The Shoulder Physio Podcast Jared Powell

Patello-femoral pain is a common, and at times, debilitating condition of the knee that can impact people across the lifespan. Professor Bill Vicenzino is a world leading expert on this topic and to that end I've enticed him onto the show to give us the ins and outs of this tricky condition. This is truly a must listen episode with a real pioneer of physiotherapy about a very common and important musculoskeletal condition. 

Key Papers:

1. Rathleff MS, Holden S, Krommes K, Winiarski L, Hölmich P, Salim TJ, Thorborg K. The 45-second anterior knee pain provocation test: A quick test of knee pain and sporting function in 10-14-year-old adolescents with patellofemoral pain. Phys Ther Sport. 2022 Jan;53:28-33. doi: 10.1016/j.ptsp.2021.11.002. Epub 2021 Nov 4. PMID: 34775189.

2. Powers CM, Witvrouw E, Davis IS, Crossley KM. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. Br J Sports Med. 2017 Dec;51(24):1713-1723. doi: 10.1136/bjsports-2017-098717. Epub 2017 Nov 6. PMID: 29109118.

3. Powers CM, Ho KY, Chen YJ, Souza RB, Farrokhi S. Patellofemoral joint stress during weight-bearing and non-weight-bearing quadriceps exercises. J Orthop Sports Phys Ther. 2014 May;44(5):320-7. doi: 10.2519/jospt.2014.4936. Epub 2014 Mar 27. PMID: 24673446.

4. Crossley KM, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM, McConnell J, Vicenzino B, Bazett-Jones DM, Esculier JF, Morrissey D, Callaghan MJ. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016 Jul;50(14):839-43. doi: 10.1136/bjsports-2016-096384. Epub 2016 Jun 24. PMID: 27343241; PMCID: PMC4975817.

5. Nimon G, Murray D, Sandow M, Goodfellow J. Natural history of anterior knee pain: a 14- to 20-year follow-up of nonoperative management. J Pediatr Orthop. 1998 Jan-Feb;18(1):118-22. PMID: 9449112.

6. Dye SF. The pathophysiology of patellofemoral pain: a tissue homeostasis perspective. Clin Orthop Relat Res. 2005 Jul;(436):100-10. doi: 10.1097/01.blo.0000172303.74414.7d. PMID: 15995427.

7. Holden S, Matthews M, Rathleff MS, Kasza J; Fohx Group; Vicenzino B. How Do Hip Exercises Improve Pain in Individuals With Patellofemoral Pain? Secondary Mediation Analysis of Strength and Psychological Factors as Mechanisms. J Orthop Sports Phys Ther. 2021 Dec;51(12):602-610. doi: 10.2519/jospt.2021.10674. PMID: 34847699.

8. Robertson CJ, Hurley M, Jones F. People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study. Musculoskelet Sci Pract. 2017 Apr;28:59-64. doi: 10.1016/j.msksp.2017.01.012. Epub 2017 Feb 2. PMID: 28171780.

 

The Shoulder Physio Online Course

Connect with Jared and guests:

Jared on Instagram: @‌shoulder_physio

Jared on Twitter: @‌jaredpowell12

Bill on Twitter: @Bill_Vicenzino

See our Disclaimer here: The Shoulder Physio - Disclaimer

When a patient comes to see a physiotherapist, or any health care professional, how much better does that patient need to get to make a treatment worthwhile? This is an important question because we're constantly making treatment recommendations to patients, day in-day-out, but based on what? My guest for this podcast, Harrison Hansford, reckons a lot of our treatment decisions should be made with consideration of something called the Smallest Worthwhile Effect, which is actually surprisingly easy to understand. Enjoy!

Key Papers:

1. Hansford HJ, Jones MD, Cashin AG, Ostelo RW, Chiarotto A, Williams SA, Sharma S, Devonshire JJ, Ferraro MC, Wewege MA, McAuley JH. The smallest worthwhile effect on pain intensity of nonsteroidal anti-inflammatory drugs and exercise therapy for acute and chronic low back pain: a benefit-harm trade-off study. J Physiother. 2023 Oct;69(4):240-248. doi: 10.1016/j.jphys.2023.08.006.

2. Abdel Shaheed C, Mathieson S, Wilson R, Furmage AM, Maher CG. Who should judge treatment effects as unimportant? J Physiother. 2023 Jul;69(3):133-135. doi: 10.1016/j.jphys.2023.04.001. Epub 2023 May 30. PMID: 37263906.

The Shoulder Physio Online Course

Connect with Jared and guests:

Jared on Instagram: @‌shoulder_physio

Jared on Twitter: @‌jaredpowell12

Harrison on Twitter: @HJHansford

See our Disclaimer here: The Shoulder Physio - Disclaimer

We're constantly told, even lectured, about the importance of exercise for most non-traumatic musculoskeletal pain presentations, shoulder pain included. We assume it works for all people across time and space, but is this true? Are there factors that might influence whether exercise will help an individual with shoulder pain or not? What are these factors and can we influence them? Listen on to hear Emily and Andrew from The Knowledge Exchange interview me about these very interesting questions. 

