MSKMag OutLoud blends cutting-edge clinical opinion with light-hearted relief from the daily grind. It features insights from leading minds in the musculoskeletal industry and aims to keep listeners up to date with best-practice evidence. The show also covers topical memes and practical discussion for MSK professionals. It is associated with Physio Matters and the MSKMag Substack.
Episodes
Who's Actually Keeping Physios in Check?
If I think about my own appointments with physiotherapists as a patient recently, I’ve been told I need an MRI and I’ve been told I don’t. I’ve been told I need an injection, and the next one said I don’t. One says I need eight treatments, one says a couple and I’ll be fine. One says it’s my hamstring, the other says it’s my glutes. Same leg and still the same old me.And I think any profession, es
Osteoporotic Vertebral Fractures: are we doing enough?
Vertebral fractures are one of the most common osteoporotic fractures, yet they are the one that we miss most often. Case studyA 58-year-old woman presents with mid/lower back pain. She was lifting shopping bags out of her car boot and felt a twinge in her back. The pain progressively got worse over the next few days. It felt like a bad ‘back spasm’, similar to one she’d had before, and the pain w
Perimenopause and musculoskeletal health: what you need to know
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIf you’re a clinician or working with active women, you’ll probably recognise this familiar picture. A woman in her mid 40s seeks your help with joint or muscle pains which are taking much longer to resolve than they used to. She’s picking up injuries more often, and with her busy life and poor sleep patterns, she’s
Headache patients – dream or nightmare? Top tips from my headache student clinics
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comAre you ever uneasy when faced with a headache patient? Could you recognise potential trouble and respond appropriately? Headache disorders are commonly seen in our practices. Almost 10% of osteopathy appointments are solely for help with headaches and facial pain [1]. This statistic shocked me into headache education
Everyone Thinks AI Can Do Anything. Just Not What They Do
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIt can write their marketing, answer their emails and probably do their accounts better than their accountant, but suggest AI might do some triage or follow-ups or (heaven forbid) some actual physiotherapy, and suddenly it’s dangerous and unproven and years away and patients will never go for it.I see a lot of false n
The Art of Managing Uncertainty in Clinical Practice
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comAs I write this, many are bracing themselves for the start of a new school year. A new year, new teachers, new schools for some, exams on the horizon for many. I’m sure many of you have had those conversations with your kids where we try to reassure them that everything will be ok; the truth is, of course, we don’t ac
Forecast: Uncertain - Editorial - MSKMag Issue 35
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIn recent years I have become obsessed with the Northern Lights. This is good timing actually, because we have been in a peak of the approximately decade-long cycle of solar activity, meaning space weather is, for a time, madder than usual. In 2024, that led to a series of events whereby we paid for flights and trains
Healthcare's best-kept secret - the pelvic floor (and why every therapist needs to know about it)
It always struck me as bizarre that sports medicine and musculoskeletal specialties deal with pain and dysfunction from head to toe in the human body, yet offer little health literacy or inclusion of the pelvic floor. Traditionally considered taboo and someone else’s remit, men and women with issues affecting the pelvic floor have largely suffered in silence. Thankfully, change is afoot, and healt
Scar Scepticism: what’s the big deal with scarring?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comYou may already be treating scars. You may not. You may have no idea that treating scars is even a treatment. You could have been in your profession for decades and have no reason to believe that assessing or ‘treating’ a scar is required. You may have built your business on the treatment and scarring. You may think s
Running Injury Rehab: The Diagnosis Is Only Part of the Story
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comWhen I first started writing this article, I found myself writing a more traditional piece on running injury rehab. The importance of a good subjective history, accurate diagnosis, load management and progressive rehab. All of that is key and I will touch on those things throughout this article. But I also wanted to w
Every Day I’m Hustlin'
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIt is 2am on a Tuesday and my girlfriend (now wife) isn’t necessarily grumpy but she certainly isn’t smiling… We have been writing names and addresses on envelopes for four hours to send my Rheumatology At A Glance booklets to people who have ordered them. We are working our way through a pile of printed out orders th
First-Rate Second Opinions
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comWhat actually is a second opinion?Many will think that a second opinion is another specialist looking at the patient and deciding whether the first specialist was right.Whilst this occasionally may happen, it usually isn’t. There are four types of second opinion.• Diagnostic second opinion: What is actually wrong?• Tr
The Zebra Farm: When Anterior Knee Pain Isn’t Patellofemoral Pain
With cases from James NoakeIn musculoskeletal medicine, we are trained to recognise patterns. Most of the time, the answer sits comfortably within the familiar: overload, strain, tendinopathy. But every so often, something doesn’t quite fit. The story is slightly off, the response to treatment unexpected, or the clinical picture just a little too inconsistent.This is where the ‘Zebra Farm’ comes i
The Great North Logistical Headache - Editorial - MSKMag Issue 34
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comHere in the North East of England, we are emerging from Great North Run season. Hosting the biggest half marathon in the world on our doorstep naturally creates a few more new patient appointments and a little less space on the path of your regular running route.I have done the Great North Run once, two years ago. Thi
AI solved our notes - but can it improve care?
