Transcript: Podcast/Episode 11

From Pain to Possibility


Episode 11: Compensation

Intro: You're listening to From Pain to Possibility, with Susi Hately. You’ll hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don't have to hear it scream. And now here's your host, Susi Hately.

Susi: With this episode, I want to dig into compensation patterns. As someone who utilizes yoga therapeutically from a foundational base of kinesiology and biomechanics, I love the physical-plane reality of movement. Either the body moves, or it doesn't. It's either moving into flexion and extension, or it's not. You're either breathing, or you're not. In this case, the body does not lie. It's actually doing the thing we want it to do, or it's not. So it provides a very clear understanding of what's working and what's not working. 

So when we're looking at what compensation is, we're looking at what extraneous patterns are we utilizing to get the desired movement accomplished. So where are we bracing? Where are we gripping? Where are we utilizing other parts of our body in order to get the job done? And when I can clear up those extraneous patterns, I can help someone become more efficient in their movement; I can help them become more optimal in their movement; and I can clear up the suboptimal patterning, which then has them absorbing and dissipating low through their tissues, they have much more efficient biomechanical patterns, and I've seen that that correlates into a reduction of pain. 

What makes this really powerful is that it gives the person who has pain the awareness of what's actually going on, because so many of these compensation patterns happen under our level of awareness. So it leads people to really question, why are they still in pain? What's really going on? And when I can show them how they're actually moving, it really opens their eyes to possibility. And with that understanding and that new awareness, they then have control over what they can do to support themselves. So it gives them a whole internal locus of control so that if their symptoms come back, they can recognize what patterns are correlated to that symptom increase, and they can then do something about it because they see over and over and over and over again the relationship between how they move and how they feel.

Now, is compensation always bad? Absolutely not. It's not always bad. What I found, though, is that people who have pain, that when they reduce their compensation, that their pain starts to go away, which is why I start with that, typically, in the process of recovery. What's important to note is that all of us compensate. The thing is that those of us who don't have pain or the pain that we have does not get in the way of us living our life, our compensation strategies are serving us. We are well compensated for the life that we want to lead. It's when we feel more constricted in our life, that's when we get to look at what our compensation patterns are, where our inefficiencies are, maybe where we're bracing or gripping or holding our breath. And when we take a look at that, we can make significant changes in how we feel and how we live our life.

Let me give you a couple of examples where I see compensation patterns very commonly. One of them is in breath-holding patterns. I will often see people do movement, and they hold their breath in order to do that movement. Now, if I asked them to only move as far as their breath allows them, then they tend to move a lot smaller. So they were utilizing a breath-holding pattern in order to get their job done. 

Another way that I see people utilizing compensation patterns is when they want to swing their leg in a walking pattern, and instead of using the leg to swing, they hike their hip. This is really common for people who have quadratus lumborum issues. The quadratus lumborum is a muscle in the lower back between the ribs and the pelvis. And I like to call it the super hero of compensation because it can take on a lot of extra work when the hip or the shoulder is not functioning well. Not all the time, but it certainly can get involved when those two are not working as well as they could. 

So when I'm working with someone who has a very spasm-y QL, I show them how their leg bone is moving in their hip socket, so how their hips are functioning, and invariably we'll find that that hip movement is quite limited. And when they start to clear it up, they feel the softness, and they feel the relaxation in their back because their back’s not having to do that extraneous compensatory work that the hips were really meant to do. And now that the hips are doing the job that they're meant to do, the QL doesn't have to do the compensatory strategy. They feel better, their system feels better, and they have an understanding of what's contributing to the pain that they're experiencing. So that, with their symptoms going down, they can now recognize that if they don't maintain their hip function, or if they go off and do an activity like basketball or hiking or walking the dog and they happen to be out for longer, or they happen to be on uneven surfaces, and they feel that back starting to kick in again, they have an understanding why, and they can then actually do something to support themselves to get back into that pain-free place.

The other piece that becomes important, too, is as they refine those movement patterns in the hip, for example, and they make those patterns better and better and better and better and integrate them more fully into their overall system, the length of time that their symptoms stay down gets longer and longer and longer to the point where they build these new neuromuscular patternings, where they don't have pain at all. 

So it's very powerful for someone to, first, become aware of how they're moving, and then, integrate that awareness into their movement patterns. It's really powerful to be able to resolve a problem that actually exists rather than the problem that you think exists. 

Now, let's come back to something that I mentioned earlier around how compensation patterns are not all bad, and they're not wrong, right? We all compensate. Are we well compensated for the life that we want to live? Let's say you're out for a run and you sprain your ankle and you have to get back home. You are going to hobble or limp your way back home. That is a compensation. And that is really, really good because you have to get home. If you didn't compensate, you'd be sitting on the side of the road, waiting for someone to pick you up. So it's a good thing that you know how to compensate in order to get yourself back. It's one of these parts of our system that's a remarkable feature. What gets us into trouble is when we don't clean up that compensation after the fact, after we've had that initial recovery through the ankle. 