Key Papers:

1. Powell JK, Costa N, Schram B, Hing W, Lewis J. "Restoring That Faith in My Shoulder": A Qualitative Investigation of How and Why Exercise Therapy Influenced the Clinical Outcomes of Individuals With Rotator Cuff-Related Shoulder Pain. Phys Ther. 2023 Dec 6;103(12):pzad088. doi: 10.1093/ptj/pzad088. PMID: 37440455; PMCID: PMC10733131.

The Shoulder Physio Online Course

Connect with Jared and guests:

Jared on Instagram: @‌shoulder_physio

Jared on Twitter: @‌jaredpowell12

Emily on Instagram: @emwalker_exphys

Andrew on Instagram:@navigatepainexphysio

TKEX on Instagram: @theknowledgex

Cliniko free trial, click here!

See our Disclaimer here: The Shoulder Physio - Disclaimer

Every iconic scientist has a quote emphasising the importance of uncertainty and doubt that underpins the scientific attitude. This holds true as much for fundamental physics and biological science as it does for health science, probably far more so in the case of health science. For we are complex, non-linear creatures, each with different stories, backgrounds, contexts and circumstances. Because of this, clinical uncertainty is ubiquitous, it's everywhere, but this should not paralyse us according to my guest on this episode, Nathalia Costa, PhD. Enjoy.

Key Papers:


Costa N, Olson R, Mescouto K, Hodges PW, Dillon M, Evans K, Walsh K, Jensen N, Setchell J. Uncertainty in low back pain care - insights from an ethnographic study. Disabil Rehabil. 2023 Mar;45(5):784-795. doi: 10.1080/09638288.2022.2040615. Epub 2022 Feb 21. PMID: 35188845.
Costa N, Mescouto K, Dillon M, Olson R, Butler P, Forbes R, Setchell J. The ubiquity of uncertainty in low back pain care. Soc Sci Med. 2022 Nov;313:115422. doi: 10.1016/j.socscimed.2022.115422. Epub 2022 Oct 3. PMID: 36215924.
Costa N, Butler P, Dillon M, Mescouto K, Olson R, Forbes R, Setchell J. "I felt uncertain about my whole future"-a qualitative investigation of people's experiences of navigating uncertainty when seeking care for their low back pain. Pain. 2023 Jul 20. doi: 10.1097/j.pain.0000000000002975. Epub ahead of print. PMID: 37478013.
Gibson, B. E. (2016). Rehabilitation : a post critical approach. CRC Press.    
Paul Christiaan Beenen, Dario Filiputti, Erna Rosenlund Meyer, Lidia Carballo-Costa, Patricia Maria Duarte de Almeida, Antonio Alves Lopes, Joost Egbertus Jacobus Lidwina van Wijchen & Alexandre Castro Caldas (2018) Epistemic beliefs as a determinant in evidence-based practice in physiotherapy – a Multi-Country (Europe) Cross-Sectional Online Survey Study, European Journal of Physiotherapy, 20:2, 85-91, DOI: 10.1080/21679169.2017.1374454
Rocca, E., Anjum, R.L. (2020). Complexity, Reductionism and the Biomedical Model. In: Anjum, R.L., Copeland, S., Rocca, E. (eds) Rethinking Causality, Complexity and Evidence for the Unique Patient. Springer, Cham. https://doi.org/10.1007/978-3-030-41239-5_5

Connect with Jared and guests:

Jared on Instagram: @‌shoulder_physio

Jared on Twitter: @‌jaredpowell12

Nathalia on Twitter: @nathaliaccosta1

Cliniko free trial, click here!

See our Disclaimer here: The Shoulder Physio - Disclaimer

Pilates exercise seems to help people with chronic low back pain...but how? What are the causal mechanisms underpinning the apparent effectiveness of Pilates? Does it activate the multifidus and transeversus abdominis muscles? Does it reduce fear and improve confidence? Both or neither? To shed some light on this question I have invited Lianne Wood on to the show, who, incidentally, has a paper on this very question! What a lovely coincidence.

Key Papers:

Wood et al 2023: Pain catastrophising and kinesiophobia mediate pain and physical function improvements with Pilates exercise in chronic low back pain: a mediation analysis of a randomised controlled trial

Connect with Jared and guests:

Jared on Instagram: @‌shoulder_physio

Jared on Twitter: @‌jaredpowell12

Lianne on Twitter: @WoodwicksLianne

Cliniko free trial, click here!

See our Disclaimer here: The Shoulder Physio - Disclaimer

What exactly is a placebo effect? When you try and pin it down, it's confusing. Technically, it's something inert that produces an effect...how can there be an effect without a mechanism? Prof. Steve Kamper is here to help bring clarity to the issue. 

Key Papers:

Kamper 2013: The placebo effect: powerful, powerless or redundant?

Testa and Rossettini 2016: Enhance placebo, avoid nocebo: How contextual factors affect physiotherapy outcomes

 Connect with Jared and guests:

Jared on Instagram: @‌shoulder_physio

Jared on Twitter: @‌jaredpowell12

Steve on Twitter: @stevekamper1

Cliniko free trial, click here!

See our Disclaimer here: The Shoulder Physio - Disclaimer