The Shoulder Physio Podcast

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

  1. 4 Aug

    #64: Is measuring strength useful? With Tim Cook

    Jared is joined by Tim Cook who is Senior Lecturer in Physiotherapy at the University of Chichester, Advanced Physiotherapy Practitioner in the NHS, and doctoral researcher to discuss their new paper with Prof. Jeremy Lewis in the Journal of Manual & Manipulative Therapy: "Rethinking strength testing in rotator cuff-related shoulder pain: a clinical tradition that lacks muscle." Tim explains what pushed him to question routine strength testing in busy clinical practice, despite guidelines recommending it, and the pair dig into whether weakness is a cause of shoulder pain, a consequence of it, or something else altogether. They look at what subacromial anaesthetic injection studies reveal about pain versus true force output, and Tim reframes the classic "weak and painful shoulder" as the "flexible but painful shoulder," drawing parallels to other oversimplified clinical narratives like posture and core stability. They also make the case for when strength testing can still earn its keep; patient engagement, expectation violation, building confidence, and sporting or return-to-performance populations such as ACL limb symmetry index, before turning to Goodhart's Law and the risk of chasing the test rather than the outcome, and why isolated isometric tests may not translate to real-world, endurance-based shoulder tasks. Tim closes out with an update on his PhD: a reliability RCT on strength and pain-free assessment currently in press, and an upcoming scoping review on the proposed mechanisms of exercise for RCRSP. Key resources Cook, T., Lewis, J., & Powell, J. (2026). Rethinking strength testing in rotator cuff-related shoulder pain: a clinical tradition that lacks muscle. Journal of Manual & Manipulative Therapy, 34(3), 193–198. https://doi.org/10.1080/10669817.2026.2663623 Register for the complete shoulder online course Melbourne workshop details Connect with Jared: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 Tim on Instagram: @Timcookphysio See our Disclaimer here: The Shoulder Physio - Disclaimer

    #64: Is measuring strength useful? With Tim Cook

  2. 21 Jul

    #63: The myth of perfect movement

    Is there really one correct way to move? For decades, clinicians and coaches have acted like there is. In this episode, we prosecute that idea. We start in a 1930s Soviet forge, where Nikolai Bernstein filmed blacksmiths and found their hammer strikes landed in the same spot every time, despite every joint angle differing swing to swing. That's "repetition without repetition." From there we bring in Mark Latash's motor abundance: why your nervous system treats extra degrees of freedom as a resource, not a problem, and what that means for scapular "dyskinesis," core stability cues, and fear-based rehab language. We close with a practical clinical translation for coaches and clinicians. Plus: a quick update on my next in-person workshop, The Complete Shoulder Workshop, Melbourne 17 October. Key resources Low M. A Time to Reflect on Motor Control in Musculoskeletal Physical Therapy. J Orthop Sports Phys Ther. 2018 Nov;48(11):833-836. doi: 10.2519/jospt.2018.0614. PMID: 30381024. Latash ML. The bliss (not the problem) of motor abundance (not redundancy). Exp Brain Res. 2012 Mar;217(1):1-5. doi: 10.1007/s00221-012-3000-4. Epub 2012 Jan 14. PMID: 22246105; PMCID: PMC3532046. Register for the complete shoulder online course Melbourne workshop details Connect with Jared: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    #63: The myth of perfect movement

  3. 7 Jul

    #62: Pain during exercise: friend or foe?

    The question of allowing pain, or avoiding it, during exercise based rehab remains contentious and uncertain. So, like any good scientist, we (led by Ivy Tran) studied the evidence-base and sought an answer to this clinical conundrum to help not just you, but us too! What did we find? Listen to the episode to find out.  Key resources Tran I et al. Effectiveness of Painful Versus Nonpainful Exercise on Pain Intensity, Disability, and Other Patient-Reported Outcomes in Adults With Chronic Musculoskeletal Pain: An Updated Systematic Review With Meta-Analysis. J Orthop Sports Phys Ther. 2025 Smith BE et al. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. Br J Sports Med. 2017 Register for the complete shoulder online course Register for The Complete Clinician Mentorship Connect with Jared: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    #62: Pain during exercise: friend or foe?

  4. 23 Jun

    #61: What is a physiotherapist?

    What is a physiotherapist? Strip away the hands, the exercises, the modalities, what's left? In this episode I argue that the "fixer" identity, the clinician who finds what's broken and corrects it, isn't where our profession came from. It's something that was selected into us through a century of professional politics and reductionist thinking. Drawing on the history of physiotherapy, Newell's constraints framework, self-determination theory, and Gopnik's gardener, I make the case for a different identity: the clinician who sets the conditions for an active, adaptive person to recover and even flourish. Register for the complete shoulder online course Register for The Complete Clinician Mentorship Connect with Jared: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    #61: What is a physiotherapist?

  5. 10 Jun

    #60: The Burnout Episode

    Burnout in our profession is widespread, with most studies reporting prevalence between 8 and 23 per cent, and up to 65 per cent of recent graduates planning to leave physiotherapy within ten years. In this episode, drawing on a recent editorial in the Journal of Physiotherapy by Ky Wynne, I lay out the empirical picture and challenge the dominant framing that burnout is a problem of individual resilience. I share my own story of burning out two years into clinical practice, what shifted before anything else did, and the disposition I've come to see as the antidote to the slow erosion the current climate produces. Key resources Wynne K. Burnout in physiotherapy. Journal of Physiotherapy. 2026;72:87–90. https://doi.org/10.1016/j.jphys.2025.12.009 Register for the complete shoulder online course Register for The Complete Clinician Mentorship Connect with Jared: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

    #60: The Burnout Episode

  6. 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

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

  7. 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

    # 58: Most rotator cuff tears don't hurt

  8. 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

    #57: Stop Looking for a Winner: The Case for Treatment Pluralism
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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
    64
  • Rating
    Clean
  • Copyright
    ©Shoulder Physio Education Pty Ltd
  • Show Website
    The Shoulder Physio Podcast

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