When the Baseline Assessments Say “Good”—But Your Client Still Struggle

How many of you have clients that assess well or good, but you still can't seem to help their chronic pain and struggle where to start?  This might be what you needed to hear today. 

You’ve been here before.

You run a full assessment on a new client. Their range of motion looks clean. 

Their gait? Balanced. 

No glaring asymmetries. 

No structural red flags. 

So why can’t they squat without pain?

Why do they wake up every morning with a stiff neck, despite “good posture” and a green light from your mobility screen?

Why can’t they get back to their sport, lift heavy again, or simply feel good in their body—even though all the assessments say they should be fine?

This isn’t a failure of your screening system.
It’s a signal that you’re looking in the wrong direction.

The Limits of Traditional Baseline Assessments

Most traditional assessments are built on two things:

1. Observable movement patterns (range, symmetry, strength)
2. Biomechanical reasoning (muscles, joints, fascia)

These are useful—but partial—data points.

They tell you what a person can or can’t do.
But they don’t tell you why their body is choosing to move that way.

Because when it comes to movement, pain, or performance, it’s not just the joints and muscles calling the shots.

It’s the brain.

It’s everything above the neck that is affecting below the neck (not just below) 

Every time we hear a coach say, I know if there lifestyle, sleep, stress nutrition etc is off or bad, I know they will assess poorly. They will say this is from experience, but we say OF COURSE it is.

This is the baseline understanding of neurology , a brain-first perspective, and why understanding threat and its affects on the body should be understood first. 

The Brain-First Perspective: Why “Good” Movement Isn’t Always Functional

Let’s break this down. 

Your client’s body is being governed by a system whose top priority is survival.

Not aesthetics.

Not mobility.

Not your checklist of optimal movement patterns.

So even if a movement “looks good,” if the brain perceives it as unsafe, it will still:

• Limit power output
• Increase tension in other areas
• Alter breathing
• Drain focus and energy
• Or create pain as a protective signal

This is what we call neurological mismatch: when movement looks good externally, but doesn’t feel good internally.

It’s the client who has a full squat range—but still gets knee pain every time they hike. 

Or the vocalist whose posture tests as “neutral,” but loses power mid-phrase because of unresolved threat in the visual or vestibular system.

 Or the executive with great core strength and “perfect” desk ergonomics… who still gets migraines at 3pm.

Why “Baseline” Assessments Can Be Misleading

If you rely solely on basic screens—like joint range of motion, single-leg balance, or gait analysis—you’re missing the hidden variables that matter most to the nervous system:

•  Interoceptive regulation (Can I feel safe in my own body?)
•  Proprioceptive clarity (Do I know where my joints are in space?)
•  Visual + vestibular harmony (Do my eyes, head, and body agree on what’s happening?)
•  Historical threat load (Is my brain still responding to old injuries, trauma, or stress patterns?)

None of these show up on a standard movement screen or baseline assessments. 

But they all influence whether the nervous system says yes or no to movement.

The Shift: From Static Screens to Purposeful Reassessment

Here’s where the real magic happens: Use something the client cares about as your assessment.

“Good” baseline doesn’t matter if the movement that matters to the client still feels wrong.

Instead of relying on generic ROM tests, try this:

• Ask the client what movement, task, or action they most want to do pain-free.
• Use that as your assessment and reassessment marker.
• Test drills and interventions not for general changes—but for changes in that specific activity.

Example:

A client’s hip flexion tests fine. But they can’t bend over to tie their shoes without sharp pain.
That’s your new assessment.

Try a vision drill. Re-test the shoe-tying posture. Did pain decrease?

Try a vestibular drill. Re-test again. Better? Worse? Neutral?

Now you’re not assessing in a vacuum.
You’re letting the client’s real-world goals guide the process.

Don’t Reassess Pain Directly

One of the most common mistakes practitioners make in this approach is asking:

“Did that drill make your pain better?”

Here’s why that’s risky:

Your client’s brain is wired to find the pain.
If you keep directing them back toward it, you reinforce the pattern.

Instead, look for:

• Improved movement
• Better breathing
• Increased ease or coordination
• Less facial tension
• Improved posture or gaze stability

Pain relief often happens as a byproduct of creating more safety and function. Not by poking the pain repeatedly.

Tools You Can Use Immediately

If you’re stuck with clients whose “baseline looks good,” try these shifts:

1. Use Personalized, Functional Assessments

Replace general tests with specific tasks:

• Singing
• Golf swings
• Picking up a child
• Typing posture
• Overhead pressing
• Sports-specific drills

2. Introduce Visual or Vestibular Drills

Even if the body moves well, if the eyes and inner ear aren’t aligned, performance and pain issues can persist.

• Pencil pushups
• Saccades
• Vestibular head tilts
• Smooth pursuits

Track changes in the specific functional assessment—not just in ROM.

3. Observe Nonverbal Signals

What to look for after a drill:

• Smoother movement
• Less hesitation or bracing
• Facial relaxation
• Change in breathing pattern
• Gait improvements

These are gold-standard signs of a nervous system that feels safer—even if the client “isn’t sure” how they feel.

A Case Study: “Everything Looks Fine” — But She Still Hurts

Meet Jess. A 42-year-old runner. She came in complaining of persistent low back pain during long walks, but her FMS and posture screens were solid.

Her gait? Normal.
Hip mobility? Great.
Core engagement? Excellent.
Pain with straight leg raise or hip flexion? None.

So what gives?

We asked Jess to show us the specific movement that bothered her: walking with her arms crossed behind her back (something she did often while thinking).

Pain flared immediately.

We introduced:

• A right-sided vestibular drill (based on prior history of left ear infections)
• A visual convergence drill
• A diaphragm reset drill

After reassessing the walk—no pain.

That was the “aha” moment. Jess didn’t need more mobility. She needed better information flowing through her sensory systems.

The Deeper Lesson: Movement Is a Decision

Here’s the kicker:
Movement isn’t just a mechanical output. It’s a neurological decision.

Your brain asks:

“Do I have enough accurate input to create a safe, efficient output?”

If the answer is no, it limits range, increases stiffness, or uses pain as a brake.

You can’t solve that with a better foam roller or more thoracic extension drills.

You solve that by increasing quality input through the visual, vestibular, and proprioceptive systems—layered on top of the client’s real goals.

Assess What They Actually Care About

It’s time we raised the standard for what counts as an “assessment.”

Because movement screens don’t heal people.

Neurological clarity does. 

And if you can help your client swing a club pain-free, sing without strain, or lift their kid with a smile—not just pass a ROM test—you’re not just fixing movement.

You’re transforming lives.

If you are looking for more education on this exact subject, or three Masterclasses that follow a 1,2,3 pattern are available free for download. Click here.