Physio Edge podcast with David Pope

Your patellar tendinopathy patients are performing a solid, progressive loading program, but their quadriceps still test weaker, with lower maximal force output. Are their quads actually weak, or is muscle inhibition limiting the strength they can access? And how does this change your rehab? In this episode, Dr Patrick Vallance (Ph.D, Physiotherapist, Tendinopathy neuroscientist, Lecturer in Physiotherapy at Monash University) and David Pope explore why force output can be reduced in tendinopathy, and how understanding the mechanisms involved can help you tailor your treatment. You'll also discover: Clinical clues that inhibition may be contributing to your patient's reduced force output How inhibition at the brain and spinal cord differs, and why this matters for rehab The reticulospinal pathway and its role in producing strength and power How metronome-paced and self-paced exercises may target different neural pathways, and what this could mean for your exercise choices Why Achilles and patellar tendinopathy may need different treatment approaches, including when to target muscular endurance How assessing strength, power and endurance helps you identify what each patient's rehab needs to address Why researchers are reconsidering TENS and ice as possible adjuncts to exercise for patellar tendinopathy Where isometrics fit when they don't relieve pain, and how their role in tendon stiffness could influence your exercise prescription Throughout the episode, Patrick uses simple analogies and practical exercise examples to make the science easier to understand and apply. He explores what the research can currently tell us, which treatment ideas are still being tested, and how to use this understanding to tailor your rehab to your patients' needs and goals. Chapters 0:00 - Introduction 2:28 - Tendinopathy, inhibition and force output 3:10 - Measuring inhibition 8:47 - Why look beyond the tendon? 10:24 - Corticospinal vs reticulospinal pathways 16:01 - Pain and spinal inhibition 22:09 - Power vs control 26:20 - Metronome-paced vs self-paced training 30:50 - What is self-paced training? 36:08 - How to reduce nociceptive drive 39:26 - How to target the reticulospinal pathway 41:16 - How to target the corticospinal pathway 43:19 - Achilles vs patellar tendinopathy 46:08 - Endurance targets 47:36 - Isometrics and tendon stiffness 50:05 - Where the research is heading Free resources Podcast handout: your key takeaways from the podcast, plus the full transcript, so you can remember it and apply it with your patients. Clinical Edge membership: improve your assessment and treatment results, including the new taping video series with Zoe Russell (Specialist Sports Physiotherapist). Free running injury resources: for the runners and running injuries you treat. Links associated with this episode Click here to download your podcast handout Improve your assessment and treatment results with a Clinical Edge membership Free running injury resources 175. Tendinopathy treatment: Your guide to isometrics, isotonics & plyometrics with Dr Ebonie Rio Dr Patrick Vallance - Instagram (Tendinopathy Circuit Breaker) David Pope - X David Pope - Instagram

Patellofemoral pain (PFP) rehabilitation doesn't end when your patient gets stronger. The real challenge is getting them back to running, training and racing without triggering another flare-up. In this final episode of the four-part series, Tom Goom (Running Physio) and David Pope explore the fourth pillar of successful PFP rehabilitation: a planned return to running. Continuing Alice's journey from the previous episodes, a HYROX athlete preparing for competition, Tom and David break down exactly how to rebuild running volume, progress training safely, and help runners hit their goals, or return to racing or competition, with confidence while minimising the risk of recurrence. You'll discover: How to structure a return-to-running program that steadily rebuilds running capacity without overloading the knee A simple progression strategy that makes increasing running volume practical and easy to implement Why recovery weeks are just as important as progression weeks, and how to use them effectively How to use a simple "traffic light" system to decide when to progress, maintain or reduce training When gait analysis and running retraining should (and shouldn't) be introduced during rehabilitation Why sleep, recovery and anxiety can have a major influence on running injury recovery, and practical ways to address them How to manage the inevitable flare-ups that occur during rehabilitation without losing progress or confidence How the same four-pillar framework can be applied to virtually every running injury, from tendinopathy to bone stress