After Lindsey Vonn's sad early exit due to injury from the Milano-Cortina 2026 Winter Olympics, it feels like an apt time to revisit the latest consensus on managing knee injury, and supporting return to sport after complex meniscus injury and surgery.

Today, we continue the conversation on the latest consensus for managing acute and degenerative meniscus tears. We jump into non-surgical treatment, and all the return to sport considerations for athletes and active people with meniscus injury. Dr Arielle Giordano (University of Delaware) shares the results of the EU-US Meniscus Rehabilitation Consensus.

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RESOURCES

EU-US Meniscus Rehabilitation Consensus on prevention, non-operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539

DREAM trial primary report: https://pubmed.ncbi.nlm.nih.gov/38319181/

Should symptoms guide treatment choice in young patients? https://www.jospt.org/do/10.2519/jospt.blog.20240415/full/

Early surgery vs exercise therapy + education for traumatic and non-traumatic meniscus tears: https://www.jospt.org/doi/10.2519/jospt.2024.12245

Ep 224: Saving the meniscus: https://pod.link/1522929437/episode/NTg3YTgzZWUtYTZjZC00ZDYwLWI2OTAtYTczMzAzNTEyNzgz

Ep 192: DREAMing of better care for meniscus tears: https://pod.link/1522929437/episode/Yzk2YzkyOWItMDk1MS00YWZkLWI2MjQtNmRlYjIwZGJmOTg0

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.

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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/

Need a refresher on youth sport-related concussion? Today's episode is a rapid review of the epidemiology and best practice for managing youth concussion.

Lisbeth Lund Pedersen (University of Southern Denmark & Danish Society for Sports Physiotherapy) shares the results of the HAAPY study, which involved more than 900 young Danish handball players prospectively recording handball exposure and injuries.

We discuss why female athletes might have a greater concussion risk, and what clinicians can do to promote you athletes' brain health.

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RESOURCES

Female, woman and/or girl Athlete Injury pRevention (FAIR) practical recommendations: https://pubmed.ncbi.nlm.nih.gov/41330629/

Consensus statement on concussion in sport: https://pubmed.ncbi.nlm.nih.gov/37316210/

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.

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RESOURCES

Read the CPG yourself here: https://www.jospt.org/doi/10.2519/jospt.2025.0301

Sleep: we all know it's essential for function in everyday life, and plays an important role in recovery and managing musculoskeletal pain. How much did you learn about assessing and managing sleep dysfunction in your musculoskeletal degree program?

Today, Dr Mark Shepherd (Bellin College) shares practical tips to help you assess sleep, identify common sleep disorders, and incorporate behavioural strategies into your musculoskeletal rehabilitation practice.

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RESOURCES

Clinician's guide to assessing and addressing sleep dysfunction in people with musculoskeletal pain: https://www.jospt.org/doi/10.2519/josptopen.2025.0198

Spine pain and sleep study: https://pubmed.ncbi.nlm.nih.gov/35642567/

UK Biobank study on predictors of persistent pain: https://pubmed.ncbi.nlm.nih.gov/37414898/

Systematic review on lack of sleep measures: https://pubmed.ncbi.nlm.nih.gov/37259893/

APTA position paper on the PT’s role in sleep health: https://www.apta.org/apta-and-you/leadership-and-governance/policies/role-pt-apta-sleep-health

DPT students and sleep behaviours: https://pubmed.ncbi.nlm.nih.gov/39425093/

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!

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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.

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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

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!

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Tune in today for the latest consensus on rehabilitation approaches for people who have had meniscus surgery.

Orthopaedic surgeons and physical therapists from Europe and the US debated the best research evidence, and brought extensive clinical experience to the table, ultimately producing a 2-part series of summary papers.

Dr Arielle Giordano (University of Delaware) was one of the physical therapy leads on the project, and today she shares the most important messages from the consensus.

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RESOURCES

EU‐US Meniscus Rehabilitation 2024 Consensus - Rehabilitation after meniscus surgery: https://www.jospt.org/doi/10.2519/josptopen.2025.0162

EU-US Meniscus Rehabilitation 2024 Consensus - Prevention, non‐operative treatment and return to sport: https://www.jospt.org/doi/10.2519/josptopen.2025.13539

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.

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RESOURCES

Gastrocnemius muscle strain injury epidemiology: https://www.jospt.org/doi/10.2519/jospt.2025.13526

Over the past decade, the term rotator cuff–related shoulder pain (RCRSP) has gained traction as a more accurate, patient-centered way to describe shoulder pain.

In this episode, Dr Amy McDevitt (Physical Medicine and Rehabilitation Department, University of Colorado) joins Dan Chapman and Marquis Sanabrais to unpack why shifting from structural labels like impingement or tendinopathy toward RCRSP can improve both communication and care.

They discuss how imaging often fails to match symptoms, why language matters for patient engagement, and how clinicians can explain shoulder pain without over-pathologizing.

Take home messages:

1. RCRSP reflects the multifactorial nature of shoulder pain, biological, mechanical, and psychosocial.

2. Clear and non-anatomic terminology helps patients understand and buy into treatment.

3. Future research should clarify mechanisms behind exercise and refine subgroups within RCRSP.

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RESOURCES

The case for using "rotator cuff-related shoulder pain" in practice: https://www.jospt.org/doi/10.2519/jospt.2025.13405

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.

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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