Movement Avoidance: What Neuroscience, Pain Science, and Rehab All Missed (Until Now) 

The More You Cue It, the More They Resist—Why?

You’ve coached the squat a thousand times.

You’ve cued the knees.
You’ve aligned the ankles.
You’ve adjusted the breath, the tempo, the stance.
You’ve demoed. You’ve modified. You’ve regressed.

And still—
They fold forward.
They hip hinge instead of drop.
They shake, wince, or rush the rep.
And sometimes… they just won’t do it.

You start to wonder:

“Is this just how their body moves?”
“Are they not trying hard enough?”
“Am I missing something?”

“Am I a poor coach/therapist”

What if you’re not dealing with a mobility issue at all?

What if the problem isn’t poor compliance—or poor effort—but a brain that’s stuck in protection mode?

Your "Noncompliant" Client Might Be in Neurological Lockdown

You tweak the program. 

Offer regression. 

Cue better. 

Still stuck.

Before you blame motivation, pain tolerance, or noncompliance—let’s zoom out and take a different perspective.

You might be dealing with movement avoidance—a neuroprotective phenomenon where the brain inhibits or alters movement to avoid perceived threat, not pain. 

And it’s far more common (and under-assessed) than we think.

So let's explain this term a little more. 

What Is Movement Avoidance? 

Movement avoidance is an umbrella term describing when a person unconsciously resists or alters physical movement, often without pain, due to internal threat signals from the brain and nervous system.

It shows up in:

• Chronic pain cases
• Post-injury compensation
• Trauma-affected patients
• Sensory mismatch dysfunctions (vision, vestibular, proprioception)

While the term has roots in pain psychology and behavioral therapy, it's now becoming relevant to rehab, coaching, and applied neurology.

Movement Avoidance in Pain Science: The Fear-Avoidance Model

The Fear-Avoidance Model (FAM) is a well-established psychological theory explaining how individuals avoid movement due to the anticipation of pain, not necessarily pain itself.

"People who catastrophize pain are more likely to develop avoidance behavior, leading to disuse, depression, and disability."

— Vlaeyen & Linton, 2000 [[1]]

 

According to FAM:

• Pain → fear → avoidance → disuse → depression → more pain

Over time, the nervous system becomes hypersensitive and reinforces the protective pattern—even when the tissue has healed.

'But Wait—What If There’s No Pain at All? 

Here’s where neuroscience steps in.

The brain doesn’t need pain to block movement.
It only needs uncertainty.

If a movement feels:

• Unmapped (e.g., poor proprioception)
• Unpredictable (e.g., weak vestibular signal)
• Or emotionally unsafe (e.g., trauma-linked)

…it gets flagged as a threat. And the brain does what it’s designed to do:

Minimize output. Rewire the pattern. Or stop it entirely. 

The Neuroscience Behind Movement Avoidance 

The following brain regions play major roles in inhibiting or altering movement:

1. Brainstem (PMRF, Vestibular)

• Core postural reflexes
• Survival-based inhibition
• Responds to head position, eye tracking, and perceived safety

2. Cerebellum

• Coordinates movement, rhythm, and timing, posture.
• Acts as an error-detection system
• Disruption leads to movement inconsistency or hesitation

3. Frontal Lobe

• Motor planning, decision-making
• Inhibition or indecision shows up as freezing, stalling, or confusion mid-movement

4. Insula Cortex

• Processes interoception (inner sensation)
• Tags movements as emotionally or physically "unsafe"

5. Midbrain (Tectum, PAG)

• Detects and filters threat (visual, auditory, somatic)
• Governs startle, freeze, and pain suppression responses

When these areas are overwhelmed or under-stimulated, movement becomes disorganized, protective, or completely absent.

Clinical and Coaching Signs of Movement Avoidance 

•  Substitution Patterns: Hip hinge instead of squat; scapular hiking in place of true shoulder elevation.
•  Fast Reps: Rushing through eccentrics to avoid interoceptive awareness
•  Plane Avoidance: Refusing to rotate, cross midline, or move overhead
•  Load Avoidance: Capable of high load in symmetric patterns, but collapse under asymmetrical, slow, or unstable ones
•  Freezing or Hesitation: Pausing mid-rep, forgetting the sequence
•  Chronic Bracing: Jaw clenching, toe gripping, shoulder elevation
•  Emotional Resistance: “I don’t like that one,” without logical reasoning

These are very observable, and modifiable patterns with strong scientific grounding in: 

• Neurophysiology
• Sensory integration dysfunction
• Pain psychology
• Motor control research

It sits at the intersection of biomechanics, behavior, and brain health.  

Let’s Review

The Real Reason They’re Not Squatting Right

What we’re seeing isn’t just poor movement.
It’s the brain protecting the body in real-time—based on its own risk assessment.

And it’s not random.

Movement avoidance is deeply rooted in:

•  Neurophysiology: The brainstem, cerebellum, and insula all contribute to how movement is initiated, inhibited, or rerouted when threat is perceived.
•  Sensory Integration Dysfunction: When visual, vestibular, or proprioceptive input is mismatched, the brain can’t create a reliable map—and the motor plan suffers.
•  Pain Psychology: Pain isn’t just a symptom—it’s a protective output. Prior injury, emotional stress, and stored trauma can all influence threat perception.
•  Motor Control Research: Studies show that motor learning isn’t just mechanical—it’s contextual. It’s influenced by perceived safety, prediction, and interoceptive awareness.

This is where biomechanics meets behavior.
Where movement meets meaning.
Where reps meet regulation. 

If you’re not accounting for the brain—you’re missing the biggest variable in client progress.

Next week, we’ll walk you through exactly how to integrate this into your practice:
✓ Assessments that reveal sensory mismatches
✓ Neural drills to build safety and restore output
✓ A clinical decision tree for choosing the right input at the right time

Stay tuned. The next level of rehab starts here.