injuries Throughout the episode, Tom shares the practical clinical reasoning behind every decision, from mapping out a patient's weekly training schedule through to progressing running distance, introducing recovery weeks, and eventually returning to continuous long-distance running. Whether you're treating recreational runners, competitive athletes or patients training for events like HYROX, you'll come away with a clear framework you can immediately apply to help your patients return to running safely, confidently and with a much lower risk of recurrence. This is the fourth and final episode in Tom Goom's four-part podcast series on patellofemoral pain. Together, the series provides a complete framework for assessing, educating, rehabilitating and returning runners with PFP back to the sport they love. Timeline: 0:00 - Introduction 3:07 - Introduction and case recap 6:03 - Weekly training structure 8:10 - Progress and recovery 11:03 - Gait analysis and the four pillars 12:13 - Recovery, sleep and anxiety 14:40 - Alice's progress and flare-ups 18:32 - Four pillars for all running injuries 20:52 - Free assessment form and webinar Free resources Running injury assessment sheet — Tom's go-to assessment sheet for every runner, giving you the structure to gather all the key information you need. It includes his screening questions for past medical history, a weekly training structure block, the key physical tests he performs, and a QR code to an energy availability questionnaire. Free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" — Join Tom's free webinar to see his assessment and treatment in action, with visuals of the assessment tests, gait assessment and the traffic-light and sweet-spot approaches, plus the exercises, evidence and best-practice guidelines behind treating patellofemoral pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs. Links associated with this episode 179. Patellofemoral pain 3 - Effective rehab that won't flare their symptoms. Physio Edge Track record: Running repairs podcast with Tom Goom 178. Patellofemoral pain 2 - What to do when runners won't reduce their training. Physio Edge Track record: Running repairs podcast with Tom Goom 177. Patellofemoral pain 1 - Why it has such a high recurrence rate, and what most rehab plans miss. Physio Edge Track record: Running repairs podcast with Tom Goom Download your free running injury assessment sheet Register for the free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Click here to download your podcast handout Improve your confidence and clinical reasoning with a Clinical Edge membership here Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Join Tom live on Facebook & ask your running-related questions Tom Goom - Running Physio Tom Goom - X David Pope - X Tom Goom - Instagram David Pope - Instagram

Strengthening exercises are a key part of successful patellofemoral pain (PFP) rehabilitation. Squats, lunges and single leg squats are often painful early on and can aggravate your patients pain, but on the flip side, we want to build up their tolerance and confidence with these movements. If you introduce an exercise your patient isn't ready for, progress too quickly, or overload the knee too early, you'll often flare your patients pain and set their rehabilitation back. In this episode, Tom Goom (Running Physio) and David Pope explore the third pillar of successful PFP treatment: progressive rehab. Continuing the case of Alice from the previous two podcasts, a HYROX athlete preparing for competition, Tom and I walk through exactly how to choose, modify and progress exercises that build strength, restore confidence and prepare patients for the demands of running and sport, without flaring their symptoms. You'll discover: How to decide when to prioritise load management before introducing strengthening exercises Why rehabilitation should be tailored to the individual rather than using a "cookie-cutter" exercise program The key strength deficits Tom commonly looks for in runners with PFP, and how to assess them How to select exercises that improve strength while minimising stress on the patellofemoral joint Practical ways to modify squats, lunges and other knee-loading exercises to reduce pain while rebuilding movement tolerance A simple four-stage progression from low-irritability exercises through to sport-specific strength and power training How to integrate rehabilitation into a patient's existing training so they are more likely to stick with the program Throughout the episode, Tom shares the clinical reasoning behind each exercise choice, showing how to progress patients from simple strengthening exercises to the powerful, sport-specific movements required for running and HYROX competition, without provoking