Compensating Structures & Postural Imbalances

These issues happen after an injury where the body has to use other muscles, or joints to accommodate the injured area. This can include when lifting something heavy, other muscles have to take over so the injured area isn’t injured even more, and using the opposite side to compensate.

This doesn’t always just affect the opposite side of the body, to help with compensating. It can also affect other areas of the body, especially when other devices, like crutches or walkers, are needed. When there is an injury in the leg, and crutches are needed, it isn’t just the opposite leg that is compensating for the injury, but also parts into the upper body.

If compensating factors are not treated, they can cause issues, even after the original injury has been resolved. This is because we get into the habit of working with this new type of posture, which makes us unbalanced, causing other muscles to become tight and potentially develop trigger points. Not only does this affect the muscles, but it also affects the joints in the body. This is because you will have certain muscles that are tighter then what they should, while the opposing muscles become overstretched. When this happens it puts tension on one side of the joint, pulling it out of regular resting position, then it was before you had the injury.

Some of the examples of compensating factors would be if you injured your elbow, we tend to change the posture of the shoulder to keep it in a sling, and then we also use the opposite side more to be able to carry things and do other tasks throughout the day. At this same time, because there is pain in the shoulder we tend to curl our shoulders forward more since this is a position that feels more comforting. Sadly, this makes our pectoralis muscles right, and over stretches the back, causing pain in the upper back.

When it comes to leg injuries, it affects even more structures, compared to an arm injury. This also depends on if you need to use anything to help you with walking, including crutches, as this directly affects the arms and the shoulders. If you can use a cast only, to be able to walk, it won’t affect the shoulders as much. However, it does affect the other leg still, as well as the tilt of the pelvis, as with a cast you won’t be able to keep the same level without using a lift on the shoe of the leg that isn’t injured. But even when using crutches, the other leg is still affected, due to having most of your body weight put on it. Both of these cases puts added stress on the other ankle, knee, and hip. The longer you have to walk in this position, the higher the chance that you will start to have complications in the spine.

This is the body’s way of trying to keep an equilibrium in the body and needs to change the position of your center of gravity, so you aren’t falling over. In extreme cases, this can cause you to have a functional scoliosis, curving of the spine from right to left, rather than being straight, up and down. If this happens you can feel changes into the lower back, rib cage, and even into the neck, as the brain wants to keep the eyes horizontal.

Postural imbalances are a bit more complicated and generally more long term. Sometimes this can be caused by the compensating structures that were mentioned above, from a more serious type of injury and the body adapted to the new normal. But usually this is more due to our daily posture that we use at work, driving, sleeping, or just relaxing at home, which causes you to change where your centre of gravity is. There are some instances where other conditions can affect your posture, such as leg length discrepancy (one leg is shorter than the other), spinal curvature dysfunctions, and pregnancy.

For most of these cases postural imbalances can be fixed, but a large amount of that success will be dependent on your commitment to exercises and noticing when you are using poor posture and correcting it.

When it comes to treatment, it will all depend on where the original issue started, then working outwards. This means that during treatment you could be in any position that is most comfortable for you, and that will support any injured areas if you have any. Then work will be done in the muscles that are tight, treating the tightness, trigger points, or spasms to help them both relax and stretch. Then the muscles that are weak and overstretched are worked on to get rid of any trigger points, then are stimulated to try to activate the muscle fibers in the muscle. Though the weaker muscles tend to be the most sensitive, relaxation techniques aren’t a good idea. Though it will make it feel like the muscles aren’t as painful, it will cause them to elongate even more, causing you to have more issues later on.

At the end of the session, exercises will be given to you, first to stretch out the muscles that are too tight. Then later in the treatment plan, exercises to strengthen the muscles that are weak will be given. This will give the weaker muscles a chance to build up their strength without being fatigued quickly, from opposing the stronger muscles.