Unlocking Self-Physio with Nell Mead

How To Be Your Own Physio for Pain-Free Movement and Peak Performance.

I recently talked to renowned physio Nell Mead about her new book, How to Be Your Own Physio, where she brings over two decades of experience into an accessible, empowering guide. With a mission to equip individuals with the tools to relieve pain, enhance movement, and maintain a resilient body, Nell’s book offers a transformative approach to self-care and physical health.

Inspired by her thinking, I now see more clearly how my approach with clients up until now has complemented their physiotherapy programmes by focusing on how stress, emotions, and the neuroscience of pain contribute to discomfort - and how mind-body skills can help realign posture and mindset.

Understanding the Health & Performance Pyramid

Nell’s Health & Performance Pyramid is a holistic model that guides patients through progressive layers of health and performance.

Foundation Layer: According to Nell, these foundational elements are often overlooked but are critical to tissue health and pain relief. “Many clients want to skip straight to exercises,” Nell explained, “but without addressing basic needs like hydration or stress, advanced techniques won’t yield sustainable results.” She encourages clients to first address underlying issues, such as systemic inflammation caused by dehydration or high stress levels, before moving on to exercise. While Nell often focuses on the physiological foundations, I work to help clients identify and manage stress factors and emotional tension that may be impeding their physical health.

Health Layer: Once foundational needs are met, the next focus is on alignment and biomechanics. Proper alignment, Nell notes, helps ensure efficient movement and injury prevention. “Alignment acts as scaffolding for physical progress,” she says. Many clients initially resist this layer, wanting to dive into strengthening exercises. However, she emphasises that aligning the body is essential for safe and effective physical progression.

Performance Layer: At the top of the pyramid, Nell works with patients on targeted goals like strength, endurance, and flexibility. These areas are tailored to individual objectives—whether climbing a mountain or managing daily tasks without pain.

Advice for Moving Through the Pyramid

When it comes to progressing through the pyramid, Nell emphasises the importance of being fully ready for each level before advancing. Readiness, she explains, means having built sufficient stability and control in simpler movements and, importantly, being free from pain. “It’s like a game of snakes and ladders,” she shared. “Clients who try to jump ahead often find themselves set back because they haven’t built a solid foundation.”

For Nell, it’s vital that clients do not push into strength or endurance exercises until their pain is managed and they have achieved the required alignment and control. This reminds me about the time when my physio said all you have to do is just keep doing neck strengthening exercises. After six months I had a neck like a racing driver yet I was still in pain. I wish Nell had been my physio!

By teaching clients to recognise when their bodies are ready for more complex exercises, Nell ensures they can progress confidently and sustainably, minimising the risk of setbacks. “A strong foundation is essential,” she notes, “to make sure they don’t fall back into old pain patterns or injure themselves in the process.” I was nodding my head a lot at this point having seen too many people irrritating their injuries persistently whilst exercising having not got alignment and biomechanics right first.

Nell’s Detective Approach: Treating the Whole Body

Rather than treating the area of pain directly, she examines the whole body, looking for interconnected issues that may contribute to the problem. “If a client comes in with knee pain, I don’t just treat the knee,” she shared. “I look at how the knee moves, sure, but I’m also assessing the hip, pelvis, and foot to see if anything is putting undue strain on the knee.” By analysing the body as an integrated system, she is often able to pinpoint the underlying causes of pain that might otherwise go unnoticed.

Nell gave a recent example of a client who experienced chronic knee pain following surgery. After performing a full-body assessment, she discovered that the client’s pelvis was rotated, which impacted her knee alignment. “It wasn’t the knee itself causing the issue,” Nell explained, “it was her pelvic alignment.” By addressing this root cause, focusing first on hip alignment to reduce inflammation, Nell was able to relieve her client’s knee pain significantly before even beginning direct knee exercises.

Nell’s approach includes careful experimentation and observation, where she “tests” different alignment corrections and stabilisation exercises to identify what brings relief. “I’m always gathering clues,” she says. “It’s a process of discovery and refinement, where I adjust my approach based on what I observe in the client’s body.

"The bit you need me for is the detective work. Once we’ve figured that out, you’re often fine with somebody else [like a personal trainer or pilates instructor]; I’ll just be in the background... It’s about me testing everything so I don’t miss something, so I can figure out the cause. It’s very easy to jump to clinical conclusions, but everyone is so individual. You have to test everything."

Just as Nell investigates physical root causes, I explore the often-overlooked psychological and emotional factors that can lead to chronic pain, helping clients break the cycle of stress-related tension.

The Role of Release, Stabilise, Move (RSM) in the Health & Performance Pyramid

In How to Be Your Own Physio, Nell introduces the Release, Stabilise, Move (RSM) method. As she explains, “RSM is a process that complements each level of the pyramid by releasing unnecessary muscle tension, activating stabilisers, and building controlled movement.” On using RSM to support the pyramid:

"We use the RSM to figure out why there's an alignment, biomechanics…. or control problem.  We work through each step, and once alignment, biomechanics, and control are good, we look at the goal—do they want to climb mountains or just get around daily life pain-free?"

In practice, the RSM method begins with Release: relieving spasms and tightness in overactive movement muscles. For instance, in the case of her client with chronic knee pain, Nell didn’t start with knee exercises but instead focused on releasing tension in the hips. “By releasing the tension in her hips first, we were able to address her pelvic alignment,” Nell shared, highlighting how RSM’s release phase helped the client improve her alignment before engaging the knee directly. 

The second stage, Stabilise, is about training stabiliser muscles to support alignment and control. “Once we’ve released tension, we focus on the stabilisers, which are the body’s natural support system,” Nell explained. This phase aligns closely with the Health Layer of her pyramid, where stabilising exercises help create a strong, balanced base. For example, after improving alignment, Nell guided her knee pain client through stabilisation exercises for her hips and pelvis, ensuring she had a solid foundation before addressing the knee further. 

I was nodding my head throughout this explanation which is similar to my work in The Alexander Technique teaching you to release and stabilise to make your postural tone more adaptable through everyday movements like sitting and standing, finding the middle ground between holding your muscles too tightly (which leads to stiffness) and too loosely (which leads to collapse).  

Release and stabilise then allow you to Move, which involves multi-joint, controlled movement exercises. “In the move phase, we integrate stability into dynamic, whole-body movements,” Nell notes. This phase aligns with the Performance Layer, geared to what your goals where clients can now incorporate strength and endurance training. For her client, this meant finally progressing to controlled knee movements and strength exercises without pain. As Nell emphasises, “RSM allows us to align, control, and then strengthen the body progressively,” supporting each level of the pyramid with a methodical, holistic approach.

Long-Term Patient Success

Nell’s ultimate goal is to provide clients with long-term solutions rather than temporary fixes. While her techniques focus initially on reducing pain and improving alignment, she also guides clients toward self-management. “I teach them to use cues, imagery, and personal insights to connect with their bodies,” she said, “so they can continue progressing outside the clinic.” By empowering clients to manage their own movement, Nell ensures they retain control over their physical health and can maintain the gains they make during therapy. 

How to Start Your Journey with How to Be Your Own Physio

For more insights, client stories, and resources, Nell encourages visiting her website, where she regularly shares blog posts and updates on client’s recoveries.

For those exploring the stress, emotions and neuroscience that hinder physical healing, I prepare the mind to support physiotherapy so that you experience quicker, longer-lasting results.