unnecessary flare-ups. This is part three of a four-part podcast series with Tom Goom on PFP. In the final episode, available later this week, Tom and David explore the fourth pillar of rehabilitation: how to safely progress running volume, speed and training so patients can confidently return to racing and competition while minimising the risk of recurrence. Timeline: 2:45 Introduction & Recap 5:20 When to Start Rehab 7:40 Assessment Findings 9:37 Squats to Rebuild Tolerance 12:03 Psychosocial Screening & Gait 13:11 Matching Rehab to HYROX 14:57 Stage 1: Low Knee-Stress Work 17:11 Stage 2: Loaded Knee Flexion 18:53 Review Frequency & Goals 21:49 Stage 3: Knee-Focused Loading 24:09 Stage 4: Power Work 27:43 Keys to Avoid Flare-Ups 28:58 Webinar & Resources Free resources Running injury assessment sheet — Tom's go-to assessment sheet for every runner, giving you the structure to gather all the key information you need. It includes his screening questions for past medical history, a weekly training structure block, the key physical tests he performs, and a QR code to an energy availability questionnaire. Free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" — Join Tom's free webinar to see his assessment and treatment in action, with visuals of the assessment tests, gait assessment and the traffic-light and sweet-spot approaches, plus the exercises, evidence and best-practice guidelines behind treating patellofemoral pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs. Click here for your access, or login here if you're a Clinical Edge member. Links associated with this episode 178. Patellofemoral pain 2 - What to do when runners won't reduce their training. Physio Edge Track record: Running repairs podcast with Tom Goom 177. Patellofemoral pain 1 - Why it has such a high recurrence rate, and what most rehab plans miss. Physio Edge Track record: Running repairs podcast with Tom Goom Download your free running injury assessment sheet Register for the free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Click here to download your podcast handout Improve your confidence and clinical reasoning with a Clinical Edge membership here Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Join Tom live on Facebook & ask your running-related questions Tom Goom - Running Physio Tom Goom - X David Pope - X Tom Goom - Instagram David Pope - Instagram

Many runners patellofemoral pain (PFP) is aggravated by the activity they love. They either stop running to let their pain settle, and then it returns as soon as they start back up again, or keep running despite the pain getting worse. They may know (and you may have told them) they should reduce their training….but what happens when they can't? Or won't? In this episode, Tom Goom (Running Physio) and David Pope explore the second pillar of successful PFP rehab: education and empowerment. Using the real case of Alice, a HYROX athlete preparing for competition, you'll discover how and when to help runners continue training safely while building long-term confidence and self-management. You'll discover: Why simply telling runners to "stop running" often leads to poor outcomes Practical communication strategies that improve patient buy-in and adherence How to uncover the real reasons patients resist reducing their training Ways to keep runners connected to the physical and social benefits of their sport during rehab How to explain PFP without creating fear around "maltracking," arthritis, or joint damage A simple framework that patients understand and can use to confidently self-manage flare-ups How to educate patients about the balance between training stress and recovery to improve both performance and rehabilitation Practical load management strategies for runners with symptoms so irritable they can't tolerate running yet Throughout the episode, Tom demonstrates how education isn't simply about explaining a diagnosis. It's about helping patients understand their pain, make better decisions independently, and confidently adjust their training as symptoms change. This is part two of a four-part podcast series with Tom Goom on PFP. In the next episode, Tom and David dive into the third pillar of rehabilitation: how to choose and progress strengthening exercises that build capacity without flaring symptoms, while avoiding the common rehab mistakes that slow recovery. Timeline 00:00 - Introduction 02:42 - Case study: Recurrent PFP and HYROX load 09:22 - Subjective clues 11:57 - Barriers to recovery 13:48 - Offloading when the knee can't tolerate running 17:12 - Helping patients understand and self-manage 23:48 - Self-management approach 27:11 - Stress, recovery and progress 28:47 - Key takeaways & free resources Free resources Running injury assessment