A few years ago, if you asked most clinicians what they wanted AI to do, ‘write my notes’ would have been pretty high on the list. Which is fair enough; nobody became a physiotherapist because they had a deep passion for clinical documentation.AI scribes have become remarkably good at solving that problem. They listen to our consultations, turn conversations into structured notes and draft letters
MSKMag goes to... Neko Health
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIn case you haven’t heard of Neko Health, let me enlighten you.Neko Health is the brainchild of Spotify founder Daniel Ek and Swedish Engineer Hjalmar Nilsonne, whose stated goal is to move healthcare from the reactive (treating illness) to the proactive / preventative (early detection). Their website describes the Ne
MSK’s Lost Carrots & Sticks
Rewards for quality, consequences for a lack of. It’s not a big ask, is it?!Yet to my eye we have neither and it risks stagnating the MSK industry. In any healthy environment the incentives are well balanced. An excess of rewards, especially for those undeserving when it comes to effort and ability, creates a cringeworthy, self-important and sycophantic atmosphere [1]. The technical literature in
Children Are Not Mini Adults: Rethinking Sudden Anterior Knee Pain in the Skeletally Immature Athlete
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comA 12-year-old soccer player lands in knee flexion from a jump and develops sudden left-sided anterior knee pain. He cannot continue playing, is reluctant to flex the knee, and describes giving way on weight-bearing. He cannot perform a straight leg raise (SLR) or adequately contract quadriceps because of pain and has
Core Memories: The Physio Matters Podcast Session 3 - The Rugby Shoulder with Ian Horsley, 2014
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIn 2014, Dr Ian Horsley joined Jack Chew on the Physio Matters Podcast to discuss the ‘rugby shoulder’, challenging prevailing orthopaedic thinking and advocating for a more functional, systems-based approach to shoulder rehabilitation. His perspectives, shaped by elite sport and emerging research, questioned diagnost
Tendons: What’s Load Got to Do With It?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comTendons are frequently discussed as though loading is either therapeutic or harmful. That distinction is too simple. Mechanical loading is essential for tendon homeostasis, adaptation and performance, yet the same load may be tolerated by one athlete and provocative for another. The relevant question is therefore not
Recalibrating the Scales - Editorial - MSKMag Issue 33
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comHappy New Football Season to all who celebrate!And godspeed to all my fellow Newcastle United fans. For those of you fortunate enough to not have endured the comings and goings and goings and goings of the Newcastle squad this summer, let me give you a brief overview.Following a few seasons of success featuring our fi
Beyond the Bump: Reframing High-Grade AC Joint Injury
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comA rugby player lands heavily on the point of his shoulder. He’s ‘done’ his AC joint. Strap it up. Add some padding. Get him through the season. If the x-ray says it is a Grade V, perhaps he gets referred to a surgeon. Everyone else carries on, often wearing their new bump like a badge of honour around the changing roo
The Forgotten Child of MSK: Why Paediatric Services Deserve a Bigger Voice
This is a free preview of a paid episode. To hear more, visit mskmag.substack.com“Children aren’t mini adults” is a phrase we hear a lot to highlight the differences in Paediatric physiotherapy to remind clinicians that children and young people have different needs and require different care. Yet Paediatric musculoskeletal (MSK) services around the country continue to be left in the shadows of ad
Auntie Version - MSKMag's Agony Aunt - August 2026
Hello! I’m Auntie Version (aka Jo Turner) and I am unbelievably excited to be MSKMag’s very own agony aunt.Oh the arrogance in my assumption that I have any wisdom to impart about your life, and the irony that much of my advice will implore you to resist that clinician’s urge to fix and advise! Nevertheless, I do hope you’ll find this column informative, thought-provoking, occasionally amusing and
