#49: Cognitive Functional Therapy with Prof. Peter O'Sullivan
In this candid and wide-ranging conversation, Dr Jared Powell is joined once again by Professor Peter O’Sullivan, one of the most influential voices in musculoskeletal care.
Pete unpacks the rationale and findings of the landmark RESTORE trial published in The Lancet, which provides some of the most compelling evidence to date for cognitive functional therapy (CFT) in people with chronic low back pain. He discusses how CFT works, its philosophical divergence from traditional “find-it, fix-it” approaches, and how it centres the patient’s experience, goals, and context.
You’ll also hear:
A simple explanation of the 3 pillars of CFT
The real-world training model used in the RESTORE trial
The importance of behaviour change, flare-up planning, and self-efficacy
What to do when CFT “doesn’t work”
Pete’s reflections on burnout, clinician support, and the importance of community
A behind-the-scenes look at the Evolve Pain Care Academy: a new initiative to democratize pain education globally
This episode is packed with practical insights, personal reflections, and a compelling vision for the future of musculoskeletal care.
Register for The Complete Clinician waitlist here
Key papers:
Listen to me, learn from me. Slater et al 2022.
The RESTORE trial 3 year follow-up
Connect with Jared and guests:
Jared on Instagram: @shoulder_physio
Jared on X: @jaredpowell12
Evoolve Pain Care
Pete X: @peteosullivanpt
See our Disclaimer here: The Shoulder Physio - Disclaimer
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#48 Rotator Cuff Surgery: What Makes it Worthwhile?
In this solo episode of The Shoulder Physio Podcast, Dr Jared Powell explores a deceptively simple question: How much benefit does rotator cuff surgery need to provide to be considered worthwhile?
Jared explores a new 2025 study by Harrison Hansford and colleagues, which uses a clever benefit–harm trade-off approach to quantify what patients actually want from surgery.
This episode challenges the way we interpret research, the limits of "statistical significance," and the need for truly patient-centred decision-making. If you're still recommending surgery after failed physio without asking what makes it worthwhile to the person in front of you, this one’s for you.
Key topics include:
The concept of the smallest worthwhile effect
Is “does it work?” the wrong question?
Shared decision-making and expectation alignment
How the evidence stacks up (or doesn’t)
Why patient-defined outcomes matter more than p-values
Check out the Shoulder Physio Online Course here
Connect with Jared:
Jared on Instagram: @shoulder_physio
Jared on X: @jaredpowell12
See our Disclaimer here: The Shoulder Physio - Disclaimer
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#47: Active Inference, Pain, and Movement with Dr Mervyn Travers
In this episode of The Shoulder Physio Podcast, Dr Jared Powell sits down with Dr Mervyn Travers, physiotherapist, S&C coach, and researcher, to explore one of the most compelling frameworks in contemporary pain science: active inference.
They discuss how this predictive brain model helps explain persistent musculoskeletal pain, why traditional exercise-based interventions might miss the mark, and how clinicians can use movement and context to shift a patient’s pain experience. Merv blends philosophy, neuroscience, and clinical pragmatism in a way that's accessible, challenging, and highly relevant.
Key talking points:
What is active inference and how does it relate to predictive processing?
The role of prior beliefs, culture, and clinical language in shaping pain
Movement experimentation as a tool for model updating and recovery
Why it’s time to rethink how we prescribe exercise in pain rehab
Clinical implications from landmark studies within the field that lend themselves to active inference
A call for compassion, curiosity, and nuance in patient care
Check out the Shoulder Physio Online Course here
Connect with Jared and guests:
Jared on Instagram: @shoulder_physio
Jared on X: @jaredpowell12
Merv website: Home - Optimise Rehab
Merv X: @mervtravers
Merv Instagram: @optimise_rehab
See our Disclaimer here: The Shoulder Physio - Disclaimer
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#46: Evidence-based medicine with its founder, Professor Gordon Guyatt
In this episode, Jared Powell sits down with Professor Gordon Guyatt, the physician and researcher who coined the term evidence-based medicine (EBM). They unpack the origins of EBM, why it’s often misunderstood, and how it continues to shape modern healthcare.
Rather than being rigid or formulaic, EBM is about integrating the best evidence with clinical expertise and—crucially—patient values and preferences.
🎙 Key talking points:
The surprising history behind the creation of EBM
Why randomised trials matter—and when they’re not enough
How to practice medicine in the face of low-certainty evidence
The role of shared decision-making in everyday care
Why acknowledging uncertainty is a sign of strength, not weakness
How EBM is sometimes misunderstood or misused
What the future holds for EBM—including education in schools
🎧 A must-listen for anyone navigating the grey zones of clinical care.
Key Papers:
Professor Guyatt has too many high impact papers to mention and he has one of the highest H-Index scores in the world (number 13 worldwide and number 1 in Canada). Here is his Google Scholar profile.
Check out the Shoulder Physio Online Course here
Connect with Jared and guests:
Jared on Instagram: @shoulder_physio
Jared on X: @jaredpowell12
Gordon on X:@GuyattGH
See our Disclaimer here: The Shoulder Physio - Disclaimer
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#45: Gluteal tendinopathy myths and misconceptions with Dr. Charlotte Ganderton
In this episode of The Shoulder Physio Podcast, Dr. Jared Powell sits down with Dr. Charlotte Ganderton, a physiotherapist, researcher, and senior lecturer at RMIT University. Charlotte shares insights from her latest research on gluteal tendinopathy, breaking down common misconceptions about imaging, corticosteroid injections, and the infamous clam exercise.
From understanding the role of compression in tendinopathy to discussing effective treatment strategies, this episode is packed with clinically relevant takeaways for musculoskeletal healthcare professionals. Tune in to hear Charlotte’s perspective on how education, exercise, and progressive loading can make all the difference in patient outcomes.
🔹 What is gluteal tendinopathy and how does it differ from other tendon issues? 🔹 Should we rethink the role of imaging and injections? 🔹 Is it finally time to ban the clam? 🔹 Practical treatment strategies for improving patient care.
If you're looking to refine your approach to gluteal tendinopathy, this is an episode you don’t want to miss!
Key Papers:
Grimaldi A, Ganderton C, Nasser A. Gluteal tendinopathy masterclass: Refuting the myths and engaging with the evidence. Musculoskelet Sci Pract. 2025 Apr;76:103253. doi: 10.1016/j.msksp.2025.103253. Epub 2025 Jan 3. PMID: 39854929.
Check out the Shoulder Physio Online Course here
Connect with Jared and guests:
Jared on Instagram: @shoulder_physio
Jared on X: @jaredpowell12
Charlotte on X:@C_Ganderton
Cliniko free trial, click here!
See our Disclaimer here: The Shoulder Physio - Disclaimer
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