What Is The Best Exercise For Hypermobility?

What Is The Best Exercise For Hypermobility?

Joint hypermobility, is when all joints in the body have an unusually large range of motion. While as a younger person, the ‘talent’ puts us at an above average performance in certain sports and activities, it has a hefty price to pay later and that ‘later’ is not many decades later either! It comes with risks such as joint instability, pain, and an increased injuries such as dislocations and sprains. Managing hypermobility means recognizing the wrong tendencies and replacing them with the correct mechanics of movement. This involves exercise regimen that not only protects the joints but also strengthens the muscles around them, providing stability and reducing pain.

Why Is exercise Important For Joint Hypermobility?

Regular exercise plays a critical role in managing joint hypermobility for several reasons:

  • Strengthening Muscles: Strong muscles around hypermobile joints act as stabilizers, reducing the risk of injuries and improving joint function.
  • Improving Proprioception: Exercises enhance body awareness and coordination, helping individuals better control their joint movements.
  • Pain Management: Consistent physical activity can help alleviate chronic pain associated with joint hypermobility.
  • Enhanced Posture: Strengthening exercises improve overall posture, reducing stress on hypermobile joints.

Why Are Muscles Tight With Hypermobility?

Muscle tension is present because of:

  • Compensation: Muscles work harder to compensate for the lack of joint stability, leading to increased tension.
  • Protective Mechanism: The body may tense muscles around hypermobile joints to prevent excessive movement and potential injury.
  • Dysfunctional Movement Patterns: Poor proprioception and coordination can lead to dysfunctional movement patterns with mechanics of movement that call for too much and too little work of the muscles that would have been otherwise used in those specific movements. This creates imbalance with tension being a part of that picture.

What Are The Best Types Of Exercises For Hypermobility?

The best type of exercise is the one necessary to set the foundation for other movement and exercises. That means Developmental Exercises such as Dynamic Neuromuscular Stabilization or DNS which is learned by studying babies moving from helpless infant stage to the running toddlers.

If we all have gone through those same movements, without being coached, going to a gym, lifting any weights, seeing any PT, DC or a personal trainer, then we must be programmed to do that automatically.

Why reinvent the wheel when we already know what our ‘factory designed’ methods of movement are! These are exercises that require following the principles of movement as shown in the video below which I emphasize for all of my patients, pelvic floor dysfunction or not.

Once the foundational exercises are established, we can focus on activities that enhance strength, stability, and proprioception further while minimizing the risk of injury. Here are some of the best types of exercise:

Strength Training

Strength training is crucial for stabilizing hypermobile joints. Focus on exercises that target the major muscle groups around the joints, such as:

  • Bodyweight Exercises: Squats, lunges, and push-ups following the principles of movement.
  • Resistance Bands: These provide a controlled way to strengthen muscles with a lower risk of injury. Once again, following the principles of movement.
  • Weight Training: Light to moderate weights with higher repetitions can build endurance and strength without overloading the joints.
  • My favorite exercises here are:

Functional Bridge:

and Functional Squat:

Pilates

Pilates emphasizes controlled movements and core stability, making it ideal for those with hypermobility. It focuses on strengthening the deep stabilizing muscles, improving posture, and enhancing overall body awareness. It is so important to note that skipping DNS exercises to do pilates exposes you to potential injuries. Pilates will extend core strength, allow controlled movement and flexibility (not instability)

I am not a big fan of Yoga for my hypermobile patients because most hypermobile individuals can easily fall on the instability of the joints with many yoga movements.

Swimming

Swimming and water aerobics are excellent low-impact options that reduce stress on the joints while providing resistance to build muscle strength. However, many times flapping the feet can lead to injuries. I, therefore, recommend to my patients to walk and move the arms. I recommend swimming because it is low impact, involves the whole body, and resistance with water is on the whole body.

Advance Developmental Exercises

Developmental exercises of DNS, focus on improving motor skills, coordination, and muscle control. I find these exercises to be extremely important because many of them challenge us to keep the principles of movement in place as performing them. These exercises enhance proprioception and stability.

When performing any exercise, the following should be kept in mind:

  • Start Slow and begin with low-impact exercises and gradually increase intensity.
  • Focus on Form vs sets and reps
  • Have a consistent schedule. I like the DNS exercises with heavy emphasis on the principles of movement; you can apply those concepts to the daily chores and activities, turning each movement an exercise opportunity.
  • Listen to Your Body and avoid pushing through pain. If an exercise causes discomfort, stop and reassess.

