From Ankles to Spines: How Injury Compensations Can Travel Up

Injuries to the ankle and knee joints are common for stunt performers and can have far-reaching consequences on the rest of their bodies. Weakness or imbalances in these areas can cause compensations in the lumbar spine, thoracic spine, deltoid muscles, shoulders, and even the cervical spine, leading to pain and reduced mobility. This article explores how early diagnosis and effective rehabilitation, including functional movement training, are essential for stunt performers to recover from injuries and prevent future complications.

Stunt performers are among the most skilled and physically demanding performers in the entertainment industry. From car chases to fight scenes, they push their bodies to the limit to create the thrilling on-screen action that audiences love. However, these extreme physical demands come with a high risk of injury, especially in the ankle and knee joints, which can lead to issues in other parts of the body if left untreated.
Injuries to the ankle and knee joints, such as sprains or strains, can cause weakness or imbalances in the muscles surrounding these joints. When this happens, the body compensates by shifting the workload to other muscles, such as those in the lumbar and thoracic spine, deltoid muscles, shoulders, and even the cervical spine. Over time, this compensation can cause these muscles to become overworked and strained, leading to pain, stiffness, and reduced range of motion.


In fact, certain types of ankle or leg injury are often linked to problems in different areas of the spine / back muscles. So if you're having back issues, use this as a handy reference to check whether the issue hasn't travelled up. 

1. Ankle sprains
   Ankle sprains are a common injury for stunt performers, and they can lead to compensations in the lumbar spine. When the muscles around the ankle are weak or imbalanced, the body may compensate by shifting the workload to the muscles in the lower back. Over time, this compensation can cause strain and tension in the lumbar spine, leading to lower back pain.
   
   
2. Knee injuries 
   Knee injuries can also affect the lumbar spine, as well as the thoracic spine, deltoid muscles, and shoulders. For example, if the quadriceps muscles in the thigh are weak or imbalanced, the body may compensate by overusing the muscles in the hip and lower back. This compensation can cause tension and strain in the muscles of the thoracic spine, deltoid muscles, and shoulders.
   
   
3. Achilles tendonitis 
   Achilles tendonitis is an overuse injury that can cause compensations in the lumbar spine. When the Achilles tendon is inflamed or weakened, the body may compensate by shifting the workload to the muscles in the lower back. This compensation can cause tension and strain in the lumbar spine, leading to lower back pain and this in turn may lead to a reduced range of motion and tightness in the hips

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The lumbar spine, in particular, is very often affected by ankle and knee injuries. This is because the muscles in the lower body are responsible for stabilizing the spine during movement. When these muscles are weakened or imbalanced, the lumbar spine can become unstable and more susceptible to injury. Additionally, compensation from ankle and knee injuries can cause tension in the hip flexors, which can pull on the lumbar spine and cause lower back pain.

Similarly, weakness or imbalances in the muscles around the knee joint can lead to compensations in the muscles of the hips and lower back, which can affect the thoracic spine and deltoid muscles. For example, if the quadriceps muscles in the thigh are weak, the body may compensate by overusing the gluteus maximus muscles in the hip. This can cause tension and strain in the muscles of the lower back, which can radiate up into the thoracic spine and shoulders.

​Shoulder pain, tightness, and rotation issues are also common among stunt performers and can be caused by compensations from lower limb injuries. Here's 2 examples:

1. Ankle sprains leading to shoulder disfunction
   Ankle sprains can cause compensations in the hip and lower back, which can affect the shoulders. When the muscles in the hip and lower back are weak or imbalanced, the body may compensate by overusing the muscles in the shoulders. This compensation can cause tension and strain in the muscles of the rotator cuff, leading to shoulder pain and tightness.
   
   
2. Knee injuries leading to shoulder disfunction:
   Knee injuries can also affect the shoulders, as well as the thoracic spine and deltoid muscles. If the quadriceps muscles in the thigh are weak or imbalanced, the body may compensate by overusing the muscles in the shoulder and upper back. This compensation can cause tension and strain in the muscles of the rotator cuff, leading to shoulder pain and tightness.

To address shoulder pain, tightness, and rotation issues caused by lower limb injuries, stunt performers can engage in functional movement exercises that focus on improving mobility and stability in the shoulders and upper back. Here are some simple exercises that can be incorporated into a warm-up or cool-down routine:

1. Shoulder dislocates 
   This exercise involves holding a stick or PVC pipe with a wide grip and slowly raising it over the head and behind the back. The goal is to increase mobility in the shoulders and upper back while maintaining a stable core.
2. Wall slides
   Stand with your back against a wall and slowly slide your arms up and down, keeping your elbows and wrists in contact with the wall. This exercise helps to strengthen the muscles of the upper back and improve posture.
3. YTWLs 
   Lie face-down on a bench or stability ball and perform a series of arm movements in the shape of the letters Y, T, W, and L. These exercises help to strengthen the muscles of the upper back and shoulders and improve mobility in the shoulder joint.
   
   

Incorporating these functional movement exercises into a regular training routine can help stunt performers to prevent compensations and improve overall physical preparedness, reducing the risk of injury and promoting long-term health and well-being. However, it's important to note that these exercises should be performed under the guidance of a qualified healthcare provider or exercise professional to ensure proper technique and prevent further injury.

Effective early diagnosis and good physiotherapy and rehabilitation are essential for stunt performers to recover from ankle and knee injuries and prevent further complications. Treatment should focus on restoring strength and balance to the affected muscles and joints, as well as improving flexibility and range of motion. However, it's important to note that linear training alone is not enough to address these issues. Stunt performers must also engage in functional movement training that simulates the dynamic movements and stresses of their work.

Why you should focus on Functional Movement Training, not Linear Training
Functional movement training focuses on improving movement patterns and coordination, as well as strengthening the muscles and joints in a way that prepares them for the demands of real-world activities. This type of training can help stunt performers recover from injuries more quickly and reduce the risk of future injuries by improving their overall physical preparedness.

Awareness of the links here helps us to see that ankle and knee injuries and / or weakness and imbalances can lead to issues in other parts of the body if left untreated, and can be especially problematic for stunt performers.

​Early diagnosis and effective rehabilitation are crucial for recovery, and functional movement training is essential for preventing future injuries and improving overall physical preparedness. By prioritizing their physical health and well-being, stunt performers can continue to create the thrilling on-screen action that audiences love, while staying safe and injury-free.