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The anatomy of Pain: 3 common types of decompensation patterns

The anatomy of Pain: 3 common types of decompensation patterns


If you’ve read our last article, Decompensation Patterns: Or, How Pain In Your Neck Can Come From Your Big Toe; you’ll know that the body works as a unit. And sometimes, when a part of your body stops working as well as it should, it results in a cascade of compensation patterns which can result in pain.


Let's have a look at the anatomy of 3 common compensation patterns, how they develop, and how they can result in pain.



#1 The tricky talus


There are 33 joints in the human ankle and foot, the mechanics of which are very important, considering we spend half our time putting all our body weight through them.


Together they produce a very sophisticated but subtle twisting-rolling-springing motion which absorbs the shock with each foot step, distributes our weight up our legs and hips, and allows us to enjoy the benefits of good old bipedalism.


The talocrural joint is central to the ankle, and is located between the bottom end of the tibia and fibula (the shin bones) and the talus, a tarsal bone sitting on top of all the other bones which make up the foot. The talocrural joint is particularly prone to restrictions because the talus is the only bone in the whole body to not have any muscles attach to it, leaving it essentially floating between the bones that it forms joints with.


Restrictions in this joint can occur after a mild trauma, like a sprained ankle, even if it didn’t seem like a major injury at the time. If the talus is locked to one side, or doesn’t move as it normally would, other parts of the body will work differently. The slight natural twisting of the leg which should occur with each step will not be able to travel down the ankle as per usual, and the foot’s ability to act as a spring during walking will be compromised. In this sort of scenario, it is quite common to see knee pain develop on the side of the restriction. This is because the knee is now receiving more of the un-absorbed force from our body weigh due to the decreased ability of the foot and ankle to do so. The same can be said of the hips and lower back as unresolved restrictions and dysfunctions can travel up the body.



#2 The anonymous AC and SC


We don’t often talk about the two little joints on either end of the clavicle (collar bone): the sternoclavicular joint- or SC, connects the clavicle to the breastbone, and the acromioclavicular joint –AC, is found between the collarbone and the shoulder.


They aren’t very glamourous compared to the famous ball-and socket joint most people identify as the shoulder, called the glenohumeral joint,


but they do contribute a big portion of the movements we can do with our arms. Try reaching above your head without moving your collar bone…



Convinced? Truth be told, these two little joints are actually as big a part of the shoulder as the glenohumeral joint, and all three should always be considered as a whole.

FUN FACT: The SC is the only joint connecting the arm to the rest of the body. So, there’s a lot of pressure resting on this little guy’s shoulders! (See what I did there?)

If either of these two little joints become restricted (which could result from various reasons such as mild trauma, posture, muscular tightness, etc), the glenohumeral joint and surrounding structures will inevitably become strained from trying to compensate for the lack of movement. This can result in a susceptibility to injury or simply achiness around the glenohumeral joint after what should normally be considered low-level activities involving the shoulder.



#3 – The CD/OA paradigm


This is by far the most common decompensation pattern, and happens when the upper part of the spine becomes stiff and tight. The vertebra there often end up somewhat locked into a forward flexed position, usually because of prolonged periods spent in a slumped posture (which is why it is so common, as a lot of people spend vast amounts of times in front of desks and computers). This happens most noticeably at the cervico-dorsal junction, or CD- the joints between the vertebra of the upper back and the one at the base of the neck.


To balance out this forward bend, the neck has to extend backward, to keep our head facing up ahead, so we can keep staring at our computer screens.


And the place where most of the compensatory movement happens is at the level of the joint between the top vertebra in your neck and the base of the skull – called the occipitoatlantal joint (often referred to as the OA). This pattern overworks the neck muscles in all sorts of ways (and article of its own), which is often the cause of neck pain, and even headaches.


Please share your thoughts and questions with us in the comments' section below.


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