Today I am going to talk about hypermobility exercises and specifically what modifications you need to make to have a hypermobility syndrome exercise program that is safe and effective. I have a section dedicated to core exercises for hypermobility. Finally, I answer the question: Do people who have hypermobility syndrome need to be careful with their choice of exercise and should they modify their exercise routine?
Hi. I’m Margaret at MelioGuide, and today I’m covering part three of the hypermobility spectrum disorder, hypermobility exercises.
We will look at elements of exercise as it relates to people who are more mobile than the average individual — people who have hypermobility syndrome.
We will discuss specific challenges and modifications you should make to your exercise routine.
I suggest you go back my first blog on this, so that if you’re wanting a clearer definition of what hypermobility syndrome is all about.
(In the first two parts of this series, I covered hypermobility test and yoga and hypermobility. To determine if you have hypermobility syndrome, I encourage you to complete the hypermobility test.)
Core Exercises for Hypermobility
The following are recommended core exercises for hypermobility.
- Plank exercise.
- Side plank exercise.
- Basic abdominal activation exercise.
- Abdominal activation with a leg drop.
- Abdominal activation with a 90/90 leg drop.
- Advanced abdominal activation with leg drops.
- Horse stance in vertical position.
- Horse stance in vertical position.
Core exercises for hypermobility will help you offset the postural, flexibility and balance issues associated with hypermobility syndrome. I recommend certain clients practice several core exercises for hypermobility.
Each of the core exercises for hypermobility listed above is described in detail in Strengthen Your Core and Exercise for Better Bones.
Here are a few points to consider regarding core exercises for hypermobility.
Benefits of Core Exercises for Hypermobility
Core exercises, when done properly, benefit the back and abdominal muscles, which in turn protect your spine. Core exercises for hypermobility help you establish and maintain a neutral position so that your movements and exercises are executed without causing hypermobility of the joints.
Components of Core Exercises for Hypermobility
Core strength goes beyond the abdominal muscles. It incorporates the diaphragm, pelvic floor, and the muscles of the spine, the hips, and the shoulders. Core exercises for hypermobility are designed to address address all of these areas while delivering the benefits. Here are the key components of program of core exercises for hypermobility:
- Establish a neutral spine position to eliminate or reduce flexion and extension of the spine.
- Integrate the pelvic floor. The pelvic floor is the foundation of core stability.
- Use core breathing from the diaphragm to support your core.
Exercise Challenges for People with Hypermobility Syndrome
Individuals who have hypermobility syndrome have several challenges when it comes to exercise.
Hypermobility and Posture
The first challenge to hypermobility exercises is maintaining perfect posture. Perfect posture is much easier to obtain if you have normal mobility. Because if somebody with normal mobility goes out of range, we can start feeling it, we can feel the tightness in the joints and our ligaments are starting to yell at us a little bit.
I have hypermobile knees and used to just be able to stand with my knees way back (hypermobile knees that went too far back). I could hold this position for a long period and compensate by keeping my hips in a forward position. My lower body never told me (or “cued” me) that I was hypermobile.
However if you’re hypermobile in many parts of your body, you never get that cueing about what your neutral body position needs to be.
Exercise form requires starting in a neutral position. If you are not getting cues that you are hypermobile, then you never get into that starting neutral position. For many people, getting into a neutral position and transitioning into exercise is a huge step.
It’s critical for somebody that has hypermobility syndrome to have a teacher that:
- Teaches them well
- Looks at how they are moving and makes sure that they are moving within a safe range of motion.
- Makes corrections as they are needed.
Hypermobility and Alexander Technique
At the hypermobility.org website they talk about the “Alexander Technique“. Check it out.
Physical Therapy for hypermobility syndrome is also important. However, make sure that the practitioner is trained in movements and teaches you proper hypermobility exercise and movements.
Because a lot of people with hypermobility have pain, passive modalities in treatment might not be as effective as learning proper hypermobility exercise and movements. To get out of the pain spectrum you need to learn to move well.
Hypermobility and Flexibility (Stretching)
The second challenge for individuals with hypermobility syndrome are their flexibility exercises — often seen in yoga. If you practice hypermobility exercises, you might need to adjust your stretching routine.
