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In this episode of The Physio Coach Podcast, host Charlie Goodchild is joined by Adrian D’Costa, physiotherapist and founder of The Running Room in London. Adrian shares his journey from early-career physio to building one of the UK’s leading running rehabilitation clinics, alongside the lessons he’s learned from working with runners, mentoring clinicians, and navigating clinic ownership. This conversation goes beyond protocols and explores how great physios actually think. You’ll hear about: • How to work effectively with runners (even if you’re not a runner yourself) • Why many running rehabs fail and how underloading holds patients back • Load management vs technique in injury and performance • The role of strength & conditioning in MSK physio • Building clinical reasoning instead of relying on templates • The realities of opening and growing a physio clinic • Advice for early-career physiotherapists This episode is ideal for physiotherapists, rehab professionals, coaches, and runners who want to better understand injury, performance, and modern healthcare. ━━━━━━━━━━━━━━━━━━━━━━ 🔗 CONNECT & LEARN MORE 🏥 Book a physio appointment in London (UK): https://www.betterneverends.com 📸 Instagram: / betterneverends ▶️ Subscribe on YouTube: / @the-physio-coach-podcast 🎧 Guest – The Running Room: https://www.therunningroom.net / therunningroom 00:00 – Intro: The Physio Coach Podcast 01:50 – “What’s the worst that could happen?” and career risk 06:10 – Early career mindset and learning foundations 10:45 – Moving countries and backing yourself 14:50 – Building clinics and taking early business risks 19:30 – Discovering running and performance rehab 22:10 – Pandemic, running boom, and mental health 27:40 – Growing clinics through uncertainty 32:20 – Mentorship and developing young clinicians 38:50 – Assessment philosophy in running injuries 44:10 – The physio pandemic of underloading 48:30 – Tendons, bones, and smarter load management 54:30 – RPE, workload ratios, and preparation vs overload 01:02:00 – Strength & conditioning for MSK physios 01:08:40 – Using tech without losing reasoning 01:14:30 – Community, run clubs, and trust 01:20:40 – Education, RED-S, and knowledge gaps 01:24:00 – Business values, ethics, and purpose 01:27:30 – Reflection, leadership, and personal growth 01:30:00 – Final thoughts and wrap-up