Arthroscopic subacromial decompression has cost healthcare systems billions over the decades. No trial to date has demonstrated superiority of this surgery over placebo surgery or an exercise based approach.

We run through 10 year results of the FIMPACT trial and discuss... should this surgery still be offered?

Please note, this episode is not intended to act as medical advice.

We've had loads of new followers and we thought this week it would be great to revisit one of our first ever episodes looking at the RESTORE trial.

CFT treatment for chronic lower back pain

We hope you enjoy!

Today we discuss an interesting 2026 paper looking at long term outcomes for Cross Bracing ACL ruptures.

DOI: 10.1097/JSM.0000000000001416

• What is cross bracing?
• Where did it come from?
• How does it compare to surgery in an athletic population?

Jeff has been waiting a while to discuss this paper that has been widely shared by a high impact journal (BJSM) and appears to have gained a lot of attention since its publication.

Are we justified in heavily critiquing this paper? Are we taking crazy pills?! Is the spin in the abstract a cause for concern and something we should rightly be angry about?

Have a read for yourself and let us know your thoughts: https://bjsm.bmj.com/content/55/9/501

In this episode, we speak with Jack Chew. A huge figure in the world of Physiotherapy

Jack reflects on his rapid early career, including becoming the youngest Band 8a Physiotherapist.

We then explore the origins of the MSK Reform Movement. Why it emerged, what it set out to challenge, and the resistance it encountered, before discussing Jack’s subsequent move into the CSP, and what he learned trying to enact change from within the system.

The conversation finishes by looking forward: what physiotherapy needs to confront, what must change, and how the profession can remain relevant, credible, and fit for the future.

This is an honest discussion about professional power, evidence, scope of practice, and leadership, and it’s essential listening for MSK physios, educators, managers, and anyone invested in the future of physiotherapy.

We hope you enjoy!

Jacks Own Words From Inside the CSP

https://mskmag.substack.com/p/how-the-sausage-is-made-insights

This week we host the amazing S+C professor, author and coach Dan Cleather to discuss concepts from his lesser talked about books 'The Little Black Book of Training Wisdom' and 'Subvert' (Jeff and James' favourite).

Topics include philosophy of science through an anarchist lens, fundamental concepts in coaching people and why Dan is cautious when it comes to adopting language associated with Dynamic Systems Theory.

We hope you enjoy this episode as much as we did!

You can find Dan at @dancleather on IG and most definitely search for his books on Amazon!

This week....

• Jeff causes a PR nightmare for Physio Pulse on social media...
• How should Physio courses better prepare students for MSK work?

We discuss ACL limb symmetry index, is there a better way we can be testing this? or WHEN we test this - https://www.jospt.org/doi/10.2519/jospt.2017.7285

This week we have an honest discussion about the importance of NOT using some words when chatting with patients, alongside some discussion on how to balance empathy and understanding without losing the clarity of our messages.

Please note, this episode is not intended to provide medical advice.