Back Pain: Why I Watch How You Move, Not Just How Far
By Dr. Jerome Fryer, Chiropractor | Dynamic Chiropractic Clinic, Nanaimo, BC
When you come into my Nanaimo chiropractic practice with lower back pain, I may ask you to bend forward, lean backward, or bend to the side. These familiar movements help me assess your active range of motion: how you move your body under your own control.
But I am watching more than how far you can bend.
I pay particular attention to the journey through the movement, especially the middle portion. Is it smooth? Is there a brief hesitation or a little catch? Does the movement change when you return to standing?
The amount of movement matters, but the quality of movement deserves careful attention too.
What Is the Midrange of Movement?
The midrange is the portion between the start of a movement and its comfortable limit. When you bend forward, for example, it is the movement between standing upright and your furthest comfortable bend.
You pass through this range when you lean over a sink, reach toward a lower shelf, or bend to put on your shoes. In an assessment, watching only where you finish can miss what happens along the way.
Someone may reach a reasonable distance yet experience a catch halfway down. Another person may move a shorter distance with an even, comfortable rhythm. Those are different observations, and I want to understand what each means for the person in front of me.
What New Research Tells Us About Spinal Movement
A 2025 study published in JOR Spine examined lumbar spine movement in 125 people with chronic low back pain. Researchers used dynamic biplane radiography, a specialized moving X-ray technique, to track individual lower-back bones during forward and backward bending and side bending.
They found that spinal levels moved differently at different points in the bending cycle. Their contributions near standing were different from their contributions through the midrange and near the end of bending.
There was also considerable variation between people. Only 7 of the 125 participants followed the group’s average pattern of which spinal levels had the greatest to least forward-and-backward movement.
For patients, the useful message is that one overall measurement cannot describe everything happening during a movement. The spine is a series of moving joints, and each person’s pattern may differ.
Why I Pay Attention to Small Catches
During your assessment, I watch for brief pauses, changes in speed, shifts to one side, and differences between bending down and returning upright. I also ask when you feel discomfort and whether the movement reproduces your familiar symptoms.
A little catch gives me something to explore. It does not, on its own, prove that a disc is damaged or that a joint is unstable. Watching from outside the body cannot show precisely how each vertebra moves.
The study used specialized imaging; an office movement assessment is a different kind of examination. The researchers also emphasized that more work is needed to determine which movement characteristics can reliably guide treatment decisions.
I interpret what I see alongside your history, symptoms, and other examination findings. My emphasis on the midrange is a clinical approach informed by movement research, rather than a diagnostic test validated by this particular study.
How Dynamic Disc Models Help Me Explain Your Back
I use Dynamic Disc Models in my practice to help me think through spinal mechanics and explain them to patients. A model allows us to explore how movement involves the discs, joints, and surrounding structures together.
We can use it to discuss the movement that troubles you and make the anatomy easier to understand. It also gives you something concrete to look at while asking questions.
The model is an educational representation, rather than a replica of your spine or a way to diagnose the cause of a catch. Its value is in helping us connect an explanation with your experience.
A Careful Movement Assessment in Nanaimo
If your back catches when you bend, or you hesitate as you straighten up, that experience is worth describing during your appointment—even if you can still reach your toes.
At Dynamic Chiropractic Clinic in Nanaimo, I pay close attention to how you move, where symptoms appear, and what you find difficult in everyday life. The aim is to understand your experience and use the complete assessment to discuss appropriate next steps.
When I ask you to bend, I am interested in the whole movement—not simply the finishing position.
Research Reference
Anderst W, Kim CJ, Bell KM, et al. Intervertebral Lumbar Spine Kinematics in Chronic Low Back Pain Patients Measured Using Biplane Radiography. JOR Spine. 2025;8(2):e70069. DOI: 10.1002/jsp2.70069. PMID: 40371271.