They invade our lives at some point or another. At times, they cause us intense angst, and other times, we pass by without thinking about what they mean—blending into the background. So why am I talking about road cones in the warm-up for BJSM? They could symbolise us, medicine, the journey.

In New Zealand, it has been reported that we have more of these than people; the road cone numbers have surpassed our national icon—the humble sheep. Road cones might be a symbol of repair or a symbol of progress—that is your perspective. I am just back from a fantastic weekend at our Sports and Exercise Physiotherapy New Zealand (SEPNZ) conference. Our Physiotherapy Keynote speakers, Tania Pizzari and Sally McLaine, made the trek across the ditch from Australia to New Zealand and presented with passion and energy—thank you! At the preconference dinner, we joked about the road cone becoming the new icon of New Zealand. However, after the conference and listening to colleagues present from multiple professions, I reflected on this—the road is also a good analogy for what we do in medicine.

I will try to make rational thoughts out of road cones and medicine. I hypothesise that road cones’ meanings can be complex, similar to the stages of medicine, from diagnostics to research to rehabilitation

Cones can be scattered to grab our attention—something could be dangerous or to alert us to possible danger. This might be similar in the medical field; symptoms or injuries may signal danger or damage—something that has happened that requires our attention. Maybe the road cone represents an injury or illness; athletes and patients present to a clinician with their issue—their ‘road cone’—the thing in the way that stops them from getting where they need to go. Or perhaps the road cone represents their concern that something is not right and the need for evaluation…sounds like diagnostics to me. An example of this in this edition of BJSM is: Noisy Knees: Knee Crepitus Prevalence and Association with Structural Pathology A Systematic Review and Meta-analysis (see page 126) .

Maybe the cone signals a split in the path ahead—stay in your lane or choose a deviation—a bypass that takes us through another possible unknown route to get to the destination. It could take us on a path different from what we intended, showing us new aspects/possibilities and other ways of reaching our endpoint. Many of the past and future BJSM editions will continue to challenge our current thoughts and beliefs on best care, such as this original research on arthroscopic partial meniscectomy versus exercise therapy for degenerative meniscal tears—10-year follow-up of the OMEX randomised controlled trial (see page 91) .

Road cones can also symbolise repair and something new. This new repaired structure has involved planning, collaboration, effort, input, time, funding and research to create something new, a breaking down of a barrier, so we can carry on our path—quickly, more safely and with confidence. A new horizon or a collaborative agreement such as the article—International Delphi consensus on bone stress injuries in athletes—symbolises this (see page 78) .

Once the above has happened, the area is repaired, researched, remediated or rehabilitated with current best practices. The athlete/patient is on their way on their journey—barrier removed/navigated or circumvented. The road cone disappears—to be stored maybe or reused on the next project.

Maybe today or tomorrow, when you are identifying or listening to someone’s barrier, devising a rehabilitation plan, researching a hypothesis or discussing an alternate pathway, spare a thought. Today is when you potentially remove someone’s road cone to their destination. I acknowledge Tim Dovbysh, SEPNZ executive, for our joint discussion on the road cone.

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