Physio Edge podcast with David Pope

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