Compensation! Compensation!


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Compensatory pain! What the heck is that? Often times people start off having pain in one foot or one knee and then over time they develop pain somewhere on the other side of their body or their back. Now people have a tendency to either think ‘My body is falling apart!’ or ‘I must be getting old, everything hurts!’ but really it is very possible these injuries could be related.


When one part of your body is injured, it’s only natural to want to ‘baby’ the injury and take pressure off that side. This may mean that you start to put more pressure on the opposite side or start using the other arm more. This can contribute to overuse injuries in other areas of your body.


Also, your body is quite remarkable in that without even realizing it, your body will compensate for injuries in your body. If you have hypermobility in one area of your spine, your body may automatically stabilize surrounding areas causing those to become hypomobile or vice versa. If you lack range of motion in your ankle, your body will compensate by placing more torque on your knee. Or if you are a runner, and you lack some range of motion in your big toe extension, you may inadvertently compensate when you run by driving your opposite shoulder forward more and develop anterior shoulder pain! (True story!) What?! Your body does this stuff without you even realizing. This may go on for some time before you start developing pain elsewhere.  


In order to avoid injury, you want to make sure your range of motion and strength is symmetrical on both sides. Often times when there is a deficit in range of motion on one side, or one side is weaker than the other, this can lead to injury……because of, you guessed it, compensation!


So to prevent these injuries from occurring, you need to try and balance yourself out. If you have a weaker knee or ankle, do some strengthening exercises for that side. If you have a more flexible side, try to stretch more on the other to even them out. The best time to address these issues is before you have pain! In this way, you may be able to prevent injuries down the road.


So basically, your body is one extremely complex, unbelievably remarkable machine, where everything works together. You may not be able to make the connection, but hopefully if you are working with a talented physical therapist, they will look at your overall movement quality and be able to determine what the heck is going on! That is also why it’s important to be aware of when you are feeling the pain, or with what movements or activity.


If you tend to isolate your rehab to just one part of the body, you may not fully address the problem, and your pain could come back. You need to look more globally at how you are moving to potentially determine the underlying cause of your pain. If you fix the underlying cause of your injury, your pain should go away and stay away! (providing you keep up with your exercises)

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Jessica is a licensed physical therapist currently living and working in NY.

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