When someone strains their rotator cuff or the muscles around the shoulder, one of the first questions I ask is: how did it happen?
If there was a significant fall, direct impact, or a heavy lift that clearly overloaded the shoulder, the diagnosis is often more straightforward. But many people can't pinpoint a dramatic event. Instead, the pain seems to appear during an everyday movement that shouldn't really have caused an injury.
That's when I start looking beyond the shoulder itself.
As mobility expert Dr. Kelly Starrett puts it, you have to assess upstream and downstream of the painful area. In other words, the place that hurts isn't always where the problem began.

​The very first thing I look at is someone's relaxed standing posture. Not the posture they're trying to correct because they know I'm watching—but the one their body naturally adopts.
Most people are familiar with the idea of "poor posture": a head that sits forward of the shoulders, rounded shoulders that slope forwards, an exaggerated curve at the base of the neck (sometimes developing into a noticeable hump), and, less obviously, a flattened upper rib cage. 

Another common clue is a shoulder that clicks, crunches, or pops during movement. You might hear grinding when circling your arms or notice a clunk at either end of the collarbone as the shoulder moves. These sounds tell us that the shoulder isn't moving as efficiently as it should.

Now, I could (and do) prescribe exercises to strengthen your rotator cuff, biceps, and the muscles that stabilise your shoulder blade. And if you stick with the programme, those muscles will almost certainly become stronger. But if the underlying issue is a posture that leaves your neck under constant strain, strengthening the shoulder alone is only treating part of the problem. The shoulder may feel better for a while, but the forces that irritated it in the first place are often still there. That means the next awkward reach, DIY project, or bag of shopping could be enough to trigger the same pain all over again.
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To create lasting change, we have to ask a bigger question: what is your neck and upper back asking your shoulder to compensate for every day?

Take a look at how you sit in the evenings. Slumping, twisting, or sinking into a soft, deep sofa or armchair can place unnecessary stress on your neck and shoulders, often undoing the progress made during treatment.
Instead, try spending some time sitting or lying on the floor. I'm a fan of yoga bolsters to sit on. This can reduce the strain placed on your neck and shoulders, and help restore mobility through your hips and spine. If this isn't an option, replacing current furniture with something that encourages an upright neutral spine, high wingback chairs can be a good option.

If you would like to find out more about your neck and shoulder issues, you know where to find me.

After completing physiotherapist Kelly Starrett's Movement & Mobility course last year, I've started placing a much greater emphasis on mobility assessments during an initial physical examination. Rather than just looking at where someone feels pain, I assess how well the spine, shoulders, hips, knees, and ankles move through the ranges of motion needed for everyday activities.
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One of the clearest examples of how mobility influences pain is the relationship between the hips and the lower back. A simple way to explore this is with the deep squat—that natural resting position many of us could comfortably drop into as toddlers while playing on the floor. As we get older, many of us lose the mobility needed to squat deeply, and when the hips can't move as they should, the lower back often has to compensate.

One of the themes Kelly Starrett comes back to time and time again is the importance of assessing hip extension. It's a fundamental movement that has a huge influence on how we walk, run, climb stairs and move through everyday life, yet it's surprisingly easy to overlook in clinical practice.
Instead, many of us instinctively focus on the hamstrings. A common question is, "Can you touch your toes?" While the posterior chain—your hamstrings, calf muscles and Achilles tendon—is incredibly important, it only tells part of the story.

Healthy movement depends on the hips having both a full range of motion and the strength to control that movement. When the hips can't move or generate force effectively, the body looks elsewhere to make up the difference. More often than not, it's the lower back that pays the price, with its muscles, joints and discs working harder to compensate for reduced hip mobility, poor core control or weakness through the legs.
I'm very much a work in progress myself, and I've decided that's a good thing. It keeps me curious, keeps me learning, and reminds me what it feels like to work through stiffness and restrictions rather than expecting overnight results. For me, trying different styles of yoga has been one of the biggest eye-openers. It's amazing how quickly certain poses reveal the differences between my left and right sides, as well as where I'm moving well and where I'm definitely not! 