If you are hypermobile, it is so important to see providers that treat hypermobility. In the world of clinical rehab. what we do with our Normie population can actually hurt the Bendies. If you are hypermobile and are ready to tackle your joint hypermobility, please contact me.

Recommended Reading:

Who Diagnoses Hypermobility?

What Is The Best Hypermobility Treatment?

What Are Best Exercises For Hypermobility?

Hypermobility, is a connective tissue disorder showing up with multiple system involvement including excessive joint movement. It is mistaken as flexibility but it is the instability at the joint that allows the hypermobile individual to go beyond the expected range of motion or ability to move a joint.  As a result of the ligaments being too loose, a Bendy individual with hypermobility is more prone to joint injuries, chronic pain, and instability. The good news is that you can manage this excess joint play by understanding your tendencies, avoiding them and learning what to replace those moves with.

In this blog I will explore the type of exercise, those based on studying babies or Developmental Kinesiology moves, based on the research that has led to Dynamic Neuromuscular Stabilization (DNS) as a cornerstone for addressing hypermobility. DNS offers a holistic approach to stabilize joints and improve neuromuscular control. We’ll explore samples of some of the DNS exercises that I do with my patients.

What Is Hypermobility?

Hypermobility Spectrum Disorder (HSD), Ehler’s Danlos Syndrome (EDS) are 2 of the common types of connective tissue disorders characterized by joints that move beyond the normal range of motion. I have written extensively about hypermobility in my blog: “Can Hypermobility Be Cured”, that I suggest you refer to before moving on.

How Should I Manage Joint Hypermobility?

When it comes to joint hypermobility, we know that the condition won’t go away however, flare-ups can occur. When it comes to flare ups, avoiding the triggering factors is obviously necessary and can be different for each person. I strongly recommend intake of electrolytes, good sleep hygiene and braces and devices to address the flare-up symptoms. Please make sure to read my blog:’ What is the best Hypermobility treatment‘ as a good source of educating yourself a bit more.

When it comes to joint hypermobility treatment, you should understand that the best approach is to understand what your natural wrong tendencies are, stop yourself before they happen and then know what to replace those moves or methods with. This means you have no choice but to be an active participant in your treatment; this also means your rehab. clinician, physical therapist, chiropractor and occupational therapist need to want to involve you by educating you as if you are going to take over the treatment of someone like you.

I always tell my patients that they are my apprentice, working with me as a team to work on their issue as the project at hand. That is the only way they don’t need to keep coming to me and that has to be their wish or we won’t succeed!

What Are The Best Exercises For Hypermobility?

If all of us started as infants, went through the same exact patterns of movement to go from helpless infants to running toddlers without any bands, weights, training, PT, DC or personal trainer, then it is fair to say that we are all programmed to move that way.

This is what Dynamic Neuromuscular Stabilization (DNS) is all about. It restores optimal neuromuscular function and joint stability by tapping into the body’s natural developmental processes.

DNS is the methodology I use to bring stability and functionality in and since we are all familiar with it (even though most of us are far from doing it) the progress, once understood, is very simple. When it comes to hypermobile joints, the tricky part is the relaxed ligaments, cueing and balancing. That is why it is so important to make sure you see a rehab clinician that treats patients with hypermobility.

baby doing a plank exercise

DNS emphasizes the integration of movement patterns to enhance functional stability. Incorporating exercises that mimic everyday movements, such as lunges and squats, helps individuals with hypermobility reinforce proper joint alignment and motor control. Bear in mind that not every lunge or squat is done right!!!

What Should I Know When Exercising For Hypermobility?

While exercise is beneficial for managing hypermobility, it’s essential to approach it with caution and mindfulness. Here are some key considerations:

  • Start Slow

Begin with gentle exercises and gradually progress in intensity and duration to avoid overexertion and injury.

  • Listen to Your Body

Pay attention to how your body responds to different exercises and modify as needed to prevent discomfort or strain.

  • Focus on Form

Emphasize proper alignment and technique to ensure effective muscle activation and joint stabilization. Commit to form and not sets and reps!

  • Learn from a rehab. clinician who treats hypermobility

What we do with our Bendy patients is different than our Normies. Many times the ‘regular’ methods actually end up hurting our hypermobile patients; it is nice to not be the subject whose wrong treatment was the reason the provider learns what not to do, right?

