Crowds stare in amazement at the flexibility of circus performers. Yet, what appears a gift can be a curse as well. People with hypermobile joints often experience dysfunction and pain. Choosing the right exercises — and avoiding the wrong ones — can help you manage this challenging condition.
Read more: Child's Flexibility Issues
Learn About Hypermobility's Prevalence
Epidemiologists give disparate numbers for the prevalence of hypermobility. Estimates range from 2 percent to 57 percent of people, according to a 2015 paper in the Journal of Pain Research. These numbers mostly depend on the population chosen.
A 2015 report in Clinical Rheumatology looked at the prevalence of hypermobility in college students. The researchers used a strict set of criteria for the diagnosis of generalized joint hypermobility disorder. About 26 percent of the students met these criteria.
Gender plays a role in hypermobility. In the 2015 report, about 37 percent of the women and 13 percent of the men tested had hypermobile joints. Healthy women also tend to show greater flexibility than men, according to a 2017 article in PM & R.
Age doesn't seem to affect these numbers. For example, about 7 percent of children and 7 percent of elders show hypermobility. Genetic factors, however, seem especially relevant. More than 90 percent of kids with a genetic predisposition for hypermobility end up showing the condition.
Certain activities are also associated with hypermobility. Musicians, for example, often have hypermobile fingers. A 2017 article in BMC Musculoskeletal Disorders noted the high prevalence of hypermobility in gymnasts, swimmers and dancers as well. A 2013 paper in Clinical Rheumatology suggested that hypermobility leads to greater success in such activities.
Know Hypermobility's Signs
Some genetic conditions will predispose you to have hypermobile joints. For example, people with collagen tissue disorders like Ehlers-Danlos syndrome typically have hypermobility as one of many symptoms.
Healthcare professionals should encourage people with hypermobility to seek medical attention. Prompt awareness of an underlying genetic disorder can help you begin seeking evidence-based care. By doing so, you can avoid the possibly fatal consequences of these genetic disorders.
Be Aware of Hypermobility's Symptoms
People with hypermobile joints can usually move their joints beyond the normal range. Yet, a professional should document this unusual flexibility and compare it to established norms. Being bendy can have consequences like muscle pain, bruising, fatigue and injury. Hypermobile people also seem at risk for gastrointestinal problems, and diagnostic tests may show evidence of white matter lesions.
Hypermobility can affect your mental health as well. A strong correlation exists between joint laxity and anxiety, according to a 2015 paper in Advances in Psychosomatic Medicine. This relationship may cause hypermobile people to overreact to frustrating and sad situations.
Read more: What Causes Stretch Marks on the Legs?
Know Hypermobility's Treatments
Most people with diagnosis of hypermobility receive advice from a physical therapist, according to a 2016 report at the IFOMPT Conference. These healthcare professionals typically recommend hypermobility exercises, and most patients see the therapeutic value of this approach. Yet, the patients must overcome substantial barriers like fatigue and pain. They also have a reasonable fear of injury.
Do Closed Chain Exercises
A 2017 article in the Journal of Education, Health and Sport recommended stabilization exercises for people with hypermobility. These movements rely on closed kinetic chain exercises, which increase muscle awareness and work many joints. Examples include power squats and rowing. A 2016 paper in Senses and Sciences looked at the impact of closed chain exercises in patients with hypermobility.
In one study, participants did eight weeks of workouts for hypermobility. The researchers gradually increased the intensity of the closed chain exercises throughout the experiment. Compared to baseline, the subjects showed dramatic improvements in proprioception, strength and skill.
Do Muldowny Exercises
Kevin Muldowny has developed the first program specifically for hypermobile patients. A 2018 report in the Journal of Novel Therapeutics described the two phases of this program. Phase one focuses on a gradual strengthening of the muscles surrounding all joints, using resistance exercise. Phase two features throwing and twisting movements as well as balance challenges.
The program begins in the clinic and continues in the client's home. It requires about an hour of exercise three times a week. A first test showed a dramatic improvement in client function within a year.
Do Resistance Exercises
The elongated connective tissues found in hypermobile people could place them at risk for injury, according to a 2017 paper from Winthrop University. Resistance exercises like weightlifting should strengthen connective tissue and lower this risk.
A 2015 thesis from Auckland University tested this hypothesis in adolescent dancers with enhanced flexibility. Participants did nine weeks of intense weightlifting. They reported to the gym twice a week. Compared to controls, girls in the treatment group gained much strength by the end of the study. The intervention also improved their dancing ability and increased their technical skill, and no injuries were reported.