sheet — Tom's go-to assessment sheet for every runner, giving you the structure to gather all the key information you need. It includes his screening questions for past medical history, a weekly training structure block, the key physical tests he performs, and a QR code to an energy availability questionnaire. Free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" — Join Tom's free webinar to see his assessment and treatment in action, with visuals of the assessment tests, gait assessment and the traffic-light and sweet-spot approaches, plus the exercises, evidence and best-practice guidelines behind treating patellofemoral pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs. Links associated with this episode 177. Patellofemoral pain 1 - Why it has such a high recurrence rate, and what most rehab plans miss. Physio Edge Track record: Running repairs podcast with Tom Goom Download your free running injury assessment sheet Register for the free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Click here to download your podcast handout Improve your confidence and clinical reasoning with a Clinical Edge membership here Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Join Tom live on Facebook & ask your running-related questions Tom Goom - Running Physio Tom Goom - X David Pope - X Tom Goom - Instagram David Pope - Instagram

  Patellofemoral pain (PFP) is one of the most common running injuries, and the high recurrence rate can make it a frustrating injury for patients to experience and clinicians to treat. In this episode, Tom Goom (Running Physio) and David Pope break down why PFP has such a high recurrence rate, and what most rehab plans miss. You'll also discover: The "Four pillars" framework Tom uses to treat PFP and other running injuries How and when to keep patients running or exercising when it is essential for their mental health and social life How to find a manageable starting point when a patient has a highly irritable pain presentation A step-by-step load management approach to find patients training and running "sweet spot" How to keep athletes connected to their sport during rehab (and why it matters for mental health) The "layering" approach to training and running that avoids pain flare-ups So you can easily apply the podcast with your patients, Tom walks through the real case of a runner and HYROX athlete who presented with recurrent PFP that flared up with each of her 3-4 weekly training sessions. This is part one in a four-part podcast series with Tom Goom on PFP. In the next episode, Tom and David continue this case study and dive into the second pillar in the framework that will help you tackle the problem of "What to do when your runners won't reduce their training?". Timestamps: 03:41 - Why PFP is tricky and recurs 04:45 - Meet Alice: HYROX athlete with recurrent PFP 05:32 - HYROX explained and its knee-load demands 08:47 - Presentation, irritability and moving beyond "stop running" advice 11:15 - Alice's goals 12:41 - The four pillars framework 15:29 - Pillar 1: Load management 23:39 - Testing tolerance 27:21 - Building Alice's weekly routine 30:06 - Key takeaways & free resources 34:10 - Free resources Free resources Running injury assessment sheet — Tom's go-to assessment sheet for every runner, giving you the structure to gather all the key information you need. It includes his screening questions for past medical history, a weekly training structure block, the key physical tests he performs, and a QR code to an energy availability questionnaire. Free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" — Join Tom's free webinar to see his assessment and treatment in action, with visuals of the assessment tests, gait assessment and the traffic-light and sweet-spot approaches, plus the exercises, evidence and best-practice guidelines behind treating patellofemoral pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs. Links associated with this episode Download your free running injury assessment sheet Register for the free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Click here to download your podcast handout Improve your confidence and clinical reasoning with a Clinical Edge membership here Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Join Tom live on Facebook & ask your running-related questions Tom Goom - Running Physio Tom Goom - X David Pope - X Tom Goom - Instagram David Pope - Instagram