If you are wondering if, or if you are hypermobile and are seeking hypermobility therapy contact me.

Recommended Reading:

What Is The Best Hypermobility Treatment?

Who Diagnoses Hypermobility?

Can Hypermobility Be Cured?

Can Hypermobility Be Cured?

sitting with legs criss crossed and bending down with elbows touching the floor

Hypermobility

Hypermobility or being double-jointed, is a condition where joints can move beyond the normal range of motion. Most people look at it as flexibility but it is joint instability that leads to joint pain, instability, and other complications. Those diagnosed with hypermobility often wonder: can it be cured? In this blog, we will explore treatment options, and address the possibility of a cure.

Current treatment approaches focus on symptom management, ongoing research aims to deepen our understanding of hypermobility and explore potential therapeutic interventions. Researchers are investigating the role of genetics, collagen abnormalities, and biomechanical factors in the development and progression of hypermobility-related conditions.

What Is Hypermobility?

Hypermobility is commonly associated with Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders (HSD). It affects the connective tissues that support the joints, leading to beyond reasonable flexibility which means instability and therefore, susceptibility to injury.

What Is The Treatment For Hypermobility?

While there isn’t a definitive cure for hypermobility, several treatment approaches aim to manage symptoms and improve quality of life. Here are some common strategies:

  • Joint Stability Exercises

Joint rehabilitation plays a crucial role in managing hypermobility and the ‘standard’ treatment for physical therapy and joint rehab. does not work with hypermobility. Bear in mind that the rehab exercises are not performed by physical therapists but also chiropractors that do physical rehab in addition to chiropractic and occupational therapists but the key is all of these clinicians should have experience treating joint hypermobility within the Bendy population.

As a rehab clinician with the majority of my patients having joint hypermobility, I can tell you that the Bendy population does not necessarily have the same strength in understanding and implementing movement as the Normies. On the flip side, they are very strong in certain understandings that the Normies don’t. This means that unless the clinician understands the hypermobile population, some of the techniques may hurt you.

baby doing a plank exerciseWhen it comes to the exercises, I only use developmental exercises such as Dynamic Neuromuscular Stabilization or DNS which are what we all did as babies and the methodology that got us from the helpless infant stage to running toddlers.

  • Bracing

I am not a big fan of bracing because we all have our needed braces within us!! When it comes to hypermobility, however, I do recommend orthotic braces or splints to stabilize hypermobile joints, particularly during physical activities or periods of increased stress on the joints.

I evaluate the need for bracing on a case-by-case basis and have noticed that the need changes rapidly within the Bendy patient population. I have the Bendy approved products that I quite often refer to.

  • Medications

While I am not a big fan of medications, there are times that pain is too much, and typically my patients use over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) for their joint pain and inflammation associated with hypermobility. In some cases, prescription medications may be prescribed for pain management.

  • Lifestyle Modifications

As mentioned on my blog, ‘What is the best hypermobility treatment’,  ‘maintaining a healthy weight, practicing relaxation techniques to manage stress and anxiety, and getting an adequate amount of sleep, proper intake of electrolytes can all help manage symptoms of hypermobility and flare-ups and improve overall well-being. Learning how to get out of bed, how to sit and stand, how to open doors and load dishwashers, and how to sleep are some of the examples of what I go over with my patients to avoid or manage hypermobility flare-ups.

  • Joint Protection Techniques

I encourage my patients with hypermobility to practice joint protection techniques by recognizing the wrong tendencies and replacing them with the right moves and positions as we learn with each treatment.

Mindful movements and awareness are the first step and as a hypermobile individual, it is important to learn about you. Prevention is the best treatment for joint hypermobility injuries and pain.

Can Hypermobility Be Cured?

The question of whether hypermobility can be cured lacks a straightforward answer. Hypermobility is a complex condition influenced by genetics, and fueled by environmental, and physiological factors. While treatment can help manage symptoms and improve quality of life, curing hypermobility is not on the plate right now but the research is happening.

It is so important to understand that individuals with hypermobility can lead fulfilling lives with proper management strategies in place. Everyone, Bendy or Normy is better off understanding the principles of movement understood from studying babies, to protect themselves from injuries and pain. The bendy population has more motivation to learn these but the need to understand does not change!

If you are hypermobile and want to start learning about the right ways to move to avoid injuries, and lessen pain contact me.

