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Tendon Injuries and Compensation Patterns

knee painTendon injuries typically occur as a result of overuse. However, there could be an underlying reason to why your tendons are strained and working over time. One reason is the compensation behavior. In this article, we delve into the compensation behavioural pattern and how it can lead to weakened tendons.

What Are Tendons?

Tendons are a tough band of fibrous connective tissue joining muscle to bone. It is situated across different parts of the body and easily visible around the wrists and ankle. Forming an integral part of a musculotendinous unit, tendons are capable of resisting high tensile forces and can sustain up to 17 times of the body weight.

What Does the Tendon Do?

The main function of the tendon is to transmit forces from the muscle to the rigid bone levers which makes joint and limb movements such as arm raises possible. More importantly, tendons act as shock absorbers, energy storage sites and helps to maintain posture through proprioceptive properties.

What Causes a Tendon Injury?

There are plenty of reasons for the occurrence of tendon injuries. One of the common reasons is gradual wear and tear due to ageing and overuse. You are more likely to damage your tendons if you engage in activities that require repetitive motions such as jumping and sprinting movements Even simple day to day activities such as wearing high heels can weaken and shrink the tendon, making it susceptible to injury.

As mentioned earlier, tendon injuries can be a result of compensation, a faulty movement pattern in the body causing tendons to work harder.

What is Compensation?

Compensation is a type of coping mechanism that the body employs to achieve a particular movement such as walking when it is limited by factors such as pain, muscle weakness, stiff joints or lack of muscle flexibility.

For instance, if you complain of knee pain one would never guess that the hips could be the cause of the pain. As your body works in tandem to achieve movement, weak hip muscles could result in poor knee stability, causing pain in the knee when you walk. Compensation occurs when your body recognises this weakness in the hips and makes the muscles around the knee joint work even harder to absorb shock and facilitate body movements.

Your bones, muscles and tendons work together to enable mobility. So as the muscles around the knees become strained from overworking, your tendons are also likely to be overused. This may cause pain and discomfort as you go about your daily activities like doing chores, climbing stairs or squatting. Overworked muscles and tendons are also more susceptible and vulnerable to injuries.

It is important to note that movement dysfunctions do not occur in isolation. So pain in a specific body part can have underlying reason that may or may not be easily detected.

Dangers of Compensation Behaviour

Some people do not even realise that their body is in danger. They can go on for months without experiencing any pain when in fact the underlying cause has been going on for a long period of time. Compensation usually goes unnoticed. It may not cause problems in the short term but can evolve to other complications in the long run.

Recognising patterns of compensation allows you to correct and reduce long term damage. It also helps to improve the efficiency of your biomechanical movements.

The next time you are experiencing pain or notice unusual movement patterns, it may be wise to get it checked as soon as possible by a medical professional.


Kvist M. (1991) Achilles tendon injuries in athletes. Ann Chir Gynaecol. 80:188–201.

O’Brien M. (2005). Anatomy of Tendons. In Tendon Injuries: Basic Science and Clinical Injuries. Springer.

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