When is your patient's shoulder pain from their neck? Are you missing a cervical spine component in your shoulder patients? After a day in clinic reviewing patients with years of unresolved shoulder pain, Shoulder Specialist Physiotherapist Jo Gibson breaks down the five most common mistakes clinicians make when ruling in — or out — the neck. In this podcast, Jo covers: Why you don't need neck pain to have neck-driven shoulder pain (and which pain locations are most pathognomonic) Why referred symptoms below the elbow don't automatically point to the cervical spine Why active range of movement alone is not enough to clear the neck What palpation findings are actually sufficient — and why you don't need to reproduce peripheral symptoms Why using neck movements to modify shoulder symptoms can be misleading Whether you're seeing patients with posterior-lateral shoulder pain, scapular pain, or symptoms that just aren't responding to local shoulder rehab, Jo shares a practical framework for refining your clinical reasoning and avoiding these common assessment pitfalls. Key takeaway: Up to 40% of patients with shoulder problems lasting six months or longer have some degree of cervical spine involvement. The subjective examination is doing 80% of the work — Jo explains exactly what to listen for. Free 7-day Shoulder assessment bootcamp Join the free 7-day Shoulder assessment bootcamp with Jo Gibson and Clinical Edge Click on an image below to access these free resources from Jo Gibson and Clinical Edge The handout for this podcast consists of a transcript associated with this podcast. Shoulder: Steps to Success online course with Jo Gibson Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess Free trial Clinical Edge membership Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial Links associated with this episode: Join the free 7-day Shoulder assessment bootcamp with Jo Gibson and Clinical Edge Free video series - How to be a shoulder detective: Solving acute shoulder pain with Jo Gibson Get your access to the free video series "Frozen shoulder assessment & treatment" with Jo Gibson Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge

Should you prescribe isometric or isotonic exercises for your patient's lower limb tendinopathy? When is it safe to add plyometric loading, and how do you progress running or jumping without flaring your patients tendon pain? Why do some "tricky tendons" refuse to respond to your best loading programs? Dr Ebonie Rio (Post-Doctoral Senior Research Fellow, La Trobe University) reveals the evidence-based answers as she guides you through the clinical reasoning and practical strategies for managing patellar, achilles, and other lower limb tendinopathies. In this conversation, you'll follow clinical examples and unpack the latest research to help you feel confident with tendinopathy assessment and treatment. Inside this podcast you'll explore: Tendon pathology explained: What's happening inside tendinopathic tendons, how to explain tendinopathy and ultrasound scan results to patients The role of isometrics: Whether isometrics actually change tendon structure, when to use isometrics to improve pain, optimal dosage, and whether isometrics are all your tendinopathy patients need Safe loading from day one: When are both isometrics AND isotonics safe to start immediately, and how to choose isometric positions and loads. The 24-hour emoji rule: How to teach patients to monitor their response after running or loading using the emoji system What NOT to do: Exercises, manual therapy and supplements that won't help tendon pain and may stir it up Differential diagnosis mastery: How to distinguish patellar tendinopathy from patellofemoral pain, mid-portion achilles tendinopathy from peritendinitis, and when you've got the diagnosis wrong Stairs as a progression exercise: The quasi-isometric stair protocol that works for everyone from sedentary patients to elite sprinters—and how to use tempo to control tendon load Criteria-based progressions: Moving beyond time-based rehab to functional milestones When loading programs fail: What to do when your patient is worse with your exercises You'll walk away with: Clear clinical reasoning to differentiate true tendinopathy from other conditions Practical loading frameworks that progress your isometrics, isotonics and plyometrics based on patient response Patient education scripts that use imaging findings to build confidence rather than fear Simple monitoring tools (the emoji system) to empower patients to self-manage their load progression Dr Ebonie Rio is a post doc researcher at La Trobe University and has completed her PhD in tendon pain, Masters Sports Phys, B. Phys (Hons) and B. App Sci. Her clinical career has included the Australian Institute of Sport, Australian Ballet Company, Australian Ballet School, Melbourne Heart Football Club, Alphington Sports Medicine Centre, Victorian Institute of Sport, 2006 Commonwealth Games, 2010 Vancouver Winter Olympics, 2010 Singapore Youth Olympics, 2012 London Paralympics, 18 months travelling with Disney's The Lion King stage show (Melbourne and Shanghai tour).   