As a chiropractor in Maroubra, understanding motor control – how the brain and body coordinate movement – is essential. Motor control depends on constant communication between the sensory and motor systems, playing a crucial role in posture, spinal stability and efficient movement. Pain can disrupt this finely tuned system, creating movement patterns that may persist long after symptoms improve.
At Sydney Neuro & Integrative Health, I frequently see patients with both adaptive and maladaptive movement strategies. These patterns vary depending on whether someone is in acute pain, experiencing chronic pain, or is technically “pain-free” but still moving in sub-optimal ways.
The Senses That Protect Your Movement
To understand where your body is in space, your nervous system relies on three major sensory systems:
- Vision
- Somatosensory input (muscles, ligaments, joints, fascia)
- Vestibular input (inner ear balance organs)
In healthy individuals, these systems work together automatically. But in people with pain or dysfunction, the brain may “upregulate” or “downregulate” one system to compensate.
For example, chronic one-sided neck stiffness may actually reflect reduced vestibular input, not just a muscular problem. Research shows that when vision is removed, many people with pain struggle to reproduce limb or trunk positions accurately. This is a sign that the brain is relying too heavily – or not enough – on one sensory stream.
How Pain Alters Your Motor Control Strategy
Pain changes movement, often in ways that increase mechanical loading on the spine and may contribute to ongoing stiffness or discomfort.
In low back pain (LBP), two primary motor control patterns sit at opposite ends of a spectrum:
1. “Tight” Motor Control
- Increased trunk muscle excitability
- High levels of co-contraction
- Reduced movement variability
- Movement feels stiff, guarded, effortful
2. “Loose” Motor Control
- Lower muscle excitability
- Excessive trunk movement variability
- Difficulty stabilising during tasks
Over time, especially if pain persists, movement variability tends to decrease, as the nervous system runs out of alternative strategies. This shift is also seen in people transitioning from acute to chronic neck-shoulder pain.
Both patterns, when prolonged, can increase spinal loading and contribute to tissue degeneration.
How Your Brain Predicts Movement: The Role of “Active Inference”
Optimal movement relies on the brain constantly predicting the expected sensory consequences of a movement. The nervous system aims for the prediction error to be zero – meaning the movement feels right, safe and efficient.
When you experience acute pain – say, from lifting a heavy weight – the central nervous system (CNS) can minimise prediction errors in two ways:
1. Adapt the proprioceptive input
By changing movement patterns or redistributing muscle activity to match expected feedback.
2. Adapt the prediction
By altering the motor cortex’s expectations to fit the altered sensory input.
According to the active inference model, the motor cortex (M1) doesn’t simply send commands. Instead, it predicts what proprioceptive feedback should be, while the spinal cord compares these predictions with muscle spindle input. If there’s a mismatch, the nervous system modifies muscle recruitment to reduce the prediction error.
This is why people in acute pain often move awkwardly or recruit additional muscles – they’re trying to match expected sensory consequences.
What Happens When Pain Persists?
When pain becomes chronic, the nervous system adapts in ways that may no longer be helpful:
- Movement becomes slower and more rigid
- Fine, segmental movements are replaced with gross, whole-body motions
- The individual develops a stable but less efficient movement strategy
- Neuroplastic changes occur in the sensorimotor cortex
Clinically, this looks like someone turning their whole body instead of just their head, or bracing excessively during normal daily tasks.
Unfortunately, these compensations can lead to ongoing spinal loading, tissue fatigue, and recurring pain, even when the original injury has healed.
Why Understanding Motor Control Improves Your Treatment
At Sydney Neuro & Integrative Health, we assess not just where pain is felt but how your brain and body are coordinating movement. By addressing sensory imbalances, motor control patterns and posture strategies, chiropractic and neuro-musculoskeletal care can:
- Reduce unnecessary muscle co-contraction
- Restore natural movement variability
- Improve proprioception and vestibular integration
- Reduce spinal loading
- Support long-term recovery
This comprehensive approach is essential for preventing recurring injuries and improving quality of life.
Ready to Improve Your Movement and Reduce Pain?
If you’re experiencing stiffness, recurring pain or difficulty moving the way you used to, a comprehensive motor control and neuro-musculoskeletal assessment can make a significant difference. At Sydney Neuro & Integrative Health, we look beyond symptoms to understand how your brain, spine and sensory systems are working together – and how they may be contributing to ongoing discomfort.
Our goal is to help you move with confidence, restore efficient motor patterns and prevent long-term spinal stress.
You can book an appointment online anytime using our secure booking link:
👉 Book an Appointment
We look forward to supporting you on your path to better movement, better function and better health.
Many people dealing with back or neck pain don’t realise that the way they move and hold themselves each day plays a huge role in how they feel. Effective back pain treatment and neck pain treatment often start with simple changes—like improving posture and learning how to engage the right muscles for support. Motor control exercises can help you reconnect with these deep stabilising muscles so your body moves more naturally and with less strain. When you combine this with gentle spinal stability exercises, your posture improves, your spine feels more supported, and over time, the aches and stiffness begin to ease. It’s a more mindful, long-lasting approach to feeling bette
References:
Hodges, P. W., & Smeets, R. J. (2015). Interaction between pain, movement, and physical activity: short-term benefits, long-term consequences, and targets for treatment. The Clinical journal of pain, 31(2), 97–107. https://doi.org/10.1097/AJP.0000000000000098
Moseley, G. L., & Vlaeyen, J. W. S. (2015). Beyond nociception: The imprecision hypothesis of chronic pain. Pain, 156(1), 35–38. https://doi.org/10.1097/01.j.pain.0000460306.37928.01
Tsao, H., Galea, M. P., & Hodges, P. W. (2010). Driving plasticity in the motor cortex in recurrent low back pain. European Journal of Pain, 14(8), 832–839. https://doi.org/10.1016/j.ejpain.2010.01.001
van Dieën, J. H., Reeves, N. P., Kawchuk, G., van Dillen, L. R., & Hodges, P. W. (2019). Motor control changes in low back pain: Divergence in presentations and mechanisms. Journal of Orthopaedic & Sports Physical Therapy, 49(6), 370–379. https://doi.org/10.2519/jospt.2019.7917
Wright, A., Moss, P., Sloan, K., & Fernihough, B. (2021). Movement variability in people with lower back pain: A systematic review. Musculoskeletal Science and Practice, 51, 102311. https://doi.org/10.1016/j.msksp.2020.102311