Hypermobility and Exercise (or Strength Training)
A week or so ago I got an email from a student asking about hypermobility and exercise. She was specifically asking if there is an online strength training programme I knew of, designed for people with hypermobility. I have to say, I’ve not come across such a programme (let me know if you do). However, I’d say that it would be good to find a trainer who has overcome the problems associated with hypermobility within their own body.
It is my experience that when it come to hypermobility and exercise, “it’s not what you do, but the way that you do it.” With this in mind, below are some movement strategies to incorporate into your exercise, sport or movement practice if you are hypermobile.
There’s More to the Core
Core strength is much talked about in movement disciplines and it’s certainly an important aspect when we are considering hypermobility and exercise. Certainly, if you have hypermobility issues it’s important to strengthen the core, but in a more holistic way. Rather than simply working on a few muscles in isolation, it’s about joining up muscle groups. To truly get out of pain, and learn to support the joints, it’s important to establish a connection from the ground to the centre – the spine. If you think of how deep and central the spine is to our musculoskeletal system, it could certainly be considered as the essence of our core. Can you connect the sense of your feet on the ground to your pelvic floor; deep abdominals and spinal muscles (multifidus) lengthening? Can you continue the lengthening all the way up which comes from the diaphragms of the arches of the feet, the pelvic floor and the breathing diaphragm? You know when you’ve got this… your body feels long and strong; your shoulders, neck and jaw are relaxed.
In relation to the subject of diaphragms, we have to consider the breath and the breathing diaphragm. We need a balance between in inhale and exhale. In relaxation and rest we need to be able to descend the diaphragm (so that the belly moves out and the pelvic floor responds with a widening). When we are lifting, walking, running, pushing we need to be able to engage the pelvic diaphragm to support the lower back and our joints in general.
These actions need to be practiced consciously so that they become unconscious programmes that can run in the background of our lives. This means the muscles (in this case the pelvic and thoracic diaphragms) shorten and lengthen, according to what is needed, without our conscious will.
It’s all About Connection
The work of connecting the dots from ground to spine and through the diaphragms is what enabled me to come out the pain I’d been experiencing since my early teens. I would get pain in my back, neck, shoulders, hips, knees due to hypermobility and excessive tension, this would cause headaches and fatigue. Thanks to my teacher Sophie Hoare for patiently and creatively explaining the way to connect with gravity. I remember a particular incident in her class when it all clicked – I was doing Tree Pose. Since then, I view joint pain as a teacher and a guide; not an enemy to be feared. For me the shift in somatic awareness meant that I could come out of joint pain, at will, in the moment. It was like magic. Working to establish connections in the body (or more accurately, the soma) it feels to be as if my movement gets more connective tissue based. This is a different sensation than the old style muscular-skeletal “lever and pulleys” sensation, which feels less juicy and connected, less supportive and more mechanical. I believe that many of us find these inner connections naturally. However, some people – especially hypermobile people – need to be taught how to have this connected connective tissue experience.
Connecting to Centre
Another way of working that’s helped me, is to connect back inwards. Hypermobile people tend to be expansive and floppy, their joints move beyond normal range. We love to over extend ourselves!! This all needs reigning in. This means learning to engage the stabilising muscles of the joints. We literally need to learn “pull ourselves together” in a quiet and thoughtful way. How can you relate a limb or a hand or even a finger back towards your spine? Can you feel how when the spine lengthens, the whole body draws inwards and upwards to support that length?
Find Your Comfort Range
One way of alleviating all the extra stress we are putting on our joints by over extending them, is to limit our range of motion. This is controversial, and it’s certainly not a long term solution. Yet, for me, it was the main way I got out of pain. I found it helpful to spend a year or so habitually consciously holding my knees ever so slightly flexed, rather than unconsciously pushing them back and over extending. This tai chi like stance helped to take the pressure out of my knee joints and strengthen my quads (front thigh muscles that help to support the knees). In my yoga standing postures, I still do bring a little micro-bend into my knee joints to stop that stress on the knee joint and the loss of energy through that joint. I took to supporting my knees with a rolled up blanket in seated forward bends. This all helped enormously. Do be aware that this example might not be the right approach for you as an individual (for instance if your quads are tight this won’t be helpful at all).
Location. Location. Location.
Another movement strategy that helped me was to locate my humerus (upper arm bones) and femur (thigh bones) back into their sockets. Often there is a slight sense of these bones not quite sitting clearly in their sockets. With arms it can feel like a heaviness, a kind of dragging or limpness. With the thigh bones it can feel like the ball of the femur is not quite in the socket and it tend to make a “clunk” sound in certain movements. Bear in mind the head of the femur sits deeply in the hip socket, and it does not dislocate. To work with this play around with reaching out from, and then locating back into, the joints in question. For instance, reaching forwards with your arms and then pulling the upper arms bones back in to the shoulder sockets. This helps the brain to connect with those stabilising muscles around the shoulder joints. These muscles that might be a little switched off and dull. This is one way to wake them up.
Going slowly is another important tip for the hypermobile person. When we slow down our brain, we can catch up with the movement we are making. This enables us to bring more consciousness into the movement, rather than relaxing back into our habitual movement patterns (that is likely to cause stress in the joints). Slowing down is how we can recalibrate the tension held in a muscle. Contracting and then slowly releasing a muscle (known in Hanna Somatics as a pandiculation) is the way we increase the flow of information along the sensory and motor nerve pathways to and from the muscle fibres. Once we have an increased awareness through the sensory nerves of the tone of the muscle, the our nervous system will recalibrate the tone in the muscles, to a more appropriate level. Pandiculation also helps to increase our ability to engage the muscles fibres so the muscles appears to be stronger and more awake after this work. By working with the muscle consciously, we encourage more unconscious firing of the muscles when we most need it.
Another benefit of slowing down is that we can catch ourselves before we move beyond our comfortable range of motion. Certainly when we start on the journey of rehabilitating, we need to be very conscious of this. Students who come to my classes will be very familiar with the phrases “stay within your comfort zone” and “less is more.” Slow movement helps us to get more control and understanding and allows us to build strength and awareness. In contrast, speedy movement necessitates that we fall back into our unconscious movement patterns. Slowing down helps us to re-pattern our movement and puts far less strain into our joints.
To Sum it Up
So in summary, if you are hypermobile, when you exercise and in your daily movement in general practice and bear in mind these concepts:
Connect gravity to your spine (your core)
Connect to your breath (your diaphragms)
Connect back in as well as reaching out (of your major joints)
Find your comfort range
And most of all enjoy your movement practice and be kind to yourself and curious!