Hypermobility and Training for Stability

Introduction

We’ve all known at least one person who seemed to be double-jointed! This phenomenon of loose joints is becoming quite common, affecting up to 25% of the population. This extreme range of motion in the joints can be classified as hypermobility. 

On the surface, excess range of motion doesn’t sound like a big deal. In the fitness world, more is always better, right? Well, maybe not. 

Let’s examine how to identify hypermobility, how a healthy vs. hypermobile joint functions, and how we can train to stabilize loose joints. 

What is Hypermobility?

Your joints are an area where sturdy ligaments connect two bones. Hypermobility is characterized by a laxity (looseness) of the ligaments surrounding a joint that allows the joint to move to extremes. You can have hypermobility in one joint or many joints. 

Hypermobility vs Flexibility

On the surface, hypermobility looks like flexibility. However, hypermobility refers to joints and ligaments, while the length potential of muscles and fascia determines flexibility. In an attempt to become more flexible, one could potentially push stretching too far to the point that they start to overly lengthen the ligaments and attachments in their joints, which can destabilize the joint much like how they might feel in hypermobile individuals. The tough part is knowing when you are stretching a muscle versus stretching the ligaments, not everyone can tune into what is being worked inside their bodies. If you don’t know the difference between your joints being hypermobile vs flexible, the safest solution is to avoid extreme stretches.

Hypermobility exists on a spectrum, with some cases going mostly unnoticed and more serious cases correlated with many uncomfortable symptoms.

• Clicking in joints
• Chronic joint pain
• Unusual fatigue after normal activities
• Increased risk of joint dislocations, subluxations 
• Increased risk of soft tissue issues such as ligament tears, muscle sprains, or tendonitis
• Premature joint deterioration
• A lack of proprioceptive awareness leading to problems with coordination or balance
• Digestive issues such as IBS
• Anxiety disorders

The Hypermobility Test - Am I Hypermobile?

The standard assessment used to gauge hypermobility is a test called the Beighton score. 

• Bending the knees backward is a sign of hypermobile knees. 
• Bending the elbows backward indicates hypermobile elbows.
• If you have had multiple shoulder dislocations, this indicates hypermobile shoulders.  
• Finger and wrist hypermobility is displayed by bending the little finger backward 90 degrees or more and bending a thumb to the forearm. 
• Touching your palms flat to the floor without bending the knees indicates a hypermobile spine and hips. 

Have you ever tested your joints using a hypermobility test? If you’ve attended a yoga class for the first time and noticed that you can stretch into ranges that others struggle to reach and can push yourself into positions without ever having to practice them before, there may be a chance you have hypermobile joints. This is not an immediate issue, but later down the line, it can lead to unstable joints.

Joint Stability

In a functional body, the balanced tension of the muscles, ligaments, and fascia will keep the bones positioned correctly in space. Someone with hypermobile joints will not have the necessary tension to maintain the correct position of their bones, especially during movement. 

You want your soft tissues to buffer forces so that your joints feel supported, similar to how suspension works to buffer sudden forces in your car. Suspension systems absorb force from sudden stops or bumps and overall make the driving experience comfortable. Once the suspension is damaged, you begin to feel more of the impacts while driving, the alignment may be off, and the vehicle can become difficult to steer. This is similar to what happens when your joints are loose. 

Imagine taking those joints for 10,000 steps daily or performing a high-intensity workout. It’s not hard to see how wear and tear can accumulate on unsupported joints and lead to serious degeneration and pain down the line. 

Training with Hypermobility

It should be obvious by now that all movement is not good movement for people with hypermobility. Stabilizing loose joints requires a precise approach.

What type of training makes sense for hypermobility? What can we do to improve joint stability?

It’s essential for people with loose joints to learn about their joint positioning and stabilize their joints in a way that relates to normal human activities. If you are looking at more holistic ways to approach joint instability, you might be interested in hypermobility exercises. However, the type of exercises you will find designed for hypermobility might only serve as a bandaid for pain. To address the root cause of hypermobility and permanently address its symptoms, we need to ask a few fundamental questions: What ranges of motion are necessary for life? When does my body default to a poor position that harms my joints? How do I activate the correct muscles to control my joint range better?

As attractive as it is to follow an exercise program associated with an internet search on hypermobility exercises, the focus should be on improving your movement. Functional Patterns does this best by focusing on the fundamental human movements of standing, walking, running, and throwing. Any normal day-to-day activities will be a byproduct of standing or walking mechanics. You might also have to squat, lunge, or bend over to pick something up, but none of those daily movements entail a large range of motion. People with hypermobility need to focus on creating proper muscle engagements through relevant ranges of motion to stabilize their vulnerable joints. Most hypermobility programs will be geared towards getting you out of immediate pain or avoiding ranges that may cause the pain, but this won’t make you move better.

While walking, for example, a large portion of the impact would be absorbed and redistributed by your glutes and hamstrings. In FP, we teach those muscles to fire throughout the entire range of motion. We also teach the glutes and hamstrings to work in unison with the muscles of the core to provide stability to the hips.

Using this framework, improvements can be made with any joint, from hypermobile hips to hyperextended elbows or knees. It’s all about getting more muscles working together to position the bones correctly. 

A great way to improve joint stability is to analyze and work on your posture. Begin with basic joint stacking and then learn to apply good muscle tension around each joint. In the Functional Patterns 10-week Online Course, you can learn how to build this fundamental joint stability. This easy-to-follow course teaches you in-depth how to control your joints to prepare you for the movement requirements of daily life. 

Train intentionally and not habitually.