Off the Treadmill, Into the Field How might nature shape the future of MSK care?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comObserving clinicians across the landscape of musculoskeletal care, I see the relentless effort poured into every consultation. Everyone is doing their best in the healthcare system, be that public or private, but as we know, the workload and complexity have increased. The total number of people living with an MSK dis
The Diagnosis That Keeps Getting Missed: Adult Hip Dysplasia
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comShe was 25 and needed a hip replacement — how can we stop this happening?Not the start to the week that I wanted.One of my patients on Monday morning was just 25 years old. Chronic hip pain for over four years. Seen by multiple clinicians. Not picked up.Hip dysplasia. Missed. Now progressed to severe osteoarthritis.Sh
The Biggest Wins in the NHS are Cheap
A community pilot reduced musculoskeletal waiting lists by 20%, and its reward was a national budget smaller than the pilot itself. The announcement, stripped of its press-release gloss, identifies an initiative that reduced community musculoskeletal waiting lists by a fifth that is now going national. The reward for that success is a grand total of £3.225m, which I had to read twice as I was expe
Time in Range - Editorial - MSKMag Issue 32
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comWhen was the last time you ate something without some input from a medical device? For me it was 2010. I was diagnosed with Type 1 diabetes aged 22 whilst seeing the GP for a UTI - which is quite undramatic as Type 1 diagnoses go. Since then, every meal starts with either a blood test or a look at the app screen of my
The Soft Tissue Cost of Testosterone
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comAs testosterone injections become normalised for strength, physique and recovery, emerging research is raising uncomfortable questions about injuries to ligaments, tendons and surgical repairs. Testosterone has had a rebrand.For many people, it no longer seems to sit in the same mental category as ‘performance-enhanci
Is this the writing on the wall for First Contact and Advanced Practitioners in the NHS?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIn May 2026, the British Medical Association, the largest doctors’ union in the UK, published the findings of a survey of over 5,000 doctors on the role of Advanced Practitioners (APs), with 81% saying that the way APs currently work poses a risk to patient safety. This was reflected in a new position statement from t
Physiotherapy Education: Getting Graduates Ready for What Exactly?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comAre physiotherapy graduates ready for practice? If you’ve ever asked this question, you’re not alone.The quick answer? No. But they’re not meant to be.The longer answer? Well that starts in 1894…The Start of Physiotherapy Education[Image 1: Almeric Paget Military Massage Corps [8]]Four women drew a line. Stories in th
The Beak Is The Breadcrumb: Tarsal Coalition and the Pain That Points the Wrong Way
A 24-year-old middle distance runner came in with dorsal midfoot pain – just distal to a little lump at the dorsal talonavicular joint.By the time she reached me she’d done the full lap. Foot strengthening. Mobilisations. Expensive custom orthotics. Shockwave. Dry needling. None of it moved the needle.Her running told the same story every time. Fine off the line but pain starting 2 to 3 km into a
Chewy and Jim - Navigating The System
Chewy and Jim are back - the lads were evaporating during the recording this month as the weather matched their opinions for heat…Chewy and Jim is best watched in full via the video above (so you can watch them melt in real time) or you can listen on the usual podcast players.In this recording, Chewy and Jim cover consultations from good to bad and their experiences sitting on both sides.“You can
The Zebra Farm: Calf pain
With cases from Dr James NoakeIn musculoskeletal medicine, we are trained to recognise patterns. Most of the time, the answer sits comfortably within the familiar: overload, strain, tendinopathy. But every so often, something doesn’t quite fit. The story is slightly off, the response to treatment unexpected, or the clinical picture just a little too inconsistent.This is where the ‘Zebra Farm’ come
An Axolotl at Breakfast - Editorial - MSKMag Issue 31