Dr. Shakib

Recommended Reading:

Who Diagnoses Hypermobility?

What Is The Best Hypermobility Treatment?

 

Can Hypermobility Cause Back Pain?

Can Hypermobility Cause Back Pain?

Hypermobility is excess joint movements and can cause pain in every part of the body, including the lower back area. This pain can be from the muscles engaging to stabilize and muscles over engaging to compensate for the lax ligaments or from issues at other structures from the lack of joint stability.

Not every back pain has the same cause; for example, you can have lower back pain from muscle tension, nerve compression or tension, or even a disc bulge, disc protrusion, or disc herniation.

What is Hypermobility?

I strongly suggest you review my blog collection to understand what hypermobility is. In short, it is instability of the joints because of the lax ligaments and connective tissue, and it impacts all the joints in the body; hypermobility can occur in some joints more than others, but as a connective tissue disorder, it is not just in one joint!

Some common signs include:

    • Excessive Joint Movement
    • Joint Pain: Discomfort or pain in the joints, especially after physical activity.
    • Joint Instability: Feeling like your joints might “give way” or are not fully supported.
    • Fatigue: Tiredness or weakness, especially in the muscles supporting the joints.
    • Easy Bruising: This is due to fragile blood vessels.

How does hypermobility cause back pain?woman standing up holding back with pain

The back pain in hypermobility is caused by the following:

  • Joint Instability

When the joints are hypermobile, support and stability are compromised; this puts extra strain on the muscles, ligaments, and discs in your back, leading to pain and discomfort.

  • Muscle Overuse

To compensate for the instability caused by hypermobile joints, your muscles will have to work harder to keep your spine aligned and supported. This can cause tension and fatigue and lead to pain.

  • Poor Posture

Poor posture happens especially in transitional areas where the neck connects to the body, the mid back connects to the lower back, the lower back connects to the pelvis, and the whole body connects to the ground!! The best practice I have found to help better posture is Developmental exercises such as Dynamic Neuromuscular Stabilization or DNS.

  • Increased Risk of Injuries

With unstable joints come higher chances of injuries, which can often mean lower back pain.

How do I prevent lower back pain?

  • Stay active and mindful

The safest exercises I have found to work best with my hypermobile patients is those of developmental kinesiology. I follow the teachings of Dynamic Neuromuscular Stabilization which make 100% sense given that we all start from helpless infants to running toddlers without being told what to do. We are programmed to do it that way, so why not use what we already innately know to bring stability?

  • Practice posture awareness

Be mindful of your posture throughout the day. Pay attention to how you sit, stand, and move to prevent unnecessary strain on your spine. I always teach my hypermobile patients their wrong tendencies and what to replace them with. That is the only way we can have success in prevention.

  • Use supportive devices wisely

I am not a big fan of braces, but I recommend them when it comes to my hypermobile patients. Not to be worn all the time but when doing activities that make them prone to injuries or flare-ups. I do recommend hard orthotics, which are good for those with flat feet who are hypermobile.

  • Find the right Rehab. clinician

It is important to ensure you find the right provider, one who knows and treats hypermobility. What we do with our ‘normy’ patients can actually at times hurt our ‘bendy’ patients. Do an online search, call the office and talk to them, ask if you can have a short visit with the provider, and check the EDS Society list, ask the local chapter of EDS groups on Facebook. Do your homework, and know that we are out there!

If you are hypermobile and have joint pain, contact me.

Dr. Shakib

Recommended Reading:

Who Diagnoses Hypermobility?

What Is The Best Hypermobility Treatment?

 

Who Diagnoses Hypermobility?

Who Diagnoses Hypermobility?

Hypermobility syndrome is excessive joint flexibility causing joint pain, instability, and other related symptoms and proper diagnosis is important for proper management and treatment. In this blog, I will explore who can diagnose hypermobility syndrome, the criteria used to identify hypermobility, and why an accurate diagnosis is essential for effective treatment.

Who Can Diagnose Hypermobility Syndrome?

