{"id":14471,"date":"2026-07-01T09:35:48","date_gmt":"2026-07-01T09:35:48","guid":{"rendered":"https:\/\/www.fitpro.com\/blog\/?p=14471"},"modified":"2026-07-01T09:35:48","modified_gmt":"2026-07-01T09:35:48","slug":"recurring-injuries-biomechanics-science","status":"publish","type":"post","link":"https:\/\/www.fitpro.com\/blog\/recurring-injuries-biomechanics-science\/","title":{"rendered":"Do we train bodies backwards? One biomechanics scientist believes recurring injuries happen when the body is not ready"},"content":{"rendered":"

Biomechanics scientist Ivana Demmel works with clients stuck in recurring injuries and argues that we need to get the foundations right first<\/strong><\/h2>\n

Aislinn Kelly <\/strong>chats to Ivana Demmel<\/strong>, a former corporate lawyer turned biomechanics scientist, who explains how chronic injury, postpartum recovery and years of cross-disciplinary study reshaped her understanding of movement. From pressure systems and motor control to pain science and ageing athletes, Ivana argues that most training models assume a level of readiness the body may not yet have.<\/p>\n

Aislinn Kelly: You’ve had an uncommon fitness journey \u2013 starting out as a corporate lawyer in Belgrade and Amsterdam, and now you’re a biomechanics scientist working with people stuck in recurring injuries. How did you end up there?<\/strong><\/p>\n

Ivana Demmel<\/strong>: Yes, it’s funny. It was injuries that brought me to a career in fitness \u2013 a feeling that my body couldn’t keep up my pace. I was not quite a sporty type. Growing up on the autistic spectrum, I was very clumsy and unco-ordinated as a child. It took a while to teach me to catch a ball. In primary school, nobody wanted to have me on their basketball team.<\/p>\n

It was just in my twenties that I started discovering physical activity through Pilates, yoga and rollerblading. But it was often challenging to copy movements and it took me a while to master new motor skills. In my late twenties, I developed chronic back pain sitting for long hours in front of my computer, drafting contracts.<\/p>\n

I was 29 when my neurologist showed me an MRI scan explaining that the nerves between my lumbar spine and sacrum were permanently damaged and I would have to get used to living in pain. I remember the tingling down my left leg that would fill me with horror, every time I carried anything slightly heavier. The front of my left foot felt numb and I couldn’t feel the big toe at all.<\/p>\n

Being autistic, my way of dealing with problems is to throw a lot of learning at them. So, over the years, I studied and studied across various modalities of movement and therapeutic exercise. I learnt how to work with my back pain and, eventually, my symptoms diminished and disappeared completely. And then, I got so passionate about exercise that I couldn’t imagine my life without it.<\/p>\n

So, I decided to quit my career in law and retrain as a yoga instructor. I was particularly interested in bodies that didn’t respond to one-size-fits-all approaches to fitness, so I went on to do over 1,000 hours of training, mostly focusing on yoga as therapy.<\/p>\n

But then, in my thirties, after two pregnancies close together, my back pain returned. I had a six-finger-wide abdominal separation and my lower back would go into spasm every time I opened a heavy door or lifted my toddler out of the bath. So, I continued learning, across the fields of physiotherapy, women’s health and exercise science.<\/p>\n

“Pain read as information keeps them moving while we adjust the variables that actually need adjusting.”<\/em><\/p><\/blockquote>\n

Working with my \u2018difficult\u2019 body required digging deeper into understanding intra-abdominal pressure, looking at the torso mechanics and understanding the whole-body biomechanics, especially patterns of loading and injury. And this eventually brought me to an MSc degree course in Sports Biomechanics, understanding mechanisms of injuries in athletes and how to prevent injuries before they happen.<\/p>\n

AK: You talk about “back pain as information”. Can you explain that a bit more?<\/strong><\/p>\n

ID<\/strong>: We tend to read pain as a damage report \u2013 something is broken, stop moving. But modern pain science treats it more like a signal of mismatch: between the load you’ve asked of a tissue, the context you’re in and what your body is currently ready for. So when pain shows up, I try not to ask, “what’s torn?” I ask what it is telling me.<\/p>\n

Has the load outpaced the tissue’s adaptation? Is this someone running on four hours’ sleep and a stressful week? Is there an old fear riding along with a particular movement, long after the tissue has healed? Pain read as damage shrinks a person’s world \u2013 they stop, they brace, they avoid and the avoidance becomes its own problem. Pain read as information keeps them moving while we adjust the variables that actually need adjusting.<\/p>\n

AK: Working with each client, you start by looking at torso mechanics, breathing and deep core muscles\u2019 timing and co-ordination. Why?<\/strong><\/p>\n