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comI recently spent some time with my five-year-old nephew on a family trip. As is often the case when travelling with children, my brain was put to work early. It was 7.30am at breakfast when I was drawn into a round of ‘Guess Which Animal I Am’.“It’s usually a dinosaur,” my sister-in-law had warned me, advising that my
Beware Concierge Healthcare
The following is not a real service. That is important to say upfront, because the uncomfortable truth is that it easily could be. If it were not so off-brand for MSKMag, you would be forgiven for assuming it was legit. And by legit, I mean real rather than credible, because this space is far from credible.Across MSK, private healthcare, wellness, performance, diagnostics and so-called longevity m
Fighting talk - Grappling with Combat Sports Rehab
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comMy interest in MSK healthcare grew out of my obsession with combat sports. In 2002 I was in the final stages of completing a maths PhD. In that same year, I became one of the first women in the UK to compete in Mixed Martial Arts (MMA) – which was at the time a small and niche sport often referred to as ‘cage fighting
Switching MSK practice management software: what it actually involves (and why it's probably less painful than you think)
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIf you’ve ever caught yourself muttering “there has to be a better system than this“ mid-clinic, you’re not alone. For many MSK practice owners across the UK, the frustration with outdated practice management software has become background noise — something they’ve learned to live with rather than fix.And the reason i
Notes on PAD
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comVascular claudication is angina in the legs: pain that starts when plaque narrows an artery enough that it cannot meet a working muscle’s demand for blood. One of the first English-language descriptions, from 1904, is still apt [1]:“The patient while walking experiences paresthesia and pains in the feet; tension, pain
AI in MSK: Useful Tool or Clever Distraction?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comAI in MSK is not about replacing physios; it is about removing friction, improving access, and helping clinicians and patients make better decisions with better data. The challenge is adopting it in ways that preserve clinical reasoning, data security, and the human side of rehab.There is a certain kind of AI conversa
Great Expectations - Editorial - MSKMag Issue 30
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIs it normal to assume that whenever someone cancels their appointment, despite explicitly thanking you and saying they’re feeling better, you’ve actually made their pain worse, ruined their life, and they’re simply too polite to tell you how terrible a clinician you are?What about when someone cancels their 8.30am ap
Shockwave Therapy: A Love-Hate Story, and Everything In Between
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comShockwave therapy… I was surprised to hear it hadn’t been covered in MSKMag. So, when the opportunity came to write an article on it, I jumped at the chance.Those who know me will know I work for Physiquipe, a company who sells shockwave therapy devices. And for those who don’t know me, now you know I work for a compa
Physios are nice...and it's killing our profession
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comPutting the finishing touches to this article, I skim back over the Writer’s Guide. It encourages me to write boldly and to not be too afraid to offend because…“you’ll be surprised how polite professional challenges are in our industry.”We are a caring bunch…and this is exactly the problem.Three years into my Physioth
The Corporate Athlete
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIf you mention the words ‘elite performance’, most people will think of sport, but I think of the corporate sector. Both elite groups have talent, skill and can perform at maximum capacity. Both environments are highly competitive, deadline driven and with high stakes. But only the elite sportsperson works at the extr
Do adolescents get rotator cuff tendinopathy?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comThe short answer is no - at least not in the way the term is typically applied in adult populations.Rotator cuff pathology is uncommon in paediatric shoulders, particularly in the absence of trauma [1]. While partial or full-thickness tears can occur, these are usually associated with acute injury, avulsion, or instab
Who is Responsible?
