JOSPT Insights

Psychological factors like a person's thoughts, beliefs and emotions can exert a strong influence on rehabilitation outcomes for people with chronic musculoskeletal conditions. When a person has pain, they might feel scared to move or convinced that moving in a certain way will damage their body. Today's discussion focuses on how a person's thoughts about shoulder pain can change over an 8-week exercise-based rehabilitation program, and the implications for how musculoskeletal rehabilitation clinicians approach discussions about fear and moving with the patients you work with. Dr Courtney Mears and Dr Matthew Heindel discuss their recent JOSPT publication (linked below).
Dr Mears is a physical therapist at the University of Southern California, and a researcher in the Clinical Biomechanics Orthopedic and Sports Outcomes Research Lab. Her research focuses on understanding the relationship between psychosocial factors, shoulder pain, and functional outcomes.
Dr Heindel is a physical therapist, and a postdoctoral associate at Duke University’s School of Medicine, where he studies the neuroimmune mechanisms of chronic musculoskeletal pain. Dr Heindel completed his PhD on the mechanics of pain and muscle dysfunction in rotator cuff tendinopathy in 2025 at the Clinical Biomechanics Orthopedic and Sports Outcomes Research Lab at the University of Southern California.
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RESOURCES
Changes in pain-related fear: https://www.jospt.org/doi/10.2519/jospt.2026.13563
OSPRO yellow flag assessment tool: https://www.jospt.org/doi/10.2519/jospt.2016.6487

Does hip crepitus make a difference to the health of the joint? Does crepitus indicate damage, harm or progression of osteoarthritis? How should clinicians explain hip crepitus and its implications to patients? Today's guest addresses those questions and more in a deep dive on hip crepitus. Dr Danilo De Oliveira Silva (La Trobe University) discusses his JOSPT article, Self-Reported Hip Crepitus Is Prevalent in Football Players With Hip/Groin Pain, but Is It Associated With Early Hip Osteoarthritis Structural Features? A Longitudinal Study, with Dan and Marquis.
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RESOURCES
Self-reported hip crepitus - longitudinal study: https://www.jospt.org/doi/10.2519/jospt.2025.13474
Beliefs and attitudes about hip crepitus: https://pubmed.ncbi.nlm.nih.gov/41056730/

Hip morphology and hip injuries have been receiving increasing attention, which is a good thing given their prevalence and impact on athletes' health and performance. Today's guests combine the hip and groin field, with the attention that female athletes deserve to their health and performance.
Dr Pim van Klij, who works with Dutch football/soccer powerhouse, Ajax, and Pirette Claes, who is starting her career in sports medicine, discuss the PROFE study. We focus on the work they have been leading to quantify the relationship between groin symptoms, and pubic symphysis radiological findings and skeletal maturity.
Dr van Klij is sports medicine physician and Assistant Professor at Amsterdam University Medical Centre, Department of Orthopaedic Surgery and Sports Medicine. Pirette Claes is a medical intern at Leiden University Medical Centre, and an early-career researcher.
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RESOURCES
Prevalence of symphyseal radiographic findings and relationship to groin symptoms (PROFE study): https://www.jospt.org/doi/10.2519/jospt.2026.13580
JOSPT focused issue on hip and groin research (July 2026): https://www.jospt.org/toc/jospt/56/7

Tendinopathy will show up regularly in the clinic for many JOSPT Insights listeners. In a person-centred care model, it's important to understand the person with tendinopathy, where they're coming from and what they're experiencing.
Today's guest has been studying patients' experience of different types of lower limb tendinopathies. The results might surprise you, in just how complex and variable people's experiences are.
Max Hopes is an osteopath and researcher (University of Technology Sydney) studying lower limb tendinopathy. Today Max shares some of the early results of his PhD work, and we explore what it means for musculoskeletal practice.
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RESOURCES
Lived experiences of people with tendinopathy: https://www.jospt.org/doi/10.2519/jospt.2026.13666

In last week's episode, Dermot Simpson and Simon Wallace explained the hamstring and rectus femoris rehabilitation pathways that they and their colleagues at the Aspetar Orthopaedic & Sports Medicine Hospital have developed to guide daily practice.
In using the rehabilitation pathways, Dermot and Simon, and the team have discovered some clinical pearls that help them help the athletes they're working with. Today, Dermot and Simon are sharing those clinical tips. These are the things that you can do in practice tomorrow to give you and the athlete the best chance of rehabilitation success.
Dermot Simpson and Simon Wallace are sports physiotherapists working at the Aspetar Hospital in Doha, Qatar. Between them, they have more than 2 decades of experience in elite sport, especially in rugby and football/soccer.
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RESOURCES
Aspetar Hamstring Injury Rehabilitation Pathway: https://www.jospt.org/doi/10.2519/josptopen.2026.0213
Aspetar Rectus Femoris Injury Rehabilitation Pathway: https://www.jospt.org/doi/10.2519/josptopen.2026.0212
Longer muscle length resistance training (systematic review): https://pubmed.ncbi.nlm.nih.gov/41646176/
Nordic hamstring exercise vs. lengthened state eccentric training: https://pubmed.ncbi.nlm.nih.gov/38857522/