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Writer's pictureDr. Robert Berghorn, Jr.

Compensations: Are They Helping You Or Hurting Your Exercise Performance (for the Endurance Athlete)



Humans are an incredible species. We’re able to adapt to a variety of environments and situations because we can learn new ways to survive. For thousands of years, we’ve been able use our brains and our bodies to respond to a changing environment.

The same is true of our bodies; you can be dealing with an excruciating pain in your lower back, but if you’re an active adult or endurance athlete, you’ll still find a way to complete a 5k run each morning. How can the body do this? Well, the human form is very resilient, and it will usually figure out a way to perform when we ask it to. We can still run even if our muscles and joints aren’t functioning like they should be. How does the body do this? I’ve got two words for: compensation patterns.

What Are Compensation Patterns?

The body uses compensation patterns to perform motions when strength and mobility are not sufficient. They begin to take form when a muscle or group of muscles is unable to properly move a joint through a range of motion. They can also form when there is a restriction within a joint that does not allow the joint to move freely, regardless of muscular strength.

Compensation patterns appear in a variety of sports, but in my practice, I would have to say that runners are most likely to commit the mistake. As a Doctor of Physical Therapy, I’m actually surprised so many runners are guilty of this. Most runners DO try to take excellent care of their bodies so they can keep running. Stretching, warming up, icing, working on their core strength, and proper diet are all practices which I know they focus on. But when runners do not address the specific needs of his body (and trust me, the body is a very good communicator, if we listen to it!), then they’re not capitalizing on all the effort they are putting into their training.

Why Can’t I Just Depend on Compensation Patterns Throughout my Training?

I know, I know…. you’ve been told countless times that you should just “work through the pain” or “wait it out” because the pain will eventually go away. Unfortunately, that’s not how it works. When we experience pain, our bodies will create a new movement pattern to decrease the pain. This sounds great in theory, but the new movement pattern is dysfunctional and begins to create an undesirable chain of events in the body.

And trust me, compensation patterns will only work for so long before something breaks down. The muscles that are compensating are not designed to perform these compensating running actions, leading to overuse, increased joint wear and tear, excessive muscle tension and tightness (even spasm), and pain in the muscle or in a nearby joint. So when you feel that pain spring up, that’s your body’s alarm sounding, alerting you that it’s compensating. And I’m here to tell you…..If you can listen to it, try to figure out what is going on, and correct it, you can help prevent injury and run stronger. Pretty incredible, right? Let’s read on to learn what some of these “alarms” signify, and how to fix, shall we?

Alarm Bell #1: The Same Running Injury Keeps Popping Up Again and Again

If you always get tendonitis, shin splints, Iliotibial (IT) Band Friction Syndrome, or any other type of overuse injury on the same side and the same body part, there is some underlying cause that has not been addressed. Think about it….if the muscle has to work overtime during your run, it’s going to alert you through pain.



For example, let’s say you keep suffering from hamstring pain while running. The gluteus maximus is the strongest extensor of our hip. Hip extension occurs when the foot is behind the body with the knee straight. The glute muscle must be firing properly for our hip to extend forcefully as in the push off phase of running. Many people have problems firing their glutes properly, which places added stress on the hamstring and the lower back extensors. These muscles compensate to get the job done, often resulting in a hamstring strain or chronic hamstring tightness. You might be spending a significant amount of time stretching your hamstrings but if you find you are never making any progress, chances are you are not strengthening the weak muscle that is causing the problem.

Alarm Bell #2: You Keep Suffering from Upper Back, Neck, and Shoulder Pain (and/or Tension Headache Pain)


A lot of neck and shoulder pain originates in ways you would never even think about, unless maybe you had some sort of acute body awareness or some sort of anatomy education. Remember - it's totally normal to have a problem that you don't even really know exists (or pay little attention to) and compensate for it in ways that affect your whole body.

For instance, your psoas muscle connects on your lumbar spine. When it shortens up from overuse or injury, it can exaggerate the lumbar curvature and take vital space away from the whole spine. This can and will put a tremendous amount of stress on your upper body, aiding in the creation of tension headaches and even harm your good posture. This is just one example out of infinite possibilities of way your body is compensating.

Alarm Bell #3: Unusual Tenderness in the Same Muscles Again and Again

Let’s say you’re performing your routine massage (e.g., foam rolling) and you’re still suffering from tenderness in the same muscle again and again…..yup, you guessed it - chances are your body is relying on compensation patterns. When that nasty trigger point you have been working on keeps coming back no matter how hard or how long you massage it out, it’s because there is some biomechanical deficiency during your run that is causing it. If you take the stress away from the muscle, the trigger point will go away.

Enough with the Compensation. Go See a Physical Therapist!

No matter how much you stretch or massage it out, there’s a high likelihood that you are missing something. If you have any of the symptoms of compensation patterns I mentioned above, it’s a good idea to talk to a Doctor of Physical Therapy to try to figure out what the underlying problem is. As a professional, I can get to the crux of the matter, allowing you to focus your precious time on reaching your personal goals.

It takes proper physical therapy training to know the correct muscles to stretch and strengthen. It’s takes years of observing hundreds of runners to learn and then teach good running form. As both a Doctor of Physical Therapy and an endurance athlete myself, I know I can provide any runner suffering from pain with the correct tips to improve their techniques and get rid of their pain.

Simply call me at (516) 387 - 0053 or email me at rberghorn@ascentphysicaltherapyny.com to set up your FREE Discovery Visit. I am always willing to discuss with you any and all issues you might be dealing with. But I can’t do that unless you call. So please reach out today.


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