For the first decade of my career as a physiotherapist, I treated body parts.
In conversations with doctors and colleagues, we would refer to “the knee,” “the lower back,” or “the shoulder.” Not because we didn’t care about the person attached to it, but because our training focused on anatomy, biomechanics, and physical dysfunction.
And often, that approach worked.
But there were patients I could not understand.
Two people could walk into the clinic with the same scan findings and similar symptoms, yet have completely different outcomes. One person recovered quickly. Another remained in pain for years.
Then there were patients whose nervous systems reacted strongly to even small movements, touch, or exercise. A simple treatment or exercise could flare their pain dramatically. At the time, I didn’t understand why.
These patients created anxiety in me as a clinician because I genuinely wanted to help, but I felt I was missing something important.
Everything changed when I moved from Sweden to Australia to complete two master’s degrees in musculoskeletal and sports physiotherapy.
At the time, I believed I simply needed to become better at diagnosing and treating physical problems. I had seen physiotherapists who seemed able to help almost everyone, and I thought the answer must lie in more advanced clinical knowledge.
While I did become better at diagnosing injuries and movement problems, I also realised something unexpected:
I had never really been a “bad” physiotherapist.
I simply hadn’t yet learned to treat the whole human being.
What I learned completely changed the way I viewed pain and the human body.
I learned that the brain and nervous system are the pain-producing system, not the body parts themselves. I learned that pain can exist even when a body part is no longer there, as seen in phantom limb pain. I learned that beliefs such as “it’s bone on bone” can stress the nervous system and increase pain and tension. I also learned that many people have significant structural changes in their bodies and experience no pain at all because their nervous systems never interpreted those changes as dangerous.
What it all comes down to is the nervous system’s evaluation of the situation. If it decides you are in danger, it will communicate this through pain, tension, guarding and increased sensitivity. If it feels safe, pain and tension can decrease.
And no, safety is not just about the body. The nervous system also responds to life. It is not “safe” to live in a toxic relationship, stay in a highly stressful job, run on poor sleep, never recover, stop moving, or constantly push through exhaustion. All of these factors influence the system.
For years, I was treating these stories every day without fully taking these factors into consideration. Once I understood this, I was finally able to help my patients in a deeper way by helping them understand what was actually happening inside their bodies and nervous systems.
I saw people who had lived with pain for decades begin to understand the pain-modulating system and realise, as one patient once said to me, that they had “the key to the kingdom.”
They had the power within themselves all along. With some good guidance, mobility work, strength work, movement, education and sometimes hands-on treatment, they were able to move out of situations they once thought they were stuck in by addressing the many factors influencing their pain, factors that are deeply individual to each person.
This is why I designed a free workbook called The Pain Fingerprint. It explains this concept further and helps you explore what may be contributing to pain and tension that just won’t go away.
My wish for you is to learn what I have had the privilege of teaching over the past 14 years: that the power is within you. Sometimes we simply need some guidance to reconnect with it again.
But if you really listened to your tension and pain, what would it say to you?
Work more?
Sleep less?
Move less?
Sit more?
Or is it trying to tell you something else?
