Big, Confusing Name
Common compensatory muscle patterning is a complex name for a relatively straightforward process. When primary muscles do not work properly in movement, the brain tells other muscles to perform that movement instead. Functional movement researchers have found that no single muscle performs a movement. Rather, movement occurs through chains of muscle contractions and releases along lines of kinetic movement.
There are many causes for muscle failure: weakness, nerve inhibition, lifestyle and poor postural habit, repetitive motion, injury, surgery, environmental, overuse, joint immobilization, problems with joint stabilization, dysfunctional movement (yes, compensations can actually create other compensations), etc.
When any of these occur, the brain sets up another way to make movement happen. In other words, the brain compensates.
Breaking Down Common Compensatory Muscle Strain Patterns
We see two types of common compensations — zonal and functional movement.
Zonal compensation theory… is developed from observing pre-natal positioning within the womb. The basics are that there are four zones; one at each spinal section junction of head/neck (OA) , neck/thorax (CT), thorax/lumbar (TL), lumbar/pelvic (LP). Each zone has a natural tendency to rotate about the vertical axis of the spine in one of three ways: (1) Easily in both directions; (2) Easier in one direction than the other, but in an alternating pattern of Left-Right-Left-Right OR Right-Left-Right-Left, or; (3) Easier in one direction than the other, but in a pattern different from #(2), ie; Left-Right-Right-Left or Right-Left-Left-Left, for example.
Researchers found that rotation taking place as in #(1) above is ideal for the human skeleton and no zonal compensation takes place. A compensation pattern develops with #(2) above, but is still acceptable and doesn’t really need to be resolved unless there are complicating circumstances. The third pattern suggests compensations which do not balance the body and result in much more likelihood of postural dysfunction if left uncorrected.
To learn many more details on this type of compensation, read this article written by Dr. Ross Pope, DO.
Functional movement compensations… more directly address muscular compensation discussed at the beginning of this page. Please note, however, that both zonal and functional movement compensations can and do affect structure and movement.
In this segment, secondary muscles compensate for primary muscle failure. Sometimes, secondaries are difficult to determine. They may be muscles local to the primary, but they may also be located rather distant from the primary. As an example, muscles in the pelvic floor may compensate for problems in hip stability, but muscles in the neck may also compensate for hip flexors.
How the brain decides which muscles to recruit to cover failing primaries is yet to be fully understood. There are general patterns, but nothing appears written in stone at the time of this writing. Some of the patterns are: kinetic chains, which are muscular lines of force. For instance, when we walk, the right leg swings ahead of the torso while the left arm swings back. There is a kinetic muscular chain that connects the right foot to left fingertip, crossing over through muscles and connective tissue in the vicinity of the L4/L5 vetebrae. Some contract, some relax.
Each of these muscles has muscle fibers which pull (contract) in the straight line of the fibers. Any muscle may have fibers leading in any direction, though the majority line of pull is longitudinal or along the length of that muscle. Fibers from a muscle that partially pull obliquely, for instance, may be compensated by other muscles in the body that pull the same direction.
Compensators may be muscle movement synergists or even antagonists. For instance, triceps on the back of the upper arm can compensate for the biceps on the front of the upper arm. Or neck extensors in the back of your neck can compensate for neck flexors on the front of your neck.
How Compensations Affect You
Many compensatory strain patterns go a long time without being noticed because the brain makes sure movement gets done somehow. If you happen to be body-aware, however, you may realize something has changed in how you move or what you’re feeling, but you might not know what it is.
Two types of common compensatory strain patterns affect the human skeleton: (1) those that affect the skeleton directly, and; (2) those that affect the skeleton indirectly. Both types affect soft tissue — muscles, fascia, tendons, ligaments, and nerves. Even organs and organ systems can be affected, because everything is connected.
