After over 25 years as a physio, I’ve learned that the secret to a pain-free, high-performing body isn’t found in the latest fitness fad or wonder supplement. It’s built systematically, layer by layer, using a framework I call the Health & Performance Pyramid.
Over the past few years, I’ve created quite a few resources to help people work through this system. There’s my book, my workbook, my online courses, my free resources, my clinic – and it’s time to explain how they all fit together.
So this blog post is your complete roadmap. Whether you’re brand new to my work or you’ve read the book and are wondering “what’s next?”, this will show you exactly where you fit in and what to do.
The Health & Performance Pyramid: A Quick Overview
As you can see, the pyramid has four layers, each one building on the one below it:
- Foundation Layer (Red) – Your vascular system
- This is all about creating the right cellular environment through hydration, nutrition, sleep, and stress management. When your vascular system works optimally (nutrients flowing in efficiently, waste products flowing out completely) your cells can thrive.
- Health Layer (Magenta) – Your nervous system and movement quality
- This focuses on achieving good Alignment, Biomechanics and Control (your ABCs) so you’re pain-free and moving well. We use the Release, Stabilise, Move model to overcome pain and dysfunction.
- Performance Layer (Purple) – Your musculoskeletal system
- Once you’re out of pain, this is where you build capacity through strength, flexibility, and endurance for whatever you want to do.
- Sports-Specific Layer (Blue) – Mastery
- This is where you excel at your chosen sport or activity with specialist coaching combined with movement patterning.
The key principle is that you can’t skip layers. Trying to build performance on top of poor foundations is like adding another floor to a house with dodgy foundations – it might work for a bit, but eventually, something will collapse.
The Complete Ecosystem: What’s Available and How It All Connects
Here’s every resource I’ve created, organised by which layer of the pyramid it addresses:
Foundation Layer Resources
- How To Be Your Own Physio (Book)
- Available as: paperback, Kindle, or audiobook
- What it does: Explains the complete pyramid system and the science behind why it works
- Best for: Understanding WHY you need to work systematically through the layers
- Foundation Layer Workbook
- Available as: PDF download or Amazon paperback
- What it does: Gives you the practical tools to actually DO the Foundation Layer: questionnaires, tracking sheets, 4-week programmes for each area
- Best for: People who understand the theory but need step-by-step guidance and accountability
- Yoga for Stressed People Course
- Price: £97
- What it does: Specifically targets the stress element of the Foundation Layer with research-backed techniques
- Best for: People who’ve identified stress as their primary Foundation Layer issue
Health Layer Resources
- How To Be Your Own Physio (Book)
- Same book as above, but the Health Layer section explains the Release, Stabilise, Move model and the science of pain and movement
- Self-Assessment Course
- Price: £100 (includes a free personalised rehab course)
- What it does: Teaches you to analyse your body like an ISM-trained physiotherapist, to identify what’s driving your pain (not just focusing on the area that hurts); and then directs you to the most appropriate rehab programme
- Best for: People with persistent pain who want to work out the root cause themselves
- 8 Individual Rehab Courses
- Price: first course free with the self-assessment; subsequent courses £100
- What they do: Targeted rehabilitation for specific areas (foot/ankle, knee, hip, pelvis, lower back, upper back, shoulder, neck)
- Best for: People who already know their driver (either from doing Self-Assessment or from working with me in clinic) or who need a second rehab course after their initial driver improves
Specialist Courses (Pyramid-Adjacent)
These courses use the pyramid principles but are designed for specific populations or situations:
- Total Knee Prehab Course (coming soon)
- For people on the waiting list for knee replacement surgery
- Uses self-assessment to prioritise pre-operative readiness work
- Total Hip Prehab Course (coming soon)
- Similar to knee prehab but for hip replacement patients
- Ergonomics Courses
- For workplace-related pain and dysfunction
Working With Me Directly
- 1:1 Clinic Assessments
- Location: Central London (Liverpool Street area)
- Best for: Complex cases or people who want hands-on expert assessment
- Pricing and booking information: click here
Where Should YOU Start? A Decision Tree
Right, let’s work out where you fit in. Answer these questions honestly:
Step 1: Check Your Foundation Layer
Tick any that apply:
- □ I drink less than 2 litres of water daily
- □ I regularly skip meals or rely on processed food
- □ I sleep less than 7 hours or wake up feeling tired and groggy
- □ I feel constantly stressed or overwhelmed
If you ticked ANY boxes → Your Foundation Layer needs work. Start with:
- The book (understand WHY this matters): Amazon paperback, Kindle or audiobook
- The workbook (get the practical tools to fix it): Amazon paperback or PDF download
- Yoga for Stressed People if stress is your main issue: click here
Step 2: Check Your Health Layer
Tick any that apply:
- □ I have persistent pain that won’t go away
- □ My body feels stiff, tight, or just “wrong”
- □ I’ve been told I have “bad posture” or poor movement patterns
- □ Simple movements hurt when they shouldn’t
If you ticked ANY boxes → Your Health Layer needs work. Start with:
- The book (understand the Release, Stabilise, Move model): Amazon paperback, Kindle or audiobook
- Self-Assessment Course (identify your specific driver and get a rehab plan): click here
Step 3: Are You in a Specialist Situation?
- Waiting for knee or hip surgery? → Start with Total Knee/Hip Prehab course (coming soon)
- Dealing with workplace pain? → Check out the Ergonomics courses
- Already know your specific driver from previous work with me? → Go straight to the relevant individual rehab course
Step 4: Do You Just Want Me to Sort It Out?
If you’re thinking “This is all very well, Nell, but I just want you to figure it out for me” – you can book a clinic assessment – just call my lovely PA, Cheryl, on 0207 175 0150 or email help@nellmead.com.
But to be perfectly honest, most people don’t need me. The vast majority of cases can be sorted using the Self-Assessment Course or the Foundation Layer Workbook. Save your money and try those first.
The Most Common Pathways
Here’s what I typically see working well:
- PATHWAY 1: General pain and poor health
- Book → Workbook (fix Foundation) → Self-Assessment Course (fix Health Layer) → pain-free and moving well
- PATHWAY 2: Specific persistent injury
- Book → Self-Assessment Course (identify driver + get rehab) → Additional rehab course if driver changes → pain-free
- PATHWAY 3: Pre-surgery prep
- Knee/Hip Prehab Course → Surgery → Rehab (potentially with me in clinic or via courses – coming soon)
- PATHWAY 4: Ongoing support
- Clinic assessment with me → Rehab course for independent work → Check-ins as needed
What Most People Get Wrong
The biggest mistake I see is people trying to jump straight to Performance Layer work whilst their Foundation Layer is a mess.
They’re chronically dehydrated, sleeping badly, stressed out of their minds, eating rubbish… and then wondering why their gym training isn’t working, why they keep getting injured, why they can’t make progress. I’ve been there and it’s literally the reason I created the Pyramid!
The pyramid works because each layer supports the one above it. You NEED solid foundations before you can build anything lasting.
Foundation first. Always foundation first.
Still Not Sure Where to Start?
If you’re reading this thinking “I’m still not sure which path is right for me,” here’s my honest advice:
Start with the Foundation Layer Workbook.
It’s £5.99 for the PDF, it’s practical, and it’ll show you pretty quickly whether your Foundation Layer is the problem. You complete the four assessments (hydration, nutrition, sleep, stress), identify your weakest area, and work on it for 4 weeks using the tracking tools provided.
In the worst-case scenario, you’ve spent six quid and learned something useful about your body’s foundations.
But an awful lot of people will find that if you fix your Foundation Layer issues, you’ll already feel dramatically better – more energy, better sleep, less stressed, moving better – without needing anything else.
And if it turns out your Foundation is solid but you’re still in pain? Then you know the issue is in your Health Layer, and you move on to the Self-Assessment Course.
Free Resources to Get Started
Not ready to buy anything yet? No problem. Here’s what’s available for free:
- Introduction to the Health & Performance Pyramid guide: Download your free guide and get weekly insights about building a pain-free, resilient body
- Blog: Educational content about the pyramid, case studies, and practical tips
- YouTube channel: Video explanations and demonstrations
Start there, get a feel for my approach, and then decide what makes sense for you.
The Bottom Line
Whether you’re dealing with chronic pain, preparing for surgery, trying to prevent injury, or just wanting to build a more resilient body – the Health & Performance Pyramid gives you a systematic approach.
No more guessing. No more jumping from one treatment to another hoping something works. No more conflicting advice from different practitioners.
Just a clear pathway from where you are now to where you want to be.
Ready to start? Here’s where to go:
- Free introduction to the Health & Performance pyramid: sign up here
- Foundation Layer Workbook: Amazon paperback or PDF download
- How To Be Your Own Physio book: Amazon paperback, Kindle, or audiobook
- Yoga for Stressed People course: click here
- Self-Assessment Course: click here
- All rehab courses: click here
- Prehab courses: coming soon
- Work with me in clinic: call Cheryl on 0207 175 0150 or email here at help@nellmead.com
Right, that’s enough from me. Go build your pyramid.
Questions about which path is right for you? Drop me a comment below or contact my lovely PA Cheryl on help@nellmead.com or 0207 175 0150.