Get free access to the "Tricky tendons" infographic series Unlock the secrets of successful tendinopathy assessment and treatment with this free infographic series for therapists. Links Improve your musculoskeletal and sports injury assessment & treatment results with a free trial Clinical Edge membership Click here to register and receive immediate access to the Tricky tendons infographic series Free Achilles tendinopathy video series with Tom Goom David Pope at Clinical Edge Download and subscribe to the podcast on iTunes Download the podcast in Overcast Listen to the podcast on Spotify Dr Ebonie Rio David Pope on Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Chapters: 00:02:57 - How isometrics emerged as a tendinopathy treatment 00:07:00 - How loading helps a tendon 00:07:38 - Tendon structure & how to describe tendinopathy to patients 00:12:27 - When and why tendinopathy develops 00:15:17 - Tendon imaging 00:17:38 - Differential diagnosis - Achilles peritendinitis vs mid-portion tendinopathy 00:19:35 - Does treatment change tendon structure? 00:21:27 - Can we load disorganised areas of tendon? 00:22:46 - Do supplements help? 00:24:44 - Avoid these in your tendinopathy treatment 00:26:47 - Finding the right level of running or load 00:28:40 - What causes tendinopathy to develop 00:31:52 - When and how to include isometrics in treatment 00:36:42 - When isometrics are likely to help or not help 00:38:51 - Choosing the starting position for isometrics 00:39:38 - How to describe isometrics to patients 00:40:23 - How to choose the load for isometrics 00:42:53 - When to include isotonics in treatment 00:44:03 - Plyometric & Stair loading   00:46:49 - How long should isometric holds be? 00:47:26 - Patient advice & discussion                                      

Have any of your shoulder patients improved and then plateaued, unable to regain their full range of movement, or get rid of their painful arc? Sometimes it's not the cuff, capsule, nerves or neck—it's the acromioclavicular joint (ACJ) holding things back. In this episode, Jo Gibson sheds light on this often-overlooked contributor to persistent shoulder pain. From real patient case studies to the latest research and simple clinic-ready symptom modification tests, Jo shares practical strategies you can use immediately. Learn how to identify ACJ involvement, and use targeted rehab exercises, symptom modification and treatment strategies to help patients break through their plateau and regain their confidence and range. Chapters: 00:00 - Intro 02:59 - Case study: Patient with shoulder pain 03:29 - Recent research around the ACJ 06:37 - Psychosocial or biomedical factors influencing the ACJ and shoulder pain 06:53 - Role of the ACJ 07:06 - Pain and movement patterns indicating ACJ involvement 08:34 - Protective movement strategies that may affect the ACJ 09:18 - Symptom modification tests 10:08 - Exercises for the ACJ 12:43 - Manual therapy for a stiff ACJ? 15:40 - Summary: When to look at the ACJ Join the free 7-day Shoulder assessment bootcamp with Jo Gibson and Clinical Edge Click on an image below to access these free resources from Jo Gibson and Clinical Edge The handout for this podcast consists of a transcript associated with this podcast. Shoulder: Steps to Success online course with Jo Gibson Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess Free trial Clinical Edge membership Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial Links associated with this episode: Join the free 7-day Shoulder assessment bootcamp with Jo Gibson and Clinical Edge Free video series - How to be a shoulder detective: Solving acute shoulder pain with Jo Gibson Get your access to the free video series "Frozen shoulder assessment & treatment" with Jo Gibson Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge

Anterior hip pain is often blamed on the hip flexors, but in runners, that's rarely the diagnosis. So how can you identify the real cause and guide patients to a safe, effective recovery? In this episode, Tom Goom (Running Physio) explores the function of the hip flexors in running, key differentials for anterior hip or groin pain, and practical rehab strategies you can use right away. You'll discover: Why true hip flexor tendinopathy is uncommon in endurance runners Red flags and key tests to identify bone stress fractures and intra‑articular pathology Early‑stage loading strategies that protect the tendon from aggravation The role of the adductors, trunk, and synergistic muscles in successful rehab Common myths and misconceptions around hip flexors How to progress rehab to sport‑specific drills and return to running If you're a physiotherapist or health professional treating runners, this episode gives you research‑backed, clinically reasoned strategies to assess and manage hip flexor pain with confidence. Timestamps: 00:00 - Intro 03:35 - Hip flexor function 06:56 - Tip 1 - Is it a hip flexor tendinopathy? 