The Shoulder Physio Podcast

Jared Powell
  • 0.0 (0)
  • Medicine
  • Updated weekly

The Shoulder Physio Podcast is a podcast dedicated to exploring meaningful topics in musculoskeletal health care.

  1. #59: Exercise, sets, reps and the pharmacology problem

    26 May

    #59: Exercise, sets, reps and the pharmacology problem

    Is more always better? Is there a dose response effect of exercise for musculoskeletal pain? Should exercise be just like a medication, where the dose has to be sufficient in order for it to elicit a therapeutic effect?  These are the questions we contend with on this episode of The Shoulder Physio Podcast.  Key resources Lawford BJ, Hinman RS, Spiers L, Kimp AJ, Dell'Isola A, Harmer AR, Van der Esch M, Hall M, Bennell KL. Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis. Arthritis Care & Research. 2024. Liang X, et al. The Best Exercise Modality and Dose for Reducing Pain in Adults With Low Back Pain: A Systematic Review With Model-Based Bayesian Network Meta-analysis. JOSPT. 2024. Malliaras P, Johnston R, Street G, Littlewood C, Bennell K, Haines T, Buchbinder R. The efficacy of higher versus lower dose exercise in rotator cuff tendinopathy: A systematic review of randomised controlled trials. Archives of Physical Medicine and Rehabilitation. 2020. Powell JK, Lewis J, Schram B, Hing W. Is exercise therapy the right treatment for rotator cuff-related shoulder pain? Uncertainties, theory, and practice. Musculoskeletal Care. 2024. Powell JK, Lewis JS. It is not all about strength: rethinking mechanistic assumptions in exercise-based rehabilitation. British Journal of Sports Medicine. 2025. Register for the complete shoulder online course Register for my Brisbane workshop  Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    22 min
  2. # 58: Most rotator cuff tears don't hurt

    12 May

    # 58: Most rotator cuff tears don't hurt

    The FIMAGE study scanned both shoulders of 602 adults from the general population using high-resolution 3-Tesla MRI. Only 7 had a structurally normal rotator cuff. In this episode, I walk through what the study found, why 78% of full-thickness tears were in people with no shoulder pain, and what happens to the diagnostic value of a scan when the finding it detects is near-universal. I challenge the assumption that prevalence equals normality, explore why the word "tear" imports a trauma narrative into what is usually a degenerative process, and make the case that imaging findings deserve a smaller seat at the clinical reasoning table than we've historically given them. Key resources Ibounig T et al. Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging. JAMA Intern Med. 2026 Apr 1;186(4):406-414. doi: 10.1001/jamainternmed.2025.7903. PMID: 41697693; PMCID: PMC12910452. Englund M et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008 Sep 11;359(11):1108-15. doi: 10.1056/NEJMoa0800777. PMID: 18784100; PMCID: PMC2897006. Jensen MC et al. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994 Jul 14;331(2):69-73. doi: 10.1056/NEJM199407143310201. PMID: 8208267. Register for the complete shoulder online course Register for my Brisbane workshop  Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    26 min
  3. #57: Stop Looking for a Winner: The Case for Treatment Pluralism

    28 Apr

    #57: Stop Looking for a Winner: The Case for Treatment Pluralism

    In this episode, I walk through my recent JOSPT paper arguing that no single treatment modality has proven itself superior for musculoskeletal pain and that the profession should stop pretending otherwise. Drawing on Isaiah Berlin's distinction between the hedgehog and the fox, I make the case for treatment pluralism: the idea that multiple interventions can lead to recovery, and that rigid allegiance to any one approach is not supported by the evidence. Key resources Powell et al 2026. Many Paths to Recovery: The Case for Treatment Pluralism. JOSPT. DOI: https://www.jospt.org/doi/10.2519/jospt.2026.13992  Register for the complete shoulder online course Register for my Brisbane workshop  Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    18 min
  4. #56: I Posted a Meta-Analysis and 50 Doctors Told Me I Was Wrong