Typically, by the time you have reached the potential for hypermobility diagnosis, you have seen a wide range of providers with most of them gaslighting you, making you wonder if it is all in your head! Hypermobility does not just impact your joints so it is common to see specialists such as rheumatologists, cardiologists, neurologists, orthopedists, primary care physicians, physical therapists, chiropractors, acupuncturists, and massage therapists.

hand holding a pen writing on a paper on a clipboard

When seeking a diagnosis for hypermobility syndrome, individuals have several healthcare professionals to consider. While rheumatologists, orthopedic surgeons, and physiotherapists are commonly associated with diagnosing hypermobility, chiropractors also play a significant role in identifying and managing this condition. Chiropractors are trained to assess musculoskeletal issues, including joint hypermobility, and can provide valuable insights and treatment options.

Believe it or not,  joint hypermobility, is not something that is taught in schools and typically when it comes to seeking healthcare providers, those who are familiar with this condition have taken the initiative to learn about it themselves.

What Are The Criteria For Identifying Hypermobility?

One of the key criteria used to identify hypermobility is the Beighton score. This scoring system measures joint flexibility by assessing specific movements in various parts of the body. While the Beighton score is widely used, it’s not the only method for diagnosing hypermobility syndrome. When it comes to the rehab. clinicians, physical therapists, and Chiropractors who treat joint hypermobility may consider factors such as medical history, symptoms, and additional clinical examinations when making a diagnosis.

Hypermobility is a connective tissue condition and can be seen in people with Ehlers-Danlos Syndrome (EDS), Hypermobility Spectrum Disorder (HSD), Mast Cell Activation Syndrome (MCAS), and Marfan Syndrome. The physical therapists and chiropractors who treat patients with hypermobility are familiar with the different presentations that the population may present with and during the history intake, and from pattern recognition, can easily identify hypermobility.

In my practice, once I suspect EDS, knowing that there are subtypes of EDS that do not have an identified gene associated with them, I advise the patient to receive genetic counseling and subsequent testing. However, just because there may be no identified genes found does not mean that the patient is not hypermobile.

Is The Beighton Score The Same As Other Criteria?

While the Beighton score is commonly used to assess joint hypermobility, healthcare professionals may use alternative criteria or additional assessments based on their clinical judgment and expertise. Ultimately, the goal is to obtain a comprehensive understanding of the individual’s condition to guide appropriate treatment.

How Can You Vet For The Right Provider?

When seeking a healthcare provider for the diagnosis of hypermobility syndrome, it’s essential to vet for qualifications, experience, and expertise. Look for providers who have specific training or experience in musculoskeletal conditions, including hypermobility syndrome. There are resources such as EDS Society that are a good resource to start your search.

Why Is Diagnosis Important In Treatment?

A timely and accurate diagnosis of hypermobility syndrome is crucial for effective treatment and management. When it comes to joint hypermobility, the treatment rendered to the non-hypermobile population can cause pain and injury to the Bendy population. It is very important and I can’t emphasize enough, to seek care from the providers who understand hypermobility and this goes for the joint issues as well as non-joint complaints.
If you think you are hypermobile and want to know what your next option is, contact me.
Dr. Shakib

Recommended Reading:

What Is The Best Hypermobility Treatment?

TMJ and Hypermobility

 

What Is The Best Hypermobility Treatment?

What Is The Best Hypermobility Treatment?

What Is Hypermobility?

Hypermobility is the ability of your joints to move beyond their normal range of motion. This is typically a result of a connective tissue disorder due to its collagen configuration. Connective tissue is like the body’s glue, giving support and structure to organs and structures by holding them together, kind of like how tape holds things in place. There is a difference between hypermobility and flexibility which I wrote about in my previous blog.

What Causes Hypermobility?

As mentioned above, Joint Hypermobility seen in conditions such as Ehlers-Danlos syndrome (EDS), Hypermobility Spectrum Disorder (HSD), Mast Cell Activation Syndrome (MCAS), Sjogren’s Syndrome and Marfan syndrome is a connective tissue disorder. It impacts all of your joints from how your head sits on your neck to how your toes are. It can come in a spectrum of presentations going beyond joint hypermobility which is the focus of my practice and the realm of my expertise.

What Are The Symptoms Of Hypermobility?

I have written a blog on this very subject that I strongly recommend you to check out. Symptoms of hypermobility can include joint pain, stiffness, frequent dislocations or subluxations, chronic fatigue, muscle weakness, poor posture, and joint instability which can occur in all joints, particularly in the hips, knees, elbows, ribs, jaw, and shoulders.

I was interviewed to talk about hypermobility by JJ Virgin on Instagram where I talked about hypermobility, its different presentation, treatments in general, how every hypermobile patient should know about pelvic floor dysfