Training with Hypermobility

The first thing that comes to mind when someone says “training” is usually training for sport or exercise. There are many different types of training: strength, endurance, flexibility, conditioning, etc.

But what about hypermobility? What does it mean exactly? How do you train for hypermobility?

Hypermobility refers to a group of conditions in which joints have been stretched beyond their normal range of motion (ROM). These include RSI, OA, patellofemorphy, scoliosis and other forms of joint hypermobility. Many of these conditions are genetic in origin and may not respond well to traditional rehabilitation methods such as physical therapy or orthopedic surgery.

Hypermobility is often associated with pain because it causes the body’s protective mechanisms to fail. For example, if your knee is constantly inflamed, it will eventually become so painful that you’ll stop using it. Other times, the condition may cause symptoms like numbness or tingling in certain areas of the body.

Hypermobility can affect any joint in the body but most commonly affects those involving the spine and hips. It is generally considered to be a chronic condition because there isn’t always an obvious trigger for its onset. It is not currently known whether the condition results in degenerative changes in the joints over time.

It has, however, been shown to be a heritable condition, which means it is passed down through families.

Hypermobility Training

If you have been diagnosed with hypermobility or another condition involving loose joints, you may have a hard time with training. The pain caused by these conditions can make physical activity unbearable and limit your ability to properly train for other sports or activities. While there are many different treatment options for these conditions, it is best to start with a proper warm up and stretching routine.

This can help increase flexibility and reduce pain caused by inflamed or unstable joints.

Warm Up

When you begin any physical activity, a proper warm up is essential to prevent injury and prepare the body for further activity. Warming up increases core body temperature, heart rate, blood flow and flexibility. A proper warm up should include both cardiovascular exercise and stretching.

A good warm up for hypermobility training should last at least 10 minutes.

Stretching

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Proper stretching is essential when training with hypermobile conditions. Stretching should always be done after a warm up and should target all of the major muscle groups used in the activity you’ll be doing, in addition to any areas affected by joint instability. This can include stretching the:

Hamstrings

Calves

Quadriceps

Hips

Groin

Lower Back

Upper Back

Shoulders and chest (if applicable)

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Stretching should be held for at least 15-30 seconds and should never cause pain. Some areas may not need to be stretched before physical activity if they do not suffer from hypermobility or conditions related to it.

Strength Training

Once you’ve completed your warm up and stretching routine, you can begin the strength training portion of your hypermobility training. It is essential that you talk to a physician before beginning any strength training routine. This will help rule out any medical conditions that may prevent you from participating in high intensity training or cause complications.

Your doctor can also advise you on any precautions you should take when performing certain exercises.

Most hypermobile individuals will experience pain when certain areas are used a high level of intensity. For this reason, it is important to start slow and ease into training. This can also help prevent against injury caused by overexertion.

Your routine should focus on strengthening the muscles around loose joints as well as increasing overall muscular endurance and cardiovascular fitness. With adequate rest and recovery time, you should begin to see improvements in your condition after 3 months of training.

One of the most common conditions related to hypermobility is decreased bone density. This may be caused by a combination of reasons such as poor nutrition, mineral deficiencies and overall inactivity. The best way to combat osteoporosis is through diet and consistent weight-bearing exercises.

Osteoporosis can be prevented by:

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Eating foods rich in Vitamin D, Calcium and other essential minerals. Some examples of these are: milk, leafy greens and sardines.

Performing weight training that targets the muscles surrounding your bones (i.e. your legs if you have issues with your hip or spine).

This will increase bone density and strength.

Getting regular exposure to sunlight. This allows your body to naturally produce Vitamin D, which helps strengthen your bones and improves their ability to absorb calcium.

As a hypermobile person you’re at risk of developing specific injuries related to your condition. These can range from mild to quite severe and are not limited to physical symptoms alone. Some injuries may not appear until years after the initial onset of hypermobility or trauma that caused it.

Some common injuries related to hypermobility are:

Muscle tears and strains

Joint dislocation

Chronic joint pain (Not related to sports injury)

Stress fractures (usually in leg bones)

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Ligament tears and stretching

Hyperextension of joints (breaks in cartilage or bone)

These injuries may increase your risk for developing Osteoarthritis, a painful condition caused by poor quality or damaged joint cartilage. It is the most common form of arthritis and can severely impact your quality of life as you age. There is no known cure for Osteoarthritis, however there are exercises that can help decrease and prevent further damage to joints.

Talk to your physician before attempting any of these exercises.

Another risk you may experience is emotional trauma as a result of your condition. It’s common for people suffering from a disease or condition to experience depression, anxiety or feelings of powerlessness. These negative emotions can be more detrimental to your overall health than the condition itself.

It is important to stay positive and surround yourself with loved ones who support you.

As a person with hypermobility, you’re prone to developing specific nutrition deficiencies. It’s important that you make healthy food choices and take supplements, when necessary. Discuss your diet with a doctor or dietician to see if you’re meeting your daily caloric and nutrient needs.

Some of the most common nutrition issues related to hypermobility are:

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Calcium Deficiency – Without enough calcium in your diet, your body is unlikely to have the strength to support itself. This can lead to bone fractures and further complications. Calcium is an important mineral that helps regulate muscle contractions and strengthens your bones.

Good sources of Calcium include milk, leafy greens and certain types of fish. Check with your doctor or dietician to see if you’re getting enough.

Vitamin D Deficiency – Vitamin D is an essential nutrient that helps the body absorb Calcium and keeps the immune system healthy. This can be found in fatty fish like salmon, egg yolks and fortified cereals. If you’re not getting enough of these foods in your diet, ask your doctor about taking a daily Vitamin D supplement.

Omega-3 Fatty Acids Deficiency – Your body needs these nutrients to keep your joints and muscles functioning properly. Without them, you may experience thin, weak or brittle bones, muscle fatigue and inflammation. Good sources of these acids can be found in oily fish like tuna, in vegetable oils like olive oil or in nuts.

If you don’t consume enough of these foods, talk to your doctor about taking a daily Omega-3 supplement.

Glucosamine and Chondroitin – There is a lot of controversy over the effectiveness of Glucosamine and Chondroitin supplements. Some people with JHS take these to relieve pain, increase joint mobility and slow cartilage damage. Talk to your doctor or dietician about whether these supplements are right for you.

These supplements aren’t intended to treat or cure any medical conditions. Always talk to your doctor before taking any dietary supplements.

Warm up and stretch properly before and after physical activity

Practice “mindfulness” to decrease your risk of getting distracted and causing yourself an injury

Use proper form when performing strength training exercises

Don’t overwork a specific muscle group by pushing yourself too hard or continuing an exercise past the point of fatigue

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Listen to your body. Most injuries occur as a result of the body being pushed too hard.

Sources & references used in this article:

A study of UK physiotherapists’ knowledge and training needs in Hypermobility and Hypermobility Syndrome by MJ Lyell, JV Simmonds… – Physiotherapy Practice and …, 2016 – content.iospress.com

Joint hypermobility–asset or liability? A study of joint mobility in ballet dancers. by R Grahame, JM Jenkins – Annals of the Rheumatic Diseases, 1972 – ncbi.nlm.nih.gov

Hypermobility and joint hypermobility syndrome in Brazilian students and teachers of ballet dance by SB Sanches, GM Oliveira, FL Osório… – Rheumatology …, 2015 – Springer

Benign joint hypermobility syndrome in soldiers; what is the effect of military training courses on associated joint instabilities? by K Azma, P Mottaghi, A Hosseini, HH Abadi… – Journal of research in …, 2014 – ncbi.nlm.nih.gov

Hypermobility and the hypermobility syndrome by JV Simmonds, RJ Keer – Manual therapy, 2007 – Elsevier

Symptomatic joint hypermobility by BT Tinkle – Best Practice & Research Clinical Rheumatology, 2020 – Elsevier

Physiotherapists’ knowledge and management of adults with hypermobility and Joint Hypermobility Syndrome in the UK: a nationwide online survey by M Lyell, J Simmonds, J Deane – Physiotherapy, 2015 – physiotherapyjournal.com

A hypermobility study in ballet dancers. by P Klemp, JE Stevens, S Isaacs – The Journal of rheumatology, 1984 – europepmc.org

Dynamic balance ability and hypermobility in pre-school children who participate gymnastic training by İ KESİLMİŞ, A Manolya – Gaziantep Üniversitesi Spor Bilimleri …, 2018 – researchgate.net