Basics and types of compensation patterns
Our musculoskeletal system is an amazingly adaptable system that can adapt to an almost unlimited number of demands and loads. This is why we are able to perform highly complex movements and deliver high performance – both in sport and in everyday movement tasks. However, the adaptability of the movement system also results in compensation patterns – in the following article, I explain how these arise and how they can manifest themselves.
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YOUR BODY IS A GENIUS!
Anyone who has ever had an injury knows the typical first reaction: you want to avoid putting any strain on the injured area in order to reduce further consequential damage. Let’s take the following common example: you twist your right foot while running in the woods, your outer ankle is briefly overstretched, supination trauma according to the experts. You can still put weight on your right leg, but not your full body weight. You put more weight on your left leg as an evasive action and automatically reduce the ground contact time of your right leg by shortening the rolling time of the injured leg.
This is a completely natural reaction that allows your body to relieve the right ankle joint for a certain period of time to allow the injured tissue to heal more quickly than under full load. The pain you feel is the first impulse for you to adopt this “protective posture”, as they say.
Compensation patterns occur immediately after an injury. Although the structural healing of tissue is complete, compensation patterns can persist for several years / decades. Image source: fotalia.com, ©lassedesignen
What does that mean?
What is simply illustrated by this case study is actually something highly impressive: Your body is able to find a kind of substitute solution for every possible form of imbalance in the organism. If your pH value is too acidic, this is compensated for by an increased respiratory rate, among other things. If an organ is not functioning at 100%, another organ in the corresponding control circuit will do more work to create a balance (homeostasis) for your body.
MOVEMENT CONTROL STARTS IN THE BRAIN!
The same laws apply to the musculoskeletal system: If something is missing in one place, it is compensated for in another. The example of the twisted foot shows this in a simple way – the right leg is relieved, the left leg is put under more strain. Our central nervous system (CNS) plays an immense role here, as our brain, together with the peripheral nerves and the myofascial system (muscle-fascia network), organizes every movement, from bending our fingers to kicking off.
What is not always visible within a complex movement, however, are the mechanisms that our body uses to “compensate”. Movement patterns are, simply broken down, a temporal sequence of muscle contractions that are started and controlled by the brain. This sequence of muscle contractions can become inefficient both in terms of timing and quality of control. You can find more information on this here:
The body thus moves in movement patterns that are available in the brain (more precisely in the cerebellum) and become “ingrained”, so to speak, when a child learns to walk, for example. After each fall, the movement improves until the child finally learns to walk and this efficient, learned movement is stored in the cerebellum. However, deviating movement patterns that enable movement are also stored if an injury or overload has occurred. The body then attempts to circumvent the resulting disruption and increasingly integrate other structures. This compensation pattern can result from a clear evasive movement (see the example of twisting an ankle), but there are also other ways in which our musculoskeletal system tries to balance out imbalances.
WHAT COMPENSATION PATTERNS ARE THERE AND HOW DO THEY ARISE?
Basically, a distinction can be made between three different types and development processes:
- Primarily neuro-based compensation patterns
This is a compensation within the movement control system in the brain. Our central nervous system constantly receives information from our sensory organs (input) and processes it. After processing, the CNS interprets the perceived information and decides on the action to be taken (output). If, for example, a system involved in controlling movement does not provide very clear signals, the neuronal activation of certain areas of the body can be inhibited, which is reflected in the movement and therefore in the performance.
Three neuronal systems are primarily responsible for movement control:
- The visual system (vision system)
- The vestibular system (balance system)
- The proprioceptive system (body’s own perception via receptors)
A “faulty” signal from even just one of the three systems can upset the entire musculoskeletal system. This could be, for example, a difference in peripheral vision on one side, or an imbalance in positional orientation in the inner ear caused by a fall on one side of the head, as well as a neuronally faulty connection to a ligament at the back of the head or, as in the example above, a ligament at the ankle joint. When our CNS perceives such faulty signals, a kind of “blind spot” appears on the representative map of the body on the cerebral cortex, the so-called homunculus. As a result, individual muscles or entire muscle chains are neuronally inhibited, while others perform excessive work. Performance is reduced as the body works compensatory, i.e. inefficiently.