Read more: Exercises for Hypermobile Knees
Do Posture Exercises
People with hypermobile joints typically have posture issues, according to a 2013 report in the journal Research in Developmental Disabilities. In fact, poor posture is common even in hypermobile people without a genetic condition. A study reported in a 2017 paper in Rheumatology International tested the effect of a lumbar spinal stabilization exercise program on posture in hypermobility.
The program featured exercise balls and elastic bands. It progressed from static training to dynamic training and then on to functional training. Participants exercised three times a week for eight weeks. Compared to controls, the women in the stability program showed improved posture. The treatment also increased their muscular endurance and decreased their pain.
Know Hypermobility's Limitations
Exercise provides many health benefits, including an increase in heart health and a decrease in disease risk. Hypermobile people, however, often experience joint dislocations during training. Thus, it's important for them to work with a healthcare professional on proper technique. Personal trainers will also discourage people with hypermobility from doing certain exercises.
Don't Do Open Chain Exercises
A 2016 report in Trends in Sports Sciences looked at joint mobility in water-based athletes. The results showed that rowers had less mobile joints than swimmers. The rowers also had fewer injuries and less pain. The author attributed this finding to the open kinetic chain found in swimming.
Open kinetic chain exercises isolate the joints and don't give you a base of support. Examples include bench presses and swimming. Open chain exercises produce more cutting force at the joint, according to a paper from the University of Southern Maine. Hypermobile people can avoid these large shear forces by doing closed chain exercises.
Stay Away From Team Sports
A 2017 article in Sports Medicine described the challenges traditional sports like basketball, hockey and soccer place on your body. The athletes in these sports change direction or speed hundreds of times during a typical game. These changes put extreme stress on your joints, according to a 2016 study in the International Journal of Sports Physical Therapy.
Hypermobile athletes are more likely to experience joint dislocation while participating in team sports, according to a 2018 paper in BMJ Open Sport and Exercise Medicine. They also take longer to recover. A 2013 study in the British Journal of Sports Medicine found a similar tendency in athletes participating in contact sports.
Don't Do Certain Stretches
Athletes benefit from hypermobility — to a point. Dancers tend to show hypermobility at several joints, according to 2016 review in Sports Medicine. Having a bendy spine, ankle and hip joint allows them to create aesthetic poses. However, there's no competitive advantage of increasing the flexibility of your elbow, knee and wrist.
Hypermobile people have to learn to limit their range of motion in these joints — not expand it. Thus, people with hypermobile joints should avoid stretching exercises that work their elbow, knee and wrist joints. They should instead focus on gaining joint awareness.
Is This an Emergency?
- Journal of Pain Research: Chronic Pain in Hypermobility Syndrome and Ehlers–Danlos Syndrome (Hypermobility Type)
- Clinical Rheumatology: Prevalence, Injury Rate and, Symptom Frequency in Generalized Joint Laxity and Joint Hypermobility Syndrome in a "Healthy" College Population
- BMC Musculoskeletal Disorders: Functional Consequences of Generalized Joint Hypermobility
- Clinical Rheumatology: Hypermobility in Dance: Asset, Not Liability
- Advances in Psychosomatic Medicine: Joint Hypermobility, Anxiety and Psychosomatics
- Journal of Education, Health and Sport: Deep Stabilization Muscles Training in Patients With Polyarticular Hypermobility
- Sense and Sciences: Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type
- Journal of Novel Therapeutics: A Novel Exercise Protocol for Individuals with Ehlers Danlos Syndrome
- Winthrop University: Perceived Importance of Resistance Training in Collegiate Dancers
- Auckland University: Effects of a Training Intervention on Strength, Power and Performance in Adolescent Dancers
- Research in Developmental Disabilities: Measuring Regularity of Human Postural Sway Using Approximate Entropy and Sample Entropy in Patients with Ehlers-Danlos Syndrome Hypermobility Type
- Rheumatology International: Effects of Spinal Stabilization Exercises in Women With Benign Joint Hypermobility Syndrome
- Trends in Sports Sciences: Polyarticular Hypermobility and Its Consequences in Rowers and Swimmers
- University of Southern Maine: Post-surgical Rehabilitation for the Anterior Cruciate Ligament
- Sports Medicine: Activity Demands During Multi-Directional Team Sports
- International Journal of Sports Physical Therapy: Biomechanics and Pathomechanics of the Patellofemoral Joint
- BMJ Open Sport and Exercise Medicine: Hypermobility and Sports Injury
- British Journal of Sports Medicine: Hypermobility: A Risk Factor for Recurrent Shoulder Dislocations
- Sports Medicine: Stretching the Spines of Gymnasts
- PM & R: Gender-Dependent Differences in Hip Range of Motion and Impingement Testing in Asymptomatic College Freshman Athletes