Most people come in expecting the same experience they’ve had everywhere else. Tell me where it hurts, I treat that spot, you feel better for a while, it comes back. Repeat.
That’s not how I work — and the reason starts with how I assess before I ever treat.
The Problem With Treating Where It Hurts
Pain is a signal, not a diagnosis. It tells you something is under stress, but it doesn’t tell you why. The structure producing the pain is often doing so because something somewhere else in the chain isn’t doing its job, and your body has been quietly compensating around that breakdown for months or years before anything finally hurts.
If you only treat the painful structure, you get temporary relief. The compensation pattern driving the load stays intact, and eventually the symptoms return. This is why so many people cycle through treatment after treatment without lasting resolution — the target keeps moving because the actual source was never identified.
What a Movement Screen Actually Does
Before I put my hands on anyone, I run them through the Selective Functional Movement Assessment — a system built around seven full-body movement patterns that tell me how your body loads, transfers force, and compensates under demand. I’m not looking at isolated range of motion. I’m watching how your whole system behaves when it’s asked to perform fundamental movement tasks.
Each pattern gets scored as functional or dysfunctional. The top tier tells me where the system is breaking down. The breakouts — a deeper layer of assessment within each pattern — tell me why.
That distinction matters more than almost anything else in the assessment process.
A Real Example: Two Failures, One Source
Here’s how this plays out in practice. A patient presents with low back pain. I run them through the top tier and find two dysfunctional patterns — multisegmental extension and multisegmental rotation. Two separate movement failures.
On the extension pattern, they can’t extend through their spine without their hips shifting forward to compensate — an anterior weight shift that tells me the hip isn’t extending and the lumbar spine is making up for it. On the rotation pattern, there’s a similar story — limited hip contribution forcing the lumbar segments to rotate more than they should.
Two different patterns. Same culprit: the hip.
The low back isn’t the problem. It’s the most stressed structure in the system because the hip isn’t moving the way it needs to. Treating the low back alone would produce temporary relief and nothing more, because the load driving the symptoms never changes.
Mobility or Motor Control — The Question That Changes Everything
Once the breakouts identify the hip as the key link, the next question is the most important one in the entire assessment: is this a mobility problem or a stability and motor control problem?
A mobility dysfunction means the tissue itself is restricted — the joint or the surrounding soft tissue doesn’t have the range available regardless of how hard the nervous system tries to access it. That needs manual treatment. Soft tissue work, joint mobilization, ART targeting the specific structures limiting the pattern.
A stability and motor control dysfunction means the range is available, but the nervous system isn’t using it properly. The motor pattern is faulty — the body has learned to stabilize and move in a compensatory way and needs to be retrained, not just released. That needs corrective exercise targeting the right movement pattern under the right load, often using DNS-based progressions that restore proper joint centration and deep stabilization from the inside out.
These are not interchangeable. Stretching and mobilizing a motor control problem won’t fix it — you’re adding range to a system that doesn’t know how to use what it already has. Loading and training a mobility restriction won’t fix it either — you’re asking a body to perform a pattern it structurally can’t access yet.
The movement screen tells me which one I’m dealing with before I ever start treatment. That’s what makes the difference between a plan aimed at the right target and one that’s educated guesswork.
Why Most Treatment Skips This Step
The honest reason most providers don’t do this is time. A full movement assessment takes longer than going straight to treatment, and in high-volume models there isn’t room for it. The shortcut is to treat what’s in front of you — the pain, the tight muscle, the restricted joint — and see what happens.
Sometimes that works, especially for acute presentations where the painful structure is the actual problem. But for anything chronic, recurrent, or that’s been through multiple treatment episodes without lasting resolution, skipping the assessment means you’re solving for the symptom and hoping the cause goes away on its own.
It usually doesn’t.
What This Means for You
If you’ve had pain that keeps coming back, or if you’ve been through treatment that helped temporarily but never fully resolved the problem, there’s a good chance the root cause was never properly identified. A movement-based assessment that looks at the whole system — not just the area that hurts — is usually where the answer is.
That’s where I start with every patient. Not because it’s the fastest path, but because it’s the one that actually works.
Book a free 15-minute movement screen at Optimal Health & Performance →
Dr. Brian Trautman is a chiropractor, certified athletic trainer, and strength and conditioning specialist at Optimal Health & Performance in Cincinnati, OH. He specializes in movement-based care for athletes, runners, and active adults.
