Could we be in the middle of the biggest breakthrough in MSK medicine?

James and Jeff check out the 2026 paper - Neuroimmune interactions in musculoskeletal conditions: An introduction for clinicianshttps://doi.org/10.1016/j.msksp.2025.103469

We dive into a paper looking at a relatively novel measurement of quadriceps tendon alignment which has been associated with lateral patella tracking and lateral facet patellofemoral osteoarthritic changes.

Is it just the tendon or the whole muscle? Does VMO volume differ with tendon position? We then go on to discuss investigating recalcitrant anterior knee pain and the reasoning for this.

James takes some well deserved heat for missing two weeks.

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

Unfortunately, James is still getting shown who is boss by bacteria so we were unable to release a new episode this week. Therefore we have seized the opportunity to re-release our episode all about exercise intensity and knee osteoarthritis, the results of which might surprise you if you haven't listened before.

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

James was bunking off so Jeff seized the opportunity to talk about the 10 year results of the FIDELITY study comparing meniscal debridement for degenerative tears, to sham surgery!

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

We cover two HUGE randomised controlled trials that look at the clinical effectiveness of hip arthroscopy versus rehabilitation for femoroacetabular impingement syndrome.

Often, these get summarised as surgery simply outperforming rehabilitation. Whilst true, there is so much more to unpack!

UK Fashion (Griffin et al, 2018)

FAIT (Palmer et al, 2019)

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

It's 2026 and we are only getting the first RCT comparing Physio treatments for FAI??

Hot off the press

Kemp et al 2026Physiotherapist-led treatment for femoroacetabular impingement syndrome (the PhysioFIRST study):

https://bjsm.bmj.com/content/early/2026/05/03/bjsports-2025-110986

A little bit of a different format this week.

We discuss the articles we have each recently written for MSK Mag (by Physio Matters).

The argument for an MSK only degree, and why being nice is detrimental for us as a profession.

This was great to revisit and explore in a little more free-flowing detail.

We highly recommend checking out MSK Mag, not for us, but for the tonnes of high quality authors who explore all issues and conditions concerning MSK health!

This week, Jeff and James talk internal / external focus of attention in ACL testing, ramble unnecessarily about isokinetic dynamometry and testing philosophy.