ID<\/strong>: In each movement we do, our bodies need to a) keep themselves together and not fall apart as they are pulled and pushed by gravity and other external and internal forces and b) accomplish the task successfully. So, thinking long term, if we want to keep performing well in the decades ahead, we need to maintain both of these aspects of performance.<\/p>\n

And, very often, injuries in a seemingly unrelated part of the body could be related to a lack of strength or co-ordination of deep torso muscles. For example, we know from the research on ACL injuries in football players that the medial collapse at the knee could be about poor neuromuscular control of the hip, pelvis and torso (check out the work of Powers and Zazulak \u2013 see the list at the end of the article).<\/p>\n

“Let’s find out what we can build” recruits agency, and an agentic body is willing to explore.<\/em><\/p><\/blockquote>\n

This is why modern ACL-prevention programmes \u2013 like the widely-used FIFA 11+ \u2013 don’t just train the knee; they train the whole chain, with trunk and pelvic stability as a key ingredient. Similarly, in people with chronic back pain, we can find a lot of answers if we look deeper in the torso \u2013 at the level of the diaphragm and its co-ordination with the pelvic floor (check out Hodges and O’Sullivan \u2013 see list).<\/p>\n

I like to start with building strength from the inside out \u2013 making sure the body can stay integrated and protect the spine and the internal organs before we load it. Once you have robust foundations, you can keep progressing the training \u2013 increasing the challenge with minimum setbacks, even in people with a history of recurring injuries.<\/p>\n

AK: You phrase your assessments as “looking for places to build capacity” rather than “finding what’s wrong”. Why does the language matter \u2013 and how does it change the work?<\/strong><\/p>\n

ID<\/strong>: Because the words I choose in an assessment set the tone of a person’s nervous system before a single rep is done. “Let’s find out what’s wrong with you” gently recruits a threat-and-defence state \u2013 and a guarded body learns guarded patterns. “Let’s find out what we can build” recruits agency, and an agentic body is willing to explore.<\/p>\n

“Is the recurring injury a \u2018weak link\u2019 or is it the one honest spot where a whole system’s deficit keeps surfacing?”<\/em><\/p><\/blockquote>\n

This isn’t soft framing for its own sake; there’s solid motor-learning and pain-science backing it. How someone feels about their body in the moment you load it genuinely shapes what that body can do. I’m not pretending limitations away \u2013 I assess them as carefully as anyone. I’m just choosing the frame that lets a person move towards something rather than flinch away from a fault. The same finding, two different doorways. One opens onto effort; the other onto fear.<\/p>\n

AK: If a fitness professional keeps running into clients they can’t quite figure out \u2013 same injury coming back, training plateaus, capacity that won’t build \u2013 what’s the first thing you’d suggest they look at differently?<\/strong><\/p>\n

ID<\/strong>: Stop trusting the foundation and go and check it. The instinct, when something won’t progress, is to add \u2013 more load, more volume, a cleverer exercise. But a capacity that refuses to build is almost always being built on a base that can’t transmit it. So, before I touch the programme, I look underneath it: can this person actually pressurise and brace on cue, or is the load leaking out of a mistimed canister?<\/p>\n

Is the recurring injury a \u2018weak link\u2019 or is it the one honest spot where a whole system’s deficit keeps surfacing? A symptom that keeps returning isn’t being stubborn \u2013 it’s reporting something upstream that nobody has addressed yet. Nine times out of 10, the ceiling you’ve hit is a foundation you assumed was already there.<\/p>\n

AK: Your MSc dissertation looked at running biomechanics in elite endurance runners over seven years of ageing. What surprised you about how active bodies actually age?<\/strong><\/p>\n

ID<\/strong>: My mentor and I followed a group of highly trained master endurance runners over seven years \u2013 they were in their early 50s when we started and around 60 by the second round of testing \u2013 and we re-ran them through the same protocol with force plates and motion capture. We went in half-expecting to document decline. The textbook signature of ageing gait is a loss of ankle power and the body shifting the work upward to the hip joint \u2013 the so-called distal-to-proximal shift. Also, in ageing gait, we usually see optimising for safety rather than performance.<\/p>\n

What surprised me was how little of that we found. After seven years of ageing, their leg stiffness \u2013 essentially how well the leg behaves like a spring on landing \u2013 was unchanged. If anything, they appeared to run more like highly trained than aged individuals. This meant: longer strides, shorter ground-contact times and higher forces.<\/p>\n

The demand did creep up the chain a little, but only from the ankle to the knee, not all the way to the hip the way it does in less-trained ageing. And the genuinely novel part was that their knees got better at producing stiffness, not worse. These bodies were still optimising for performance \u2013 biomechanically, they kept moving like \u2018young\u2019 bodies.<\/p>\n