09:48 - Tip 2 - Rehab of hip flexors 11:35 - Tip 3 - Other muscle groups to include in rehab 13:08 - Common misconceptions 13:37 - 1. Pronation 14:49 - 2. Firing order 16:13 - 3. Weak transversus abdominis 17:12 - 4. Rib alignment and breathing patterns 🔗 Free Webinar Alert! Don't miss out on our free webinars for therapists on shin pain and Achilles tendinopathy in runners. Check the link in the description for more information. Free running injury assessment & treatment video series available now         Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs. Get free access to the "Tricky tendons" infographic series Unlock the secrets of successful tendinopathy assessment and treatment with this free infographic series for therapists. Article associated with this episode: Click here to download your podcast handout Lenhart R, Thelen D, Heiderscheit B. Hip muscle loads during running at various step rates. journal of orthopaedic & sports physical therapy. 2014 Oct;44(10):766-A4.   Links associated with this episode: Free Achilles tendinopathy videos Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge

Your patient presents with shoulder pain, and straight away you need to identify: Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is the pain actually coming from the shoulder? Could it be the cervical spine? Is there a tear that needs urgent referral? Should you order imaging? Refer to a surgeon? Or confidently continue with rehab? In this podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio) guides you through a simple, evidence-informed clinical reasoning framework to help you confidently assess and treat patients with shoulder pain. Drawing on decades of clinical experience and the latest research, Jo breaks down four essential questions you need to ask in every shoulder assessment—helping you identify red flags, tailor your treatment plan, and avoid common diagnostic pitfalls. In this episode, you'll discover: How to distinguish shoulder pain from cervical spine referral Key subjective clues that guide your diagnosis and treatment decisions Whether it's "torn"—and how to know if a surgical referral is appropriate Clinical signs that help differentiate frozen shoulder from other causes of stiffness Why pain irritability matters—and how it impacts your rehab approach When to use (and when to avoid) imaging How to identify instability and assess the likelihood of recurrence What assessment tests to perform in your objective examination The real value—and limitations—of special tests like the Hawkins-Kennedy, drop arm, Hornblower's, and more. How to modify testing to better isolate rotator cuff contributions Why symptom modification tests are useful—and what they tell you How to help your patient overcome fear, regain confidence, and move again What research says about exercise prescription, and how many exercises you should give patients Listen in to strengthen your clinical reasoning and give your shoulder assessments a clear structure that helps you feel more confident—and gets better outcomes for your patients. Chapters: 00:00 - Intro 03:12 - Subjective clues that guide diagnosis 04:33 - What to call shoulder pain? RCRSP or SAP? 06:04 - 4 key questions to ask 06:29 - Cervical spine driven shoulder pain 10:03 - Is it torn and does it matter? 11:29 - Traumatic dislocations 12:37 - Special tests in the "Is it torn" group 15:56 - Is it stiff? 17:36 - Is it irritable? 20:38 - Can I change it? 23:05 - Summary Click on an image below to access these free resources from Jo Gibson and Clinical Edge The handout for this podcast consists of a transcript associated with this podcast. Shoulder: Steps to Success online course with Jo Gibson Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess Free trial Clinical Edge membership Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial Links associated with this episode: Free video series - How to be a shoulder detective: Solving acute shoulder pain with Jo Gibson Get your access to the free video series "Frozen shoulder assessment & treatment" with Jo Gibson Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge Chapters: 00:00:00 - Intro 00:03:12 - Subjective clues that guide diagnosis 00:04:33 - What to call shoulder pain? RCRSP or SAP? 00:06:04 - 4 key questions to ask 00:06:29 - Cervical spine driven shoulder pain 00:10:03 - Is it torn and does it matter? 00:11:29 - Traumatic dislocations 00:12:37 - Special tests in the "Is it torn" group 00:15:56 - Is it stiff? 00:17:36 - Is it irritable? 00:20:38 - Can I change it? 00:23:05 - Summary