- Primarily biomechanically caused compensation patterns
These types of compensation patterns usually follow a predictable pattern, as the musculoskeletal system is subject to biomechanical laws that are expressed in a certain way by the anatomical characteristics of the body. Let’s stay with the above example of twisting an ankle: after the supination trauma to the right ankle joint, the body actively tries to avoid the movement of the injury mechanism (excessive inversion/supination in the lower right ankle joint). This is followed by a series of evasive movements that are subject to a specific sequence due to the shape of the bones and joints:
- The lower right ankle joint tends to pronate (turn inwards) more in order to avoid the supination movement; the body’s weight and centre of gravity therefore move away from the right foot. Muscularly, this is noticeable, for example, in that the inner muscles (e.g. adductors) in the right leg are activated more than the outer muscles (e.g. abductors), while the left leg is inverted.
- The excessive pronation (compared to the neutral foot position) results in internal rotation of the tibia and femur in the right leg.
- Based on the anatomical articulation between the thigh and the pelvic blade, the right pelvis tilts more forward (based on the more neutral alignment before the injury) and tilts slightly downward (footward). This often results in a compressed sacroiliac joint on the side of the twisted foot.
- The lateral lowering of the right pelvic blade results in a further series of compensations, these are a left lateral curvature of the lumbar and thoracic spine and the rib cage and thus a lowering of the left shoulder as well as a right lateral curvature of the cervical spine. One-sided neck tension can therefore be caused by the position of the feet.
To simplify the explanation, not all movement planes of each joint are mentioned in this description; in reality, there are even more subsequent movements. However, this description of a compensation pattern may help you to better understand why many people have unilateral neck pain and have also twisted a foot several times in the past.
The point is this: The compensation patterns that the body implements make total sense at times, as they enable us to move forward. In the long term, however, they can cause damage, as some structures work more while others are inhibited.
- Changes in posture and movement due to psychosomatic causes
This refers to postures that we adopt when our emotional system is out of balance, for example when we are feeling very sad or depressed. It is then more likely that we will ‘slump our head or shoulders’, hold our spine less upright and keep the whole body in flexion (bending) and internal rotation. This naturally carries over into the movement patterns we need in everyday life or sport. Basically, this is also a kind of compensation – the body saves energy by going into “protection mode” as the mind or mental state robs more energy. A different kind of homeostasis, you could say.
It is important to know that the aforementioned possible causes of compensation patterns do not occur in isolation in reality, but rather manifest themselves in a focal manner, although they are interrelated. For example, the primary neurophysiological dysfunction will influence the musculoskeletal system and thus also change the biomechanical load. Conversely, the altered biomechanical situation in the foot also leads to neuronal changes, as the right foot is loaded less in maximum supination. On the “map of the body”, the homunculus, the sensory information of the outside of the ankle joint is therefore represented less strongly, which in turn can lead to neuronal compensation.
Finally, we still have emotional-mental influences that can always bring our body into an imbalance, which can also be reflected in the two other areas (biomechanics and neurophysiology).
SO WHAT CAN A MOVEMENT COACH DO?
As every musculoskeletal system is altered by the influences mentioned, we can say that compensation patterns are a fundamental part of the body. They are not bad in principle, on the contrary! Our body does an incredible job of adapting.
Despite this, it is worth recognizing compensations and compensating for individual weaknesses with a balanced training program. Trainers and therapists have various options for doing this. The simplest option is to study movements and check them again and again using video recordings, for example through gait analysis or functional movement tests. When it comes to changing movement patterns, there are a number of methods that solve this efficiently. The central nervous system with all its movement-controlling systems must never be ignored, because if an underlying “signal error” is not corrected, any form of conventional training is useless.
Conclusion – recognizing compensation patterns is important, but should not determine the entire training philosophy
The human organism seeks a permanent balance (homeostasis) between different functional systems, organs and components of the musculoskeletal system. This can be reflected in compensation patterns of various kinds, which can be caused biomechanically, neurophysiologically, but also psychosomatically and can be changed accordingly.
Whether you work as a therapist, trainer, coach or doctor: if you work with the human musculoskeletal system and want to improve the quality of movement of your clients or patients, you should deal with the topic of compensation.
The ability of a movement coach of any kind to discover compensations can and should be constantly improved – from the development of a “trained eye” to test procedures that can uncover specific connections in the body. At the end of the day, however, the important thing is to do this in a healthy and constructive way, i.e. not to always want to improve every possible compensatory movement. It’s about the corrections that have a significant influence on the quality of movement – make sure you have a good foundation here and then get into training!
Sporting greetings,
Daniel
