457654/ Modern way to teach and practice manual therapy: https://pubmed.ncbi.nlm.nih.gov/38773515/ Living review of manual therapy mechanisms: https://pubmed.ncbi.nlm.nih.gov/40100908/ Unravelling the mechanisms of manual therapy: https://www.jospt.org/doi/10.2519/jospt.2018.7476 Developing manual therapy frameworks: https://www.jospt.org/doi/10.2519/josptopen.2023.0002 Integrating person-centred concepts and modern manual therapy: https://www.jospt.org/doi/full/10.2519/josptopen.2023.0812 How do patients believe manual therapy works? https://www.jospt.org/doi/10.2519/josptopen.2025.0149 Does it matter how you apply spinal manipulation? JOSPT Insights ep 221: https://pod.link/1522929437/episode/NmM0MTg4OGMtODMwMi00ZTA3LTg1NzUtYjY2ZjBiMThiZGUy

Trust is integral to the therapeutic relationship between patients and clinicians in musculoskeletal rehabilitation. But does that trust go both ways? If you do a deep dive into the literature on trust, you'll find that it almost always talks about whether patients trust clinicians, not if clinicians trust patients. There's also an inherent bias built into the biomedical environment where so called 'objective' tests - the imaging, the bloodwork, the physical performance tests that clinicians administer - are prioritised over patients' lived experience and expertise, which is derided as 'subjective' and somehow less trustworthy. Today's guests today invite you to join a revolution of starting from a place of trusting people with pain, and acknowledging the patient's expertise. Joletta Belton is an author, advocate and patient engagement in research specialist, who makes sense of pain through science and stories. Dr Ben Darlow is a physiotherapy specialist and Professor of Primary Health Care at The University of Otago in Aotearoa/New Zealand. ------------------------------ RESOURCES Do we trust patients in pain viewpoint: https://www.jospt.org/doi/10.2519/jospt.2025.13725 Jo's substack (MyCuppaJo): https://mycuppajo.substack.com/ Framework for establishing connections in physiotherapy practice: https://pubmed.ncbi.nlm.nih.gov/29432058/

The updated clinical practice guideline for managing hip osteoarthritis landed in late 2025. Today, Dan and Marquis speak with lead author Dr Thomas Koc Jr. to highlight what's new, what's changed and what’s currently considered best practice for hip osteoarthritis. Dr Koc shares the upgraded evidence for dry needling, downgraded evidence for ultrasound, and everything in between. ------------------------------ RESOURCES Read the CPG yourself here: https://www.jospt.org/doi/10.2519/jospt.2025.0301

The JOSPT Insights team has been on a hiatus in December. We're very pleased to say we're back and recording new episodes to share with you in 2026. We're back in your feed with new episodes from mid-January. Until then, we're sharing a couple of our most impactful episodes of 2025. Enjoy! ------------------------------ Patellofemoral pain can affect anyone at any age, which mean you're likely to come across it in your clinical career. What is best practice in managing patellofemoral pain? Today, Dr Brad Neal (Queen Mary University of London) walks us through how to apply the best research to your practice. Dr Neal has worked for over a decade in elite sport, private and public health care settings as a specialist musculoskeletal physiotherapist. His PhD work in biomechanics has helped guide understanding of how to manage patellofemoral pain. ------------------------------ RESOURCES Best practice guide for patellofemoral pain: https://pubmed.ncbi.nlm.nih.gov/39401870/ Effects of treatment for patellofemoral pain - systematic review with meta-analysis: https://www.jospt.org/doi/full/10.2519/jospt.2022.11359 Patellofemoral pain 2019 clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2019.0302

Calf strains are challenging for athletes and clinicians to manage—with uncertain return to play times and risks for reinjury if they're not managed well. Dr Brady Green (University of Notre Dame, Perth, Australia) shares his research and clinical expertise on muscle strains in elite and subelite athletes, including from his previous work in elite Australian football at the Essendon Football Club. Today's episode launches from Dr Green's latest study of the epidemiology of calf strains, and discusses how musculoskeletal rehabilitation specialists, including sports physical therapists, can use this information to guide their practice. ------------------------------ RESOURCES Gastrocnemius muscle strain injury epidemiology: https://www.jospt.org/doi/10.2519/jospt.2025.13526

Some of the most powerful drivers of change in musculoskeletal rehabilitation aren’t researchers or administrators—but clinicians working shoulder-to-shoulder with their peers. These so-called "local opinion leaders" often shape practice more effectively than top-down mandates or distant guidelines. And they're more than simply influencers or savvy social media marketers. In today's episode, Dr Seth Peterson explores how local opinion leaders—those trusted voices within clinical settings—can play a pivotal role in translating research into practice. Dr Peterson shares practical strategies for fostering cultures of learning and supporting clinicians to lead. Dr Peterson is a clinician-researcher based in Tucson, Arizona. He leads care at his clinic, The Motive, and teaches nationally with The Movement Brainery. ------------------------------ RESOURCES Empowering local opinion leaders in physical therapy systems: https://www.jospt.org/doi/10.2519/jospt.2025.13508 Why higher standards are needed in physical therapist professional development: https://www.jospt.org/doi/10.2519/jospt.2022.11377 2025 hip osteoarthritis clinical practice guideline: https://www.jospt.org/doi/10.2519/jospt.2025.0301