And to highlight this point, let me give you the example of a hip or a knee replacement. A lot of times when I'm working with people to help them recover from a hip or a knee replacement, we will help them with their overall mobility and stability of the hip that had the surgery, but also spend a really good deal amount of time on all the other areas of the body that were compensating while the person was waiting for surgery, because while the person was waiting for surgery, that joint was in pain. There was damage. The brainstem didn't want to load through that damaged tissue, because it hurt. So it found other ways through the opposing joint; or further up the chain, in the rib cage; or through the shoulder girdle to find other ways to lift up and out of that area with pain. 

So it's important that if you want to have success, not only is it success of the surgery itself, but also, after the surgery, in the recovery process, that you improve the entire system’s movement patterns in addition to the movement of the damaged joint. It's really, really vital. And a lot of people miss out on the recovery of all of the body that was helping that injured joint in the first place. And when you don't do that, then you can have these cyclical patterns, and then that hip that had been replaced, other complications can happen, whether at that hip itself or further up the chain, in other areas, simply because those inefficient movement patterns, those suboptimal patterns, weren't resolved. And so you can do a lot of good for yourself when you pay attention to the whole system in addition to that injured joint. 

Now, there's one more piece to this compensation conversation that I think is fascinating and really important, and it's where we blend the biomedical view with the whole person or biopsychosocial view. When I see clientele who are compensating and who have pain, oftentimes I will see their personality or their characteristics inside of how they move. So I tend to see people who have a lot of drive and ambition. They're really good at pushing aside symptoms. If they've been challenged or have been proverbially knocked down, they know how to pull up their bootstraps and get back up again and dust themselves off and carry on. They know how to get the success that they want to get. They've got a drive and ambition, they know what they want, and they want to go get it. Which is great. 

It can also put them into a bit of a pickle if they've got an injury and they keep pushing aside symptoms in order to do their marathon running or in order to do their work goals or in order to do the fill-in-the-blank outcome. And that will start to break down on them, and they'll be frustrated because their typical strategies of pulling themselves up by the bootstraps and compensating and carrying on are no longer working. Now, they don't realize that they're compensating. They're just doing themselves. They're just doing them. 

So when I'm working with them and I'm seeing this, and I'm seeing this desire to really push through or to get a big stretch, I get a little excited because I'm actually seeing them. I'm seeing who they are, and I’m seeing how who they are, while it has contributed in part to the pickle that they're in, it is also going to contribute to getting them out of that situation and into a place of recovery and of healing. 

And I think this is really important because I'll also see, these same clientele, who will tell me that other professionals have said, “You really have to give up this,” or “You really have to stop being this way.” Whereas, I don't see it that way. I actually see that the very characteristic that has been successful for them through their life—and sure, it might not be entirely successful for them in this current piece of their life, meaning their pain or their strain or their burnout—it will be the thing that gets them out. And how I explain this to them is that I'm helping them channel it in a way that really serves them. 

So initially, when they start to realize how they actually move, which is often a lot smaller than they really realized, what I'm showing them is the reality of the situation. And I let them know that when you get real about the way you're actually moving, you can actually solve the problem that is. As I like to say, where the pain is is not the problem; the problem lies under the level of awareness. So when you really get clarity on what is working, you can really resolve the actual problem. When you don't have clarity, when you're unaware, you can't solve the thing you're unaware of. So I really bolster up this idea of when you're aware, yep, it sort of sucks becoming aware of what you're becoming aware of, but at least you're now aware of reality, and you can sort it out. 

Now, with these guys with the drive and ambition that they have, they're all over it. Sure, they don't really like what they're becoming aware of, but now they know what to solve, and they can put their drive and ambition into solving that problem. And then what ends up happening is they start to clue in on a much subtler level, the whispers, the signals that are letting them know how far they can push, maybe when they should back off, and they get a better and better understanding of how to really utilize their energy for good. So they've learned how to channel their drive and ambition in a way that really, really serves them. And that will propel their recovery and their healing trajectory very, very quickly. So it's this idea of being able to get very clear on what the compensatory patterning is and how someone's personality weaves in through that and leverage that to help someone recover very quickly.

So the key pieces of this compensation conversation are that compensations are important. They are significant for understanding how someone moves or doesn't move. And when we can become aware of those compensation patterns, we can then start to recognize what's working, what’s not working, and how we can support someone in making more efficiency in their movement pattern, better breathing, better connection, and through that, more inner stillness, which can overall settle a nervous system and overall support someone in their healing trajectory. 

Compensations are not all bad. There is a time and a place for utilizing them. And we want to make sure that we're supporting someone becoming more and more and more efficient in how they move, which helps them feel better. 

So some takeaways for you. If you are out for a run or you're on your yoga mat, notice how you're feeling. Notice how you're moving. Are you really moving the leg bone in your pelvis, or is your pelvis hiking? Are you tucking when you don't need to tuck? Are you bracing with your breath in order to make a movement happen? Again, not that it's a bad thing, just notice what it is that you notice about your movement patterns. And what does it reveal to you?

If this has resonated with you and you feel that your pain experience is related to compensatory patterning that you might not be aware of, or maybe you are aware of it but aren't sure what to do, there are two options for you to explore. One is Susi’s Resource Library, which is a membership site where I help people improve their movement patterns and train teachers and health professionals on how to recognize them and improve it in their own clientele. As well, if you want more personal attention, you can reach us through our website at the Contact Us page to inquire about a private one-to-one session.

Have a great time exploring.