I look around the waiting room. There’s an average BMI of about 40. I observe oedematous ankles and a variety of walking aids (some flowery so you know they’re not a temporary feature). I can almost smell the inflammatory soup. A young person sits glued to an iPad, headphones shielding them from the world. No doubt an ADHD diagnosis inbound.The health of the nation has changed, and not for the bet
What's Spanish for 'nice'? - Editorial - MSKMag Issue 29
This is a free preview of a paid episode. To hear more, visit mskmag.substack.com¡Buenos dias!I’ve been in Valencia for a few days to explore the city, get in some runs and fit in my obligatory new-city stadium tour. I heard all the best teams are 14th in their league this season so don’t even worry about it, Valencia C.F.This was a solo trip because every few years I like to push myself out of my
Finding true value: how to build something worth selling
I spent the better part of a decade buying MSK practices before I ever helped anyone sell one.I founded a physiotherapy clinic group in my twenties, growing it from a single site to 36 locations. Acquisitions were a significant part of how we scaled. I would sit opposite an owner, run the numbers, and work out what I was prepared to pay, doing this more times than I can count. Aged 30, I went thro
Industrialised Rehabilitation: Where Does the Patient Sit?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comRecently I found myself in two very different rooms: Laing Buisson’s Out of Hospital Healthcare Conference and HETT (Health Excellence Through Technology).Laing Buisson is a well-known health market intelligence organisation that convenes leaders from the independent and private healthcare sector, commissioners, insur
Trained to Struggle?: Why MSK physio needs to be its own degree
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comPicture it. The next patient is walking through the door and you don’t have a f*****g clue what to do with them. You just hope they don’t ask too many questions.I know I’ve been there… have you?Thankfully, less so in recent years, although I certainly do still have those moments! I’m experienced enough now however to
Core Memories: The Physio Matters Podcast Session 10 - 28/09/2014 with Ann Gates
In 2014, clinical pharmacist and exercise medicine champion Ann Gates spoke to Jack Chew on The Physio Matters Podcast about the need to reposition physical activity at the centre of healthcare. She described physical inactivity as a public health crisis, advocated for integrating exercise into every patient consultation, and encouraged us to view exercise as a therapeutic agent as legitimate as d
What is Expertise?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comExpertise is special skill or knowledge that is acquired by training, study, or practice.I follow an Orthopaedic surgeon from the US who is of a similar vintage and much of what he posts aligns with my current thinking. I like his posts because they ooze expertise. He is extremely considered when it comes to non-opera
The Best Dynamometer For Clinical Practice
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comDynamometry and assessment of performance are hot topics right now and with the drive to provide data-driven decisions in clinical practice, you can see why rehab professionals are seeking tools to capture this information.A couple of years ago I had the pleasure of writing an article for MSK Mag [1], covering some of
Barking at Our Reflection - Editorial - MSKMag Issue 28
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comI took a phone call from a friend this month. She’s been called up for HCPC audit and we both run very similar sole practitioner clinics.A great deal of my replies to her questions about whether I had x, y or z policy in place were “erm… no?” Sure, I have consent forms for patients and a plan in place for the patient
Chewy And Jim - Two Tier MSK?
Chewy and Jim are back and so is the theme tune. Now I am not usually one to call out Chewy’s mum for bias but apparently she is in a grump about the lyrics. Yes maybe we do omit ‘Chewy’s dashing looks’ but there is reference to his ‘gags’ which of course are absolutely dreadful and often unpublishable trash.Chewy and Jim is best watched in full via the video above (so you can check out Jim’s dash
Advanced practice without the title: The reality of the FCP role
Over the past decade few developments have reshaped UK musculoskeletal (MSK) care as profoundly as the rise of First Contact Practitioners (FCPs) in primary care. What began as a pragmatic response to workforce pressure has quietly evolved into something far more significant: advanced-level clinical decision-making at the very forefront of the system.In many ways FCPs have changed the front door o
Continence Considerations
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comUrinary incontinence is often seen as something that belongs firmly in the realms of pelvic health. When I worked solely in MSK, I rarely asked about it unless I was screening for cauda equina. If I am honest, I hoped for a straightforward “no”. If someone did say yes, I clarified that it was not new or acute, reassur
The business and life lessons learned from MSK industry titans!