A main concern is that compensators are not generally primary muscles for a certain movement and secondaries are not intended to do the work of the primaries. Thus, they will eventually tire or overwork. This usually means unrelenting muscle tension and soreness, limitations in range of motion, weakness in movement and gait, etc. Since skeletal muscle attaches from one bone to another, constant tension on a muscle can affect how bones align and move.
Direct affects are seen in posture — bent over, slouch, stiffness, leaning to one side, hi/lo shoulder, tilted head, etc. Indirect affects are seen in function — the way you walk, stoop, squat, reach, sit, stand, twist, bend, pick something up,etc. Less complex compensations may solely present as muscle soreness or perhaps a sensation of tendon clicking or snapping across bone.
The Pain Chasing Trap
Most people have experienced muscle compensation and soreness at some point in their lives — a sore neck, shoulder, arm, knee, hip — or one or more of any number of symptoms relating to muscle tension. Most often, we take some kind of analgesic or muscle relaxer. When the pain lasts or becomes too much to bear, we look for help from doctors, chiropractors, physical therapists, acupuncturists, and massage therapists. Very often, the pain subsides and we get relief from these professionals and that’s the last we hear of it for a while. Sometimes, the pain returns. Sometimes, pain may diminish but not completely resolve. This is the pain-chasing trap.
Oftentimes, professionals go after the pain because a patient is most concerned about where pain is felt. Other times, professionals themselves are unaware that the site of pain is not necessarily where that pain is caused. Still others do not know how to determine the origin of a patient’s muscle pain.
For instance, someone walks into a professional’s office complaining of neck and shoulder pain. The professional may check neck and shoulder movement, and poke and prod the area tissue to see what it feels like. They may make a simple statement such as, “Wow, you sure are tense!” or, more specifically, “The muscles along the slope of your shoulder are very tight. No wonder it’s sore.” A diagnostic professional may order an X-ray to make sure there is nothing serious going on in the bones of the area, then prescribe a muscle relaxer or physical therapy if X-rays are clear. Others may work the muscles of the painful area to loosen them up and restore the tissue to a more pliable state, and send you on your way with the suggestion that you apply ice or heat or a combination of the two when you get home.
No one has necessarily addressed the cause of the painful musculature, only the symptoms which present at the professional visit. Suppose, for instance, that the upper trapezius muscle, which overlays the painful area, is doing the work for other muscles, as is often the case. The upper trap typically does the work for the lower trapezius, latissimus dorsi, quadratus lumborum, gluteus medius, and the tensor fascia lata! If the upper trap is doing its own work plus the work of five or six more muscles, don’t you think that may be why it hurts? If the upper trap is then relaxed, either by manual therapy or [all the muscles with] drug therapy, which muscles are now going to do the work for those six or, now, seven muscles? The brain will find a way! And it won’t be good.
Patients and professionals in the know do well to look for the cause of pain, wherever it is, and resolve it at the source. In doing so, results tend to last longer, if not permanently.
Having common compensatory muscle strain patterns is very common and can be seen everywhere, in every occupation, in every culture. It’s not a debilitating disease, although many symptoms can certainly make a person’s life more difficult. Some compensations are never even realized and may never present a problem to those who have them. Compensations are just one of many coping mechanisms the brain ingeniously comes up with in order to protect the body, the skeleton, and central nervous system, and to carry out the orders and wishes of its various control centers.
For those with muscle pain symptoms, it is important for the professional, whether a physician or manual therapist, to recognize compensatory muscle strain patterns. And it is highly beneficial to the patient that the professional do the detective work to determine (if they can) the origin of the strain rather than to simply address the pain itself.
At Manchester-Bedford Myoskeletal, relieving common compensatory muscle strain patterns before they become pain patterns is our primary goal. Educating the prospective patient is supremely important as preventive maintenance. Address the strain before pain sets in. Once pain does arise, it takes longer to get the patient out of pain and back on the road to optimal health. However, in our culture, people often tend to ignore minor symptoms until they feel they have no choice. Regardless, we work with people at every level and with excellent results.