AK: The rePower Method \u2013 Restore, Rebuild, Reinforce \u2013 is your synthesis of everything you’ve learned. What gap in mainstream training did it grow from?<\/strong><\/p>\n

ID<\/strong>: Mainstream training quietly assumes a baseline of readiness that most of my clients simply don’t arrive with. The standard model loads people first and trusts the foundations to sort themselves out along the way. For a body that doesn’t behave to spec \u2013 a back that has been in pain, a deep core that lost its timing after pregnancy \u2013 that assumption is exactly where the plateaus, the flare-ups and the quiet drop-outs come from. People get loaded before they’re ready, then blame themselves for not progressing.<\/p>\n

rePower just names the phase everyone skips. Restore settles pain, rebuilds the pressure system and lays the foundations. Rebuild is honest progressive overload \u2013 muscle, load tolerance, building up capacity. Reinforce is about performance: sport-specific work, injury-proofing, training for the decades ahead.<\/p>\n

The order matters far more than any single exercise inside it. And what I’d actually offer a fellow coach isn’t “use my exercises” \u2013 it’s the structure. Don’t assume the foundation. Build it. Then load it. You can lay that sequence over almost any population you work with.<\/p>\n

AK: Your studio is designed to feel like a safe, nourishing kitchen rather than the performance pressure of a gym. What does that environment make possible in the work itself?<\/strong><\/p>\n

ID<\/strong>: A kitchen is the room where you’re allowed to experiment, make a mess, taste as you go and not get it right the first time \u2013 and that’s exactly the atmosphere I like to create in my coaching sessions. My studio really is a blend of a kitchen, a gym and a yoga studio.<\/p>\n

There is just enough warmth and unhurriedness for a nervous system to feel safe. I try to create a non-judgemental, collaborative atmosphere in my sessions, offering a supportive space for people to get to know their bodies and get stronger on their own terms.<\/p>\n

AK: Over 14 years, you’ve gathered an unusual mix of qualifications. From the outside, that can look like generalism. From the inside, what’s the through-line?<\/strong><\/p>\n

ID<\/strong>: I felt none of the disciplines offered a full answer to the needs of my \u2018challenging\u2019 body that didn’t seem to respond to training, especially after the babies. This was more than a decade ago, when it wasn’t easy to find fitness \u2013 even medical \u2013 professionals with experience in working with active female bodies freshly postpartum. I was in pain and I saw three different physios who had no idea how to help me. I had so many questions and very few answers. So, I kept digging across disciplines and each of them offered a slightly different lens to look at my problem.<\/p>\n

I was really excited when I discovered the work of Diane Lee on diastasis recti and finding the primary driver between the pelvis and thorax; the work of Julie Wiebe on pelvic health in the context of the whole deep core system; the work of Antony Lo on intra-abdominal pressure and load tolerance in female athletes returning to sport postpartum.<\/p>\n

But the more I dug, the more I realised these weren’t islands. Each of them sat on older foundations that I then went back and learnt properly. The pelvic-floor-and-pressure thinking only made sense because of the spinal-stability people before it \u2013 Panjabi’s idea of the spine’s “neutral zone”, the deep-core motor-control work of Hodges, the pain-science work of Moseley and Butler.<\/p>\n

And because my real job was always to get a \u2018difficult\u2019 body strong, not just pain free, I had to take the strength tradition just as seriously: progressive overload going all the way back to DeLorme, periodisation, Jill Cook’s work on how tendons adapt to load, and more recently Stacy Sims on the perimenopausal body specifically.<\/p>\n

Threaded through all of it is a more stubborn idea I picked up from the movement-variability researchers \u2013 Bartlett, Nigg’s “preferred movement path” \u2013 and from my own years in yoga and somatics: that there is no single correct way to move.<\/p>\n

So, it was all one long attempt to answer the same question: why won’t this body behave the way the textbook says it should? The synthesis of all those lenses is what eventually became rePower.<\/p>\n

AK: You say you start with questions, not answers. What questions are you sitting with right now?<\/strong><\/p>\n

ID<\/strong>: My current preoccupation is perimenopause-specific training. Some questions I’m still pondering are: How much of what we call ageing in women is actually deconditioning plus hormonal shifts we haven’t learned to train around? I’m also wondering how to adapt strength training to ageing bodies and how to continue building muscle as our bodies gradually shift from building-mode to recycling\/maintenance-mode.<\/p>\n

I’m very excited about training for long-term health and extending the healthspan, especially in women, where there is a more prominent difference between how long we live and how long we maintain a good quality of life.<\/p>\n

To dig deeper, check out \u2026<\/strong><\/p>\n

On the knee and the torso<\/strong><\/p>\n