    14 Apr

    #56: I Posted a Meta-Analysis and 50 Doctors Told Me I Was Wrong

    I posted a meta-analysis showing PRP doesn't beat saline for tennis elbow. The regenerative medicine community came for me, hard. This episode walks through the incident, what the evidence states, why the comparator you choose determines the conclusion you reach, and what the pushback reveals about incentives in musculoskeletal medicine. References Antunes Júnior et al. (2026). Platelet-rich plasma does not improve pain or function in patients with lateral epicondylitis as compared with placebo: A meta-analysis of randomized clinical trials. American Journal of Sports Medicine. Coombes BK et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. The Lancet, 376(9754), 1751–1767. Gosens T et al. (2011). Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: A double-blind randomized controlled trial with 2-year follow-up. American Journal of Sports Medicine, 39(6), 1200–1208. Kamble P et al. (2023). Is ultrasound (US)-guided platelet-rich plasma injection more efficacious as a treatment modality for lateral elbow tendinopathy than US-guided steroid injection? A prospective triple-blinded study with midterm follow-up. Clinics in Orthopedic Surgery, 15(3), 454–462. Krogh TP et al. (2013). Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: A randomized, double-blind, placebo-controlled trial. American Journal of Sports Medicine, 41(3), 625–635. Oeding JF et al. (2025). Platelet concentration explains variability in outcomes of platelet-rich plasma for lateral epicondylitis: A high dose is critical for a positive response — A systematic review and meta-analysis with meta-regression. American Journal of Sports Medicine, 53(10), 2489–2496. Orchard JW. (2025). Rock, paper, scissors: Resolving the conflicting results of randomized trials involving corticosteroid, platelet rich plasma (PRP) and placebo injections. JSAMS Plus, 5, 100081. Register for the complete shoulder online course Register for my Brisbane workshop  Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    24 min
  5. #55: Will AI Replace Physiotherapists?

    31 Mar

    #55: Will AI Replace Physiotherapists?

    The argument that AI replaces "the science" while clinicians should "lean into the art" has become common across healthcare. In this episode, I explain why I think both sides of that framing get it wrong, and why the art vs. science debate was always a false dichotomy that AI has simply made harder to ignore. I draw on four thinkers to make the case: Michael Polanyi on tacit knowledge, Donald Schön on reflective practice in the swampy lowlands, Aristotle on phronesis, and Herbert Dreyfus on the limits of artificial intelligence. Together, they point toward a different answer, that what makes a clinician an expert isn't information retrieval or technical craft, but practical wisdom: the capacity to think with another person under conditions of uncertainty. Register for the complete shoulder online course Register for my Brisbane workshop  Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    25 min
  6. #54: Physiotherapists are Knowledge Workers

    17 Mar

    #54: Physiotherapists are Knowledge Workers

    In this episode of The Shoulder Physio Podcast, we discuss why musculoskeletal clinicians are, at their core, knowledge workers. Not in the corporate buzzword sense, but in the truest sense: professionals whose value comes from the quality of their thinking, not the techniques in their toolkit. We explore why knowledge compounds but repetition doesn't, why information alone fails to change behaviour, and why trust is far more than a soft skill. If you've ever wondered what actually separates a good clinician from a great one, this episode is for you.  Register for the complete shoulder online course Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    13 min
  7. #53: Shin Splints: The Most Misunderstood Running Injury with Laura Anderson PhD(c)

    24 Feb

    #53: Shin Splints: The Most Misunderstood Running Injury with Laura Anderson PhD(c)

    Physiotherapist and PhD researcher Laura Anderson just published a paper arguing that "medial tibial stress syndrome" is a 'garbage' name that's been freaking runners out and leading to terrible treatment for decades. Her proposed replacement? Load-Induced Medial Leg Pain (LIMP). Yes, LIMP, pun not intended. The Problem: "Tibial stress" makes everyone think bone stress injury → stress fracture → panic → rest for months Clinicians still aggressively massage shins until they're bruised  People rest for months and it comes right back when they start running again It's one of the most common running injuries and we have almost zero quality research on it What It Is: Not a bone stress injury on a fracture continuum Doesn't get worse if you keep running (unlike actual bone stress injuries) We honestly don't know exactly what tissues are involved (probably multiple) Imaging usually shows nothing useful The fix? Tune in.   Register for The Complete Shoulder online course Key papers: MTSS needs a new name - Laura's LIMP paper  Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12   Laura's clinic: The Injury Clinic See our Disclaimer here: The Shoulder Physio - Disclaimer

    46 min
  8. #52 It’s Not All About Strength: What the Evidence Shows and What the Reaction Reveals

    13 Jan

    #52 It’s Not All About Strength: What the Evidence Shows and What the Reaction Reveals

    In this episode, I discuss our recently published BJSM editorial “It’s Not All About Strength” ; what the paper argues, why we wrote it, and what the evidence says about mechanisms of exercise-related pain relief in musculoskeletal conditions. I then turn to the reaction. Not to name names or settle scores, but to examine what the response reveals about how we handle criticism, uncertainty, and challenges to familiar explanations in rehabilitation science. This episode is about evidence, mechanisms, cognitive comfort, and why letting our theories (ideas) be criticised is essential for progress. Register for The Complete Clinician here Key paper: It is not all about strength: rethinking mechanistic assumptions in exercise-based rehabilitation for musculoskeletal pain relief Connect with Jared and guests: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    12 min
See All (59)

About

The Shoulder Physio Podcast is a podcast dedicated to exploring meaningful topics in musculoskeletal health care.

Information

  • Creator
    Jared Powell
  • Years Active
    2022 - 2026
  • Episodes
    59
  • Rating
    Clean
  • Copyright
    ©Shoulder Physio Education Pty Ltd
  • Show Website
    The Shoulder Physio Podcast

You Might Also Like