As I mentioned in the blog on yoga and hypermobility you need to learn how to stretch the muscles that are tight and not over stretching the joints that are already loose. That’s very critical if you have hypermobility syndrome.
Hypermobility and Balance
The third challenge to hypermobility exercises is balance.
Because your joints are so much more mobile, you’re not getting proper feedback on your balance.
Your little joint receptors that give your brain that information, the proprioceptors, aren’t firing as quickly as those for of individuals who have less mobile joints.
Safe and effective balance exercises and gradual progression of balance exercise is very very critical for individuals that have hypermobility syndrome.
Hypermobility and Osteoporosis
A study (1) going back to 2006 looked at 25 premenopausal women that were prediagnosed, using the BeightonHypermobility Scale, as being benign hypermobile or having the Benign Hypermobility Syndrome.
The researchers matched this group with 25 age-matched controls. All of the women in the control group were Caucasian. Further, they matched in terms of:
- Body mass index.
- Number of pregnancies they had had.
- If they had nursed.
- How many years they had nursed or lactated for.
- Their calcium intake.
- Physical activity level.
This is a very good control study in the terms of matching all of the characteristics that we know affect our bones.
The researchers looked to answer the following questions:
- Was there a difference in their bone mineral density at the hip — specifically the trochanteric bone mineral density?
- Was there a risk for lower bone mass?
The research team found that the women diagnosed with Benign Hypermobility Syndrome showed a decrease in the bone mineral density at the trochanteric site located at the hip and demonstrated an increased risk for low bone mass, by as much as 1.8 times, compared to the control group.
What does this mean?
If you are hypermobile and you are premenopausal, I strongly encourage you to have a bone mineral density test well before the recommended age of 65.
If you have hypermobility syndrome, your approach to exercise and movements needs to be different than most people. You should have a better idea of adjustments you need to make to your exercise regime. Your persistence in safe movement (during exercise and your activities of daily living) will lead to you having a healthier and stronger body.
- Gulbahar S, et al., Hypermobility syndrome increases the risk for low bone mass. Clin Rheumatol, 2006 Jul:25(4):511-4
Visit my page dedicated to Joint Health.
Debbie Stier says
Thank you for validating me. I am hyper mobile right hip greater trochanter and this where I have severe osteopenia (both hips) I have exercised for years and always explain to my trainers why I am so careful. My left side works very hard to balance my right. Recently I fell in a cafeteria, did not fracture anything, but my training has been interrupted other than core strengthening. I am fortunate of my body awareness. I appreciate your emails. I am 64 years old. My hips often ache, any suggestions?
Margaret Martin says
Hi Debbie, You are very welcome! Sorry to hear about your fall. Most of my hypermobile clients tell me that falling has been a yearly occurrence going as far back as they can remember.
As I mentioned, try to limit the amount of stretching. Ensure that you do not have any trigger points in the hip muscles or surrounding muscles. Culprits after a fall include gluteus medius, quadratus lumborum, deep hip rotators including piriformis, to name a few. If you take a soft tennis ball between you and the wall you may be able to identify some areas that need some attention (trigger point massage). You may wish to seek the assistance of a Physiotherapist with good hands or a massage therapist or you could do some of this work yourself.
An excellent guide is the Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief by Davies, Davies and Simons, available at: Amazon: https://amzn.to/2BFEiNT
Be sure to get rid of your trigger points before you start strengthening again.
All the best, Margaret
Diana Mackenxie says
I have hyper mobility in many joints, and when lifting weights, 3kg, my elbows hurt. My physio said it was Bowler’s Elbow as it only hurts on the inside. As I have severe osteoporosis, I am anxious to increase the weight, but am unable to do this without pain. Any ideas how to resolve this problem, and alleviate the pain?
Rosemary Erickson says
Margaret, I truly appreciate the info you share. Do you have references in NJ for specialists who treat women with hypermobility? I have been to different PT and trainers who claim to have experience with such, but indeed, do not…very frustrating!
Margaret Martin says
Ask your Physiotherapist to look at your lifting technique. She/he should be able to identify if there is something you are doing during your lifting. Issues I see with my hypermobile clients include incorrect the position of their wrists, especially at the top of the lift or overextending at the bottom of the lift.
Richard Martin says
Hi Rosemary: Thanks for your inquiry. Sorry, we cannot suggest someone in the New Jersey area who can treat hypermobility.
Is there any advice on how to do some of these exercises to strengthen core muscles when you have severely unstable wrists? I can not do a plank or push up style of exercise as just putting my hands flat on the floor or a wall (not even supporting body weight) causes my wrists to bend to a very weird angle & my fingers all subluxate if any pressure is applied. Then my elbows rotate/pop out of position & my shoulders subluxate too. Even when I was a kid doing ballet I had that issue – could never figure out how to hold my joints straight.
Lots of advice seems to assume you know what the words mean for the exercises or tell you to activate certain muscles and I don’t know how to do that. I can’t even do sit ups! I don’t know how to make my stomach muscles do any pulling. If I lie backwards off the edge of a bed (bending backwards at the waist) I can pull myself back up to lying flat or partially sitting up, but from flat on the ground I can not. I’ve also never been able to touch my toes from standing nor sitting and sitting with my legs straight out in front of me makes my legs go numb – all pins and needles! In less than a minute. And my knees pop inwards which isn’t pleasant. My kneecaps shift & lock in place if I kneel at all.
Most strengthening exercises seem to require the use of those kinds of positions which feel impossible for me to do. I feel like there should be info on how to strengthen hand muscles and wrist muscles an so on first as how can you hope to strengthen everything else if you can’t even move your hands and feet without them subluxing or dislocating?
Margaret Martin says
I am sorry to read about all your challenges. I hear your frustrations as there are not many services in North America for individuals on the hyper mobility spectrum.
Specific to your questions/comment I can assist with two points:
1. For wrist strengthening view: https://melioguide.com/osteoporosis-exercises/grip-strength-important/
Part I will not be appropriate for you but Part II will be.
2. Follow my book Strengthen Your Core. It will walk you through many gentle and gradually more challenging core exercises that you can do from your forearms. https://melioguide.com/products/strengthen-your-core/
3. A helpful web site is http://www.Hypermobility.org
4. I encourage you to find a health care professional familiar with hyper mobility who can assist you with your unique challenges.
Wishing you more body control in 2020.
Can you use resistance bands if you have Hypermobility?
Richard Martin says
Hi Cameron. Thanks for your question. You can use resistance bands but you should loop them the way Margaret describes in Exercise for Better Bones. Depending on the exercise, a resistance band with handles would be more appropriate because it makes it easier for you to keep your wrists in a neutral position.
Hi Richard I am a male at the age of 20 & I do have Hypermobility I lift weights on the week days & sometimes when I get done working out & it feels like my bones can barely hold my muscles & it feels like my bones gets stress on them. Were can I go online too make them stronger? Exercises
I am 34 years old, I have an osteopenic spine, spondyloepiphyseal dysplasia (a very mild case that has manifested as malformed C1 and L5, shallow shoulder and hip joints, squared femoral heads and slightly barrel chested) osteoarthritis and cysts in my shoulder, and hypermobile through the spine and joints.
Fitness has played a huge part of my life through the last 10 years, but I am struggling hard since turning 30. Staying consistent in the gym is impossible as there is ALWAYS an injury or problem spot (and they are usually in the back and neck), and I cant seem to find anyone knowledgeable enough in these things to help! My latest issues are a ‘slipping rib’/joint where my rib meets my spine causing severe inflammation and nerve pain, intense muscular ache and pain in my groin and pelvic region, and nerve pain in the neck that is flared up very easily (planks flared the rib joint up, and boat pose flared the neck up!). Could you recommend a few exercises or ANYTHING to help strengthen this supportive muscles around my spine so I can continue with my training? Thank you and Im so happy I found your website.
Richard Martin says
Hi Sheena. Margaret is unable to provide specific medical guidance without an assessment. If you are interested in this service, please read the following:
Thank you for this information. I still look for more help for my daughter. She is 13 years old, and she frequently has her hip, ribs/spine, knees or ankles dislocate. We went to the doctor, xray, PT with little improvement. I was wondering if you have specific point of view regarding kids.
Richard Martin says
Hi Elena. Thank you for contacting us. Your daughter’s situation requires the attention of either a Physician or Physical Therapist. Margaret is unable to provide specific advice without an assessment. Since you have already tried a PT and Physician but are not satisfied, I recommend you try another PT or Physician. Hope it works out for you.