He pushed into the interior, and Elizabeth followed him through the darkened narthex and into the
light beyond. She moved as if it hurt and kept her eyes down until the balcony passed above her head,
and the ceiling rose up.
She moved as if it hurt mean?
I am not a native speaker, just nobody answering you.
I think it means that she moved as she had a pain ( ache), it was difficult to move for her by physical, emotional or other reason.
A healthy person makes big, relaxed movements. Healthy people swing their arms. Their ankles bend as their foot touches the floor.
A person with a sore foot, or another injury, moves slowly and carefully. An injured person takes small steps. An injured person doesn't lift their feet high off the ground. They do not move any body parts farther than they need to. Normal movements may cause pain to injured parts.
A person who is very tired, depressed, or old might move the same way, even if nothing is injured.