Show Notes
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
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Jared is joined by Tim Cook who is Senior Lecturer in Physiotherapy at the University of Chichester, Advanced Physiotherapy Practitioner in the NHS, and doctoral researcher to discuss their new paper with Prof. Jeremy Lewis in the Journal of Manual & Manipulative Therapy: "Rethinking strength testing in rotator cuff-related shoulder pain: a clinical tradition that lacks muscle."