What is compensation? Compensations and compensatory muscles are given a bad name in the rehab and fitness world. How many of you know why compensations happen or what it implies?
I've had to explain to patients what compensation is and found it very challenging. We use the word so often, its meaning is essentially "lost in translation".
So what does it really mean? Compensation is the recruitment of the incorrect muscles is an adaptive change that your body undergoes to perform a chosen task.
Let's use walking for instance. Typical desk jobs can create compensation issues when walking. By sitting most of the day, your hip flexor complex located at your groin area tightens or shortens. A shortened hip flexor muscle will then cause you to tilt forward. When walking few people will actually allow this tight hip flexor to cause them to walk hunched over because then you'll be facing the floor. Instead, we compensate by walking upright which causes the front of your hips to tip forward instead. Now, what muscles will allow you to walk upright with a tight hip flexor? Well, your tiny thin back muscles (paraspinals) are going to overextend your low back and be overused ALL THE TIME! Then….I think you know the breakdown process: low back pain. The hip flexor and low back muscles are compensations for your glute muscles and your abdominal muscles such as your transverse and oblique abdominals.
This is just one of many compensatory strategies your body could do. Let's breakdown the main principle: YOUR BODY WILL USE UP ALL AVAILABLE RESOURCES TO PERFORM A TASK. That means that if you have a limitation, your body will find a way to rearrange itself to perform the task the best way it can. It won't be the healthiest way, but the task will be accomplished. The main task you thought was perhaps to just walk, but the real underlying task is to walk upright. Your body will compromise from using the correct muscles because your hip flexor is a limiting factor and prevents you from being upright. Compensations ultimately lead to the breakdown of other muscle groups that are relied upon to complete those tasks. Those muscles weren’t built for those specific tasks and when overused, will break down. Thus, it becomes important to reduce compensation as much as possible.
How do you decrease the likelihood of compensating? Better muscle timing will decrease compensation. It’s necessary to create a re-organization of the strategy and to have your muscles fire at the correct moment during each movement. If your muscles are not firing properly, other muscles can compensate for this lag.
It’s also critical to maintain a proper posture to prevent compensation. Constantly engage your core muscles and be mindful of the alignment of your body, whether sitting or standing. If you’re sitting for too long, stand up every 15 to 20 minutes to reposition your body briefly.
Additionally, I use manual techniques to re-educate the muscles and taping techniques to keep joints from moving too much. If compensations are a great concern for you, it’s best to see a physical therapist. But, if you are only in a mild level of discomfort, you can decrease tension by using a foam roller. Use the foam roller to roll out any tension in your body. For example, for stiffness in your buttocks from sitting too long, simply sit on the roller and roll it back and forth. Similarly, you can use the roller on different areas of your body.
Compensations can cause all sorts of discomfort in your body. Be mindful of what muscles you are using, so that other muscles are not overcompensating for weak ones and thus, causing you discomfort.
We heal smarter, not harder!
Dr. Justin C. Lin