I've grown to genuinely enjoy it, and it's been really rewarding to see the slow, steady improvements over time. It's also a great reminder that progress doesn't happen overnight—consistency is what really makes the difference.​

The sequence begins with a forward fold, where you might notice tension through the hamstrings and calves—or even in the lower back if it has become stiff or restricted. As you move into the Warrior poses, the demand shifts towards strength and stability in the hips and legs. The flowing transitions between postures challenge the upper body too, requiring enough strength and control to lower through a press-up and push back into Downward Facing Dog. Depending on the style of vinyasa flow, you're also likely to discover how well your balance, coordination and body control hold up as you move from one posture to the next.
Rather than isolating individual muscles or joints, a sun salutation provides a simple yet powerful snapshot of how your whole body moves and works together.

If you've been dealing with aches and pains that start in your lower back and spread around your pelvis, hips, legs, or even into your lower abdomen, it may not just be your back that's to blame.
If you've also noticed that simple movements—like bending down to pick something up from the floor or lifting your leg to put your socks on in the morning—have become more difficult than they were a few years ago, restricted hip mobility could be playing a significant role in your discomfort.

If you're ready to move more freely, reduce your back or hip pain, and find out what's really contributing to your symptoms, I'd be happy to help. Give me a call or send me an email to book an appointment, and let's work together to get you moving comfortably again.

The good news is that morning lower back pain is often linked to factors that can be identified and improved. While every person is different, there are usually a combination of causes involved. Throughout our lives we accumulate old injuries, repetitive strains, poor habits, and postural stresses that can all contribute to how our body feels when we wake up. When discussing morning back pain with patients, I usually focus on three key areas: 

1. Your mattress – its age, condition, and firmness. 
2. Your pillow – its height, support, and material. 
3. Your sleeping position. 

Whether you’re currently receiving treatment or simply looking for ways to help yourself, making positive changes in these areas can support your spine, reduce strain on old injuries, and improve the quality of your sleep. 
​Let’s look at each one in more detail...​

Your mattress plays a significant role in how well your spine is supported overnight. If it's too soft, your hips and shoulders may sink excessively, placing extra stress on your lower back. On the other hand, even the ideal mattress won't provide good support if it's paired with the wrong pillow. Together, your mattress and pillow should keep your spine in a comfortable, neutral position throughout the night.
The age and condition of your mattress are also important. A simple way to assess it is to run your hands firmly over the area where you sleep, feeling for dips, sagging, or compressed sections. Even if a mattress still looks perfectly fine, its supportive qualities gradually decline over time. If yours is more than seven to ten years old and you regularly wake with stiffness or discomfort, it may be worth considering whether it's still providing the support you need.
Sleeping away from home can also provide useful clues. In my experience, softer-than-usual hotel mattresses and pillows can sometimes trigger back pain, particularly in people who already have a sensitive back. However, I've also had many patients tell me they woke feeling noticeably better while staying in a hotel, guest room, or holiday accommodation. If that happens, it may suggest your mattress at home is contributing to your symptoms.
Of course, it's important not to jump to conclusions. When you're on holiday you're often more relaxed, sleeping longer, and taking a break from the physical and mental demands of work, all of which can influence how your back feels. Nevertheless, noticing how your symptoms change when you sleep in a different bed can be a valuable clue when trying to identify the cause of persistent morning back pain.

