When it comes to pain, injuries, and movement, there’s a lot of noise out there.
Conflicting advice, outdated beliefs, and fitness myths can make it hard to know what’s actually true.
That’s why I rely on First Principles Thinking—breaking things down to fundamental truths and building up from there.
Here are some of the first principles I use in physiotherapy—ideas that shape the way I assess, treat, and guide people toward moving better. You might find they help you think differently about your own body, training, and recovery.
1.The Body is Adaptable, Not Fragile
Many people assume pain means something is broken—that their body is fragile and needs protecting. But the human body is remarkably adaptable.
- In my practice: I remind patients that their tissues are built for resilience. If you give your body the right stimulus—whether that’s gradual strength training or controlled movement—it will adapt and get stronger.
- In your training: If you avoid certain movements out of fear, you could be making yourself more vulnerable. The key is to load progressively, not avoid movement altogether.
2. Pain Does Not Always Mean Damage
Pain is complicated. It’s not just about tissues being injured—it’s about how your nervous system interprets signals.
- In my practice: I see patients with old injuries that have healed but still experience pain—or, on the flip side, people with significant tissue damage who don’t feel much pain at all. Pain is a warning signal, not always an indicator of harm.
- In your training: Instead of thinking “I’m in pain, so I must stop moving,” think “What’s my body telling me?” Is it fatigue? A strength imbalance? Poor mechanics? Or could it be that I’m overly anxious about moving in case it does more damage? Addressing the cause is the goal, not just avoiding discomfort.
3. Head Toward Resilience, Not Fear-Avoidance
Too often, people are told to avoid movements entirely: “Don’t squat.” “Don’t run.” “Don’t lift overhead.”
- In my practice: I don’t believe in blanket movement restrictions unless there’s a clear reason. Instead, I teach patients how to move better, not less.
- In your training: Rather than eliminating certain exercises, find ways to make them work for you. Modify, strengthen, adapt—don’t just stop moving.
4. Listen First, Test Second
Someone’s story gives me 80% of the information I need before I even start testing.
- In my practice: I listen to how the pain started, what makes it worse, and what makes it better—then use objective tests to confirm or refine my thinking.
- In your training: Listen to your body’s feedback. When do you feel pain? Break it down further. If it’s painful to walk, see if you can identify which part of walking does it hurt most such as mid stride, heel lift or toe off? This type of information helps to home in on what the problem is.
5. The Body Functions as a Single, Integrated Unit
Every part of the body has a role to play at all times. If one part of the body isn’t doing its job, another will compensate—and that’s often where pain and dysfunction start.
- In my practice: A patient’s knee pain might actually be caused by poor hip stability or restricted ankle mobility. I assess full-body movement patterns—not just the painful area.
- In your training: If something hurts, don’t just target the painful spot—look at the bigger picture. Weak glutes, stiff thoracic spine, or poor neutral spine control might be the real issue.
6. Red Flags Always Come First
- In my practice: I rule out serious issues (red flags) first. If something doesn’t add up, I dig deeper, and refer on if need be.
- In your training: If something keeps hurting, don’t just push through. This is especially true for pain that is unusual , extreme or unrelenting. Pain from sinister sources can mimic everyday aches and strains. If you’re not sure or are worried, get in touch with your health professional.
7. Injuries Happen When Load Exceeds Capacity
Tissue damage or injury happens due to too much force, too fast, or too long without enough recovery.
- In my practice: I see injuries caused by sudden increases in training load (e.g., going from running 5km to 15km overnight) or chronic overuse without recovery.
- In your training: Manage the load amount, duration and speed. Progress gradually and give your body time to adapt. Sudden spikes in load = higher risk of injury.
8. Pain is Often the Effect, Not the Cause
Pain usually isn’t random—it’s a result of something else happening in the body.
- In my practice: If someone has mechanical lower back pain, I check their hip mobility, core control, and movement habits. Fixing the cause means the pain is less likely to return.
- In your training: If you keep getting the same nagging injury, don’t just treat the pain—figure out what’s leading to it.
9. In the Right Environment, the Body Will Heal Itself
My role isn’t to “fix” you—it’s to remove barriers to healing and create the right conditions for recovery.
- In my practice: I focus on guiding the body’s natural healing process through movement, strength, and progressive loading.
- In your training: If you have an injury, ask "is this in the best healing environment?" Different stages of healing require different conditions to optimise healing. It's usually best to have relative rest in the early stage but do more strengthening and flexibility in the middle and late stages. Knowing what stage of healing you are at means you do the right things at the right time.
10. Understanding Drives Recovery
If we don’t understand why we’re doing something, we won’t follow through.
In my practice: I explain exactly why an exercise matters. When patients understand the “why,” they’re much more likely to stick with it.
In your training: The more you understand about how your body works, the more in control you’ll feel over your progress and recovery.
Final Thoughts: Movement is Medicine
Pain and injury don’t mean your body is broken.
Understanding how load, movement, and adaptation work can help you recover faster and train smarter.
By applying these First Principles, you can move better, feel stronger, and stay injury-free—whether you’re an athlete, weekend warrior, or just trying to stay active.
Which principle resonates with you the most? Let me know in the comments!