Does nagging pain in a joint equate to hypermobility? Reaching for something in the cabinet and experiencing clicking in the shoulder, or a minor aching sensation as you grab that heavy pan off the top shelf? Maybe you feel it while playing tennis with a friend, or even just from a morning jog.
You may, or may not, be aware of certain ranges of motion that feel unstable or almost scary to attempt because of shoulder pain. The main question people have when dealing with this chronic nagging sensation is: Will it ever go away? In this article we will cover how to address a hypermobile shoulder. We will also cover the importance of posture, how posture can effect hypermobility, and how asymmetries and other dysfunctions in posture can cause shoulder instability and shoulder weakness.
What is hypermobility and is it dysfunctional?
How do you know if your shoulder is hypermobile? A joint is considered hypermobile when it has an usually large range of motion. This should not be confused with flexibility of a joint. Common signs of hypermobility are frequent joint and ligament injuries, such as dislocations and sprains, pain or stiffness in the joints and muscles, and clicking joints and other recurring injuries around the area of the shoulder. This can include pec pain such as feeling overly stretched, or tight knotted pain under the arm, to the outside of the arm pit or what would connect into the latissimus dorsi. Typically these problems are due to instability in the joints and muscles.
This can lead to the question of “why is my shoulder weak”? When addressing pain in the body it is important to take a look at the body as a whole unit instead of individual components. Viewing hypermobility or an injury in the shoulder as having a “weak shoulder” might be a surface level approach to fixing the pain. It is important to not isolate the shoulder when fixing hypermobility in the shoulder. For example, some people who think they have weak shoulders might do exercises to strengthen their shoulders. This could include but is not limited to the shoulder press, lateral raises, incline dumbbell row, and the Arnold press. They do these exercises or exercises similar to these to “strengthen” their muscles. Then, they will counter their strength routine with some sort of flexibility training like yoga or stretching. These practices can actually be very damaging for someone who suffers from hypermobility in a joint.
The reason this is an issue is because that person already has too much slack in their joints, like a loose rubber back. When there’s slack in the joint, the muscles in the surrounding area won’t be able to support or move the joint within a safe range, putting the joint under unnecessary pressure or loading it with too much weight. This is why it is important to not have a surface level approach to fixing their hypermobility. If someone wants to strengthen their muscles they need to do that in a way that is not compromising to their joints. A traditional approach of isolating the joint and strengthening the muscles around it is not ideal. It accounts for some variables, but not enough to resolve it. And because the joint has slack already, overly-utilizing it in a press or overstretching during yoga, can actually make the situation much worse.
Will my hypermobility ever go away?
When dealing with hypermobility of a joint it is important to be proactive with the care and regeneration of the joint. Problems in the body simply do not just go away. If the hypermobile joint is left untreated it could get worse, leading to more problems in the body and a continuous cycle of injuries and pain in the body. This is can be a frustrating task, because a lot of the solutions on the market actually can worsen the condition - And you can work out hard, thinking you are helping your shoulder, only to end up at another physical therapy clinic trying to fray the loose ends.
Continued overuse of the hypermobile joint could lead to dislocation of the joint, muscle tears, and potentially surgeries. However, surgery does not have to be the only option when dealing with hypermobility. The most efficient way to address hypermobility is to think of the body as a tensegrity model. The tensegrity model represents the body as a mechanically stable structure, composed of compression-bearing struts and tension-bearing cables (1).
Essentially our body is a tensegrity model, it has forces in it pulling in different directions depending on where the tension is oriented. The tensegrity model has rods and bands similar in our structure, such as our bones and fascia. When someone pushes on the model the whole structure is affected. This is similar to our bodies, meaning if someone is dealing with shoulder imbalances it could be stemming from another location on the body, not just the shoulder.
Posture and Hyper Mobility
The relationship between posture and hypermobility is very significant. Typically if someone suffers from hypermobility in their joints, they most likely issues with their posture as well. Think about the body as a building, if the building does not have a structurally sound foundation or frame it will eventually fall apart. You may think that all buildings must fall apart some time, but with a solid structure and maintenance, it can last for hundreds of years. Human beings are the same, requiring structuring and maintenance in the body to last for years to come.
When someone has imbalance in their posture this could result in hypermobility in the joint. Tension needs to be properly oriented in the body for a person to have a stable posture, which will result in less hypermobility in the joints. Balanced tension in a person’s body is a result of bones being properly spaced in relation to each other.
Training in a way that will correct posture and imbalances in the body will result in correcting hypermobility in joints. A way to do that is focusing on the “big four”, standing, walking, running, and throwing. Focusing on these fundamental principles will help change the overall structure of a body which will lead to stability in the joints, in addition to being pain free and reducing injuries when training. The most effective methodology at applying these principles is Functional Patterns. Functional Patterns focuses on addressing imbalances in the body to correcting posture. Addressing posture in a static and dynamic context will ultimately create a more balanced and structurally sound body. Unlike other methods such as a chiro or physical therapy which will isolate the problem area, Functional Patterns will consider changing someone's posture to address the hypermobility rather than just treating the hypermobile joint.
Someone who is struggling with hypermobility, especially with their shoulder, should focus on taking a holistic approach to solving that. Fixing the body as a whole structure will result in a better outcome for addressing hypermobility. Starting with the 10 week online course or finding a Functional Patterns practitioner is a step in the right direction towards addressing imbalances in the body.