When people think about pillows, they usually associate them with neck pain or headaches. However, the right pillow plays an important role in the alignment of your entire spine.
If your pillow is too high or too low, it can tilt or twist your neck during sleep. This altered position forces the neck and upper back to compensate, creating tension that can eventually affect the lower back as well. Because we spend many hours sleeping each night, even small alignment issues can have a cumulative effect.
For side sleepers, the pillow should fill the space between the shoulder and the head, keeping the neck in a neutral position. Back sleepers generally benefit from a lower pillow—in fact, I often recommend using just a couple of folded towels rather than a traditional pillow. This height may need to be adjusted if there are restrictions in the normal movement of the neck or mid-back, but the key principle is to avoid pushing the head too far forwards.
Over the years, I've made customised pillow packs consisting of multiple layers of firm and soft foam. This allows people to adjust the height and firmness at home until they find the combination that best suits their body and their mattress.
If you want to experiment before investing in a new pillow, a simple temporary solution is to build up the height using folded towels to create a firm base, then place a thin, soft pillow on top for comfort. This approach makes it easy to fine-tune the support until your head and neck are comfortably aligned.

The position you sleep in can have a surprisingly big impact on how your back feels when you wake up.
Sleeping on your stomach is generally the most challenging position for your spine. It tends to increase the arch in the lower back, flatten the natural curve of the upper back, and requires your neck to stay turned to one side for hours at a time. Over time, this combination can place unnecessary strain on your spine and surrounding muscles.
If you're trying to move away from sleeping on your stomach, the first step is often to optimise your pillow, as discussed above. A pillow that properly supports your head and neck can make side sleeping feel much more comfortable and sustainable.
When sleeping on your side, placing a thin pillow between your knees can also help. It keeps your pelvis more level, reduces twisting through the lower back, and can lessen the stress on your hips, pelvis, and knees throughout the night.

A recent client at Unwind came to see me after four months of near-constant pain from tennis elbow. He’d done all the right things — researched exercises, worked with an NHS physiotherapist, and initially made great progress. His day-to-day pain reduced significantly.
Then it flared up again with a vengeance.
That frustrating feeling of “I’ve done everything — and I’m back to square one” is incredibly common with tendonitis (more accurately called tendinopathy). If you’re reading this, you may know that story well.
I do too. I’ve had tennis elbow (lateral epicondylitis) and, more recently, golfer’s elbow (medial epicondylitis) courtesy of some over-enthusiastic indoor bouldering. What I’d like to share is how I stopped my own golfer’s elbow before it fully took hold — and the approach I used with this client.

Renowned physiotherapist Kelly Starrett encourages us not to focus only on the site of pain, but to look at what’s happening “upstream and downstream.” In the case of tennis elbow, that means considering the relaxed position and function of the shoulder, head and neck, wrist, and hand.
Many extremity problems also stem from altered alignment in the spine and pelvis, often the result of old injuries the body has adapted around.
Since completing Kelly Starrett’s movement and mobility course in 2024, I use his assessment methods to identify areas of restricted motion and weakness. I also draw on Grey Cook’s Functional Movement Screen to help uncover the underlying drivers that often cause conditions like tennis elbow to keep returning just when you think they’ve resolved.

The hands-on chiropractic work I provide aims to improve structural alignment, changes that many clients notice from the very first session.
The “homework” I give is based on the research of Dr Keith Barr, Professor of Molecular Exercise Physiology, whose work focuses on how tendons heal and how to build their strength and resilience. If you’re interested in learning more, you can find several interviews with him on YouTube and Instagram where he explains his research in detail. 

This is exactly what my recent client did. He adjusted the exercises he had already been doing — which had stopped producing results — and applied Dr Keith Barr’s principles of tendon healing. After just one chiropractic session, he returned the following week reporting the most progress he’d experienced in months: his daily, near-constant elbow pain had reduced to being mostly pain-free, with discomfort only at specific and predictable times. 

​This was fantastic news and exceeded my expectations for how quickly he might notice improvement. That said, his elbow isn’t completely out of the woods yet. The biggest challenge now will be resisting the temptation to use the arm as normal too soon and risk setting the problem back. 

At the time of writing this blog it's still early days and with his permission I will add an update on his progress.

Could your discomfort be the result of a lifetime of your body compensating for old injuries or poor posture? If so, I can help. In this blog post, I’ll explain how past injuries are often compensated for and hidden from our day-to-day awareness, while quietly building into bigger problems over time. I’ll also share a couple of simple ways you can test the current state of your body.​