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comI didn’t set out to write a book. I set out to understand people.Through founding and running Physiquipe, I’ve been incredibly fortunate. The business gave me a platform to step into elite sport environments, private clinics, NHS settings and boardrooms and, more importantly, to meet some amazing people along the way.
PAIn Care in 2050: what might it look like?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comImagine we can teleport to 2050 and witness a pain clinic visit. Before the patient enters the room, the clinician reviews a multimodal dashboard that has information from wearables, sleep tracking, movement, mood, and lifestyle pillars.An AI-generated risk profile with confidence intervals is generated along with psy
Football Has a Hamstring Problem
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comWho was the first player you pictured when you read the title? I would bet for most of you it would have been someone famous. Perhaps Lionel Messi or Ronaldo (Brazilian version or Portuguese)? I would also bet that it would have been a male?I pictured European Champion, England Lioness and Chelsea forward Lauren James
Fear, Frustration and the Fifth Round of the FA Cup
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIf you’re a football fan, you’ll know the feeling of cup draw day. If you are not a football fan but live with one, you have no doubt endured this spectacle. The day a bag of small numbered balls are released into an empty goldfish bowl on live TV, agitated by a one-time footballing great, now retired player, and pull
Shoulder instability. It's all getting a bit silly
How many shoulder classifications systems are enough?Or rather, how many shoulder classification systems are too many?Five sounds fair?Ten seems a little bit too much?and 18 would be… ridiculous right? RIGHT?!Well folks, hold onto your shoulders.In 2011 (15 years ago) a systematic review identified 18, yes EIGHTEEN, published classification systems in the existing literature, BEFORE they went on t
The Back Story: What to axially say to your patients
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comThis summer, I was watching my two children running around the garden with their cousins. They don’t see each other very often so there was a lot of energy, a lot of noise, a lot of chaos, and a lot of joy. And as I watched them, it struck me that I could describe exactly the same scene in a few very different ways.I
ACL and PFP: Related Risk Factors
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comACL injury and patellofemoral pain (PFP) are rarely invited into the same conversation. One is acute, traumatic and unmistakable. The other is persistent, frustrating and often labelled ‘non-specific’. Yet when we step back from tissues and diagnoses and instead consider risk, these two conditions begin to overlap in
The Private Practice Barometer: What Is The State of the MSK Industry?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comI think I know the MSKMag audience well enough to know that we’re a bunch that does love some evidence. We debate the nuances of treatment techniques, and we even (sometimes) read past the abstract of the RCTs we’re citing. We do this for a simple reason: we want to provide the best possible care based on what is actu
Unfogging Fibromyalgia
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comFibromyalgia is a symptom-based disorder characterised by persistent widespread pain and accompanied by fatigue, poor and unrefreshing sleep, low mood or depression, and cognitive symptoms. The diagnosis is made using the 2016 American College of Rheumatology criteria [1] and, importantly, is not a diagnosis of exclus
Maintaining the Streak - Editorial - MSKMag Issue 26
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comAt time of writing, I am on Day 1335 of learning French on Duolingo. I am very, very good at Duolingo. Unfortunately that doesn’t mean I’m very good at speaking French; in fact, put me in front of a French speaker and I’ll be asking them to slow down and perhaps even draw me a picture.If you’ve not used the app yourse
With Great Power Comes Great Chiropractic Responsibility
Chiropractic manipulation has been around long enough to be both revered and misunderstood in equal measure. For some, it’s the magic button that fixes everything from a sore back to a bad mood. For others, it’s a mysterious cracking ritual that must be avoided at all costs. In truth, spinal and extremity manipulation is a highly skilled, evidence-informed tool, but like any powerful tool, it requ
Should we treat neurodivergent patients differently?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comNeurodiversity is estimated to affect 15% of the population [1], and despite a similar cause and a great deal of crossover, there are a variety of different diagnoses and expression of traits. Although many neurodiverse profiles are spiky by neurotypical standards, stigmatising terms implying severe disability such as
The Human Factor
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIn 2011 I took a year out to study for an MSc in Loughborough. At a crossroads in my career, I had become bored and a little disillusioned as a clinician and wanted to step into something new for a while.When I announced my plans to study for an MSc in Ergonomics, my physio colleagues were perplexed as to how studying
The road to failure is paved with good intentions
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comWe’ve all heard the following words before and if we’re honest, probably even said them ourselves:“Don’t worry, I’ll do my exercises at home.”“I’ve got an incredible idea for a new venture.”“I really need to spend more time on the business, not just in it.”They’re statements of optimism and enthusiasm, small bursts of
Rheumatology and Tendons - Certainly No SpA Day
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comMost of the time I talk about recognition of Rheumatological diseases that have developed and require onward referral; it has become my schtick. Reasonably many people ask me about people they work with who have already been diagnosed or don’t meet criteria for onward referral but have risk factor comorbidities.Here I
Auntie Version - MSKMag's Agony Aunt - January 2026
Hello! I’m Auntie Version and I am unbelievably excited to be MSKMag’s very own agony aunt. (We’re never going to be able to keep it secret so will immediately reveal that it’s me… Jo Turner 😉)Q: Dear Auntie VersionHow can I tell if I am suffering from imposter syndrome or if I am indeed not very good at something? Sometimes I worry that I’m failing at work when I don’t get good outcomes but then
It is Very Important You Don’t Ignore This - Editorial - MSKMag Issue 25
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comGreetings and Happy New Year from my new role as Editor in Chief of MSKMag! Admittedly it looks a great deal like my previous role of Editor Adjacent to Chief of MSKMag, only with the added responsibility of penning this Editorial every month.Of course with such great power comes great editorial responsibility (to bor
Focus on POCUS: Not as Black and White as It Looks
In the UK, more clinicians are taking the plunge into MSK Point of Care Ultrasound (POCUS). The buzz is real!Some are seeing it as the modern MSK clinic’s next essential tool, while others raise their eyebrows at how practical it truly is, asking whether it is just another expensive thing we can charge more for. Either way, it’s here, and growing FAST.Our social feeds are showing packed-out course
20 years of LBP care – What has changed (and what has not)?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comBox 1. An acute non-specific LBP patient with no ‘red flags’A 28 year old woman has been suffering from her first episode of low back pain since lifting a 10kg box at work three weeks ago.She says that she has been unable to do her job managing a hospital cafeteria for this time, and has not worked since her symptoms
The Incomplete Map: Rehabilitation for the Real Work of Real People
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comWork: the thing that you love or at least the thing that pays for the thing that you love.It would be great if return to work planning was a simple A–B journey. The person is signed off, nature takes its course, they go back to work, and everything is fine. However, we know it isn’t like that.The trouble is that most
Does Ownership Matter?
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comThe Two Receptionist ProblemI was treating a private equity investor one afternoon when he asked, with genuine curiosity, why we employed two receptionists when technology could easily let us get by with one.Fair question. After all, this is a man whose job involves finding inefficiencies in businesses and eliminating
(Un)reasonable Adjustments
Definitions of Reasonable Adjustments (unofficial, but entirely reliable):* The Employee: “Anything that allows me to do my job while never being inconvenienced again, ever.”* The Manager: “Anything that doesn’t require rewriting the rota, or attending another meeting.”* The Colleagues: “Anything that doesn’t mean I pick up your shifts, your caseload, or your endless sighs.”* HR: “Anything we can
Changed for Good? - Editorial - MSKMag Issue 24
This is a free preview of a paid episode. To hear more, visit mskmag.substack.comIt remains to be seen if Wicked will dominate culture in the coming weeks as it did this time last year, but since you lot made the mistake of enjoying/tolerating my Defying Gravity musings back then, here I am once again with a witchifying editorial.I’m in a rather ponderous, reflective and mushy mood which usually n
