Hypermobility and Pilates

Hypermobility is often considered to be an admirable trait someone has. We may hear people say “Look how flexible she is, she can touch her toes!” or “Look what I can do, I’m double jointed”

However hypermobility can often be a root cause of injuries. If you are questioning whether you may be someone who deals with stability issues, joint pain, and would consider yourself ‘pretty flexible’ this article may be very beneficial for you! Knowing where you fall on this spectrum can actually be a valuable source of information and may even prevent injury.

 A study in 2008 looked at post puberty but younger athletes, and it was estimated that 28.5% of females and 6.5 % of these men fell on a spectrum of having a degree of hypermobility.  Females are clearly more affected than males, and as we age, hypermobility becomes less of a factor as our joint motion and connective tissue changes over time.

Hypermobility stems from a connective tissue disorder, in which a person’s body has extreme joint laxity and potentially altered levels of collagen. To understand connective tissue, we understanding that it literally holds the form of joints, structures, and organs in our body. It also moves nutrients, stores fat and repairs damaged tissue.  

Hypermobility is considered to be on a broad spectrum because those with hypermobility do not all present alike. It is quantified based off the Breighton scale. This involves a trained professional such as a physical therapist or Primary care physician assessing your joints for laxity and hyperextension. If you score a 4 or more out of 9 scoring points, you do have a degree of hypermobility.

So on this scale we find those who are mildly hyper mobile, who learn a little bit of stability training and manage symptoms easily… those who are moderately hypermobile, who may experienced joint subluxation or dislocation before, or those who are severely hypermobile, meaning it may affect them daily, with joint pain, fear of injury, and potentially a diagnosis of what’s called Ethos Danlos Syndrome, or EDS.

There are a few different types of EDS but we wont get into all of them. The classic form involves highly elastic connective tissue, as well as symptoms such as fragile or stretchy skin, digestive or cardiac issues, chronic joint pain or joints that are suspectible to dislocating. Those with a high degree of hypermobility may also experience depression and anxiety. There is no cure other than managing the symptoms, however it isn’t known to have a shortened life expectancy.

So, how does this condition affect the mild to moderately hypermobile person?  We’re going to talk about three main activities that are good to avoid.

Repetitive activity, heavy weight lifting, and over stretching.

-       Repetitive activity is extremely hard on the hypermobile individual. Laxity in the joints causes certain muscles to have to work extra hard to support you, which can lead to inflammation and pain.  Do you have a job that requires you in a fixed position every day? If so, how can you change this or alternate between different positions each hour to avoid onset of pain? 

-       Heavy weight lifting can be too difficult for a hypermobile person to manage. While light to medium weight lifting is usually safe with proper training, progressively loading an unstable joint leads to labral tears in the shoulders or hips, and back pain from poor mechanics, even if this person is also committed to stability training.

-       Stretching is most often NOT the answer. Hypermobile people like to stretch because they are GOOD at it. It feels natural and doable. However stretching should be limited to only specific muscles that truly need it, and a physical therapist can help you to figure out where to focus your stretches.

If you’re thinking, “this might be me, and most of what she is saying right now is kind of hard to hear, and makes me wonder how can I manage this condition better?!” I’m here to tell you that Pilates is where you belong. Pilates and barre based principles combine the appropriate amount of Length and tension on the muscles, while also training the spine and core to properly stabilize and avoid overstretching.  It’s an amazing feeling to walk into an exercise class that you know will be appropriately challenging but also incredibly low chance of injury, and can be the absolute best way to manage your instability.

Schedule a free discovery call if you would like to learn more!