As a rehabilitation professional turned personal trainer, I have spent years watching the fitness and healthcare industries chase an elusive mechanical panacea for injury prevention and pain management, where every ache and pain can be traced back to an anterior pelvic tilt, a weak core, and underactive glutes.
As queen of anterior pelvic tilt myself, I believe this is a wildly oversimplified view. When I say “we” need this model, I mean everyone—trainers, medical professionals, coaches, and individuals dealing with pain. I’ve gone back and forth about posting this because it’s such a nuanced topic, but the BPS model has become my passionate advocacy platform, so here we are.
For decades, the fitness, athletic training, sports performance, and healthcare industries have clung to a predominantly mechanical or tissue-based model of pain. This approach suggests that pain and injury stem from “faulty” movement patterns or underactive muscles. It’s the foundation for countless interventions and terms like the Alexander Technique, the McGill Big 3, myofascial release, and my least favorite industry buzzword, “corrective exercise.”
To be clear—I’m not saying biomechanics or form don’t matter. I’m an ex-gymnast. I love precise, well-executed movement and can nitpick your form into oblivion. But not for the reasons you might think. Biomechanics have their place, but modern pain science tells us that viewing pain solely through a mechanical lens is entirely insufficient.
I was first introduced to the BPS Model in graduate school. If you don’t know—I started my career in rehabilitation as an occupational therapist—a career I chose because I have always had a heart for working with disabled folks. Given that pain is the leading cause of disability in the United States, this framework was a huge part of my education and shaped the way I view and understand pain.
The power of the BPS model lies in its recognition that chronic pain (not acute injury) is far more complex than just tissue damage or movement patterns. Rather, it’s an interplay between:
- Biological factors: The physical aspects we traditionally focus on
- Psychological elements: Our thoughts, emotions, and stress levels
- Social components: Our relationships, environment, and cultural context
This explains why two people with identical injuries can have two very different experiences—one might return to activities pain-free, while another struggles with chronic symptoms.
A concept within the BPS model that resonates with me is load versus capacity. Think of this as your personal stress bucket. Load includes physical demands from exercise and daily activities, mental and emotional stressors, and environmental pressures (work, finances, relationships). Capacity, on the other hand, encompasses physical resilience and fitness level, mental and emotional robustness, and overall well-being (sleep quality, nutrition, social support).
One of the things I find most empowering about this perspective is that it moves us away from trying to “fix” people through corrective exercises. A lot of us—trainers, PTs, coaches—feel the pressure to have an answer for every pain or discomfort a client has. But when we take a biopsychosocial approach, it simplifies things. We can let go of needing a solution for every symptom and instead focus on:
- Building physical capacity through foundational strength training
- Educating clients about the multiple factors influencing their pain experience
- Fostering resilience and self-efficacy
- Supporting overall well-being and a lifestyle conducive to pain-free living
Pain and injury aren’t signs of brokenness; they are part of being human. Often, what people need most isn’t another corrective exercise but rather movement that brings joy and builds confidence, belief in their body’s resilience, and permission to trust their healing process.