[臨床思考] 什麼是代償 What is compensation

代償這個名詞在這幾年又重新引起風潮
你幾乎可以在每一個地方聽到
而相對產生的就是所謂的矯正性的運動
你是否有想過 什麼是代償 為什麼有代償 代償到底哪裡不好
COMPENSATION is getting fancy again in recent years.
You can hear about it almost everywhere.
Correspondingly, there's so-called CORRECTIVE EXERCISE
However, have you ever wondering
WHAT is compensation? WHY does the compensation happen? Is it really BAD?

用最簡單的方式來解釋代償
就是身體為了執行超出能力的任務所產生的策略
The simplest way to explain what is compensation is
"The strategies that your body corresponds to the task beyond its ability"

身體的設計非常巧妙
有非常多層的保險系統以及很大的容錯空間
你的大腦會在你無意識之下做出許多的調整
正因為如此
動作的分析與矯正才會如此的複雜以及困難
The body is designed to live.
So it has multiple back up plan and ability to tolerate the dysfunction.
Your brain will adjust it unconsciously.
And that makes the movement analysis and correction complicated and difficult.

 
代償的出現可以粗分為兩種情況
一種是需要執行的任務大於身體能力的情況
一種是因為受傷或其他因素使得身體能力暫時下降而不足的情況
雖然看起來很相似 但成因會影響介入的方式
後者特別需要醫療專業人員的介入
The occurrence of the compensation can be divided into two condition:
1. The task you want to perform is over your ability
2. The injury or other factors that temporarily decrease the body ability to perform the task.
They seem alike but that difference will affect how you deal with it.
The second condition must be seen by medical professionals.

如果你是教練/運動訓練員
你需要特別了解第一種情形
只有在能力大於負荷的時候 你才能做出正確的動作
但對於提升運動的表現與能力 代償可能是必需的

取決的你的訓練周期與訓練目標

If you're a trainer or athletic specialty, you need to understand the first situation well

You can only perform the correct movement if your ability is above loading.

But sometimes you might need the compensation to help you perform better in specific movement.

It's all depend on your training period and goal.

如果你是治療師或動作分析專家

這兩種情形你都會遇到

If you're a therapist or movement specialty, you'll face both condition

例如腳踝急性扭傷之後的步態肯定會以代償的方式執行

這種情況下 你需要回復身體的能力同時逐步降低對代償的依賴性

之所以許多人在復原之後反而產生其它問題或是產生反覆同樣的傷害 

多數因為他們的身體無法離開代償的模式

For example, if you get acute ankle sprain, you definitely walk in a compensation way.

You need to make the injury healed and gradually decrease the reliance on the compensation.

The reason why so many people get other problems or repeat the same injury is because that

they don't really get rid of that pattern even though their ability is recovered.  

另一種情況是身體功能由於退化或習慣問題導致不足以應付日常性的動作

此時你的身體會使用各種代償來替你完成

而在日常生活中慢性的積累傷害

例如核心的不活化造成了呼吸模式的異常 長期下來可能造成許多地方的疼痛

Another condition is that your body can't handle the daily task due to degeneration or habit.

Now your body will compensate to finish the task.

And it cause the chronic injury accumulation in your life.

For example, the inhibited core might cause the breathing dysfunction and result in pain at many area.

下一周我們會談談各種不同型態的代償方式

給予臨床上面分析治療時更多的線索去解決問題

Next article I'll talk about some different type of compensation.

Hope that can give you more clues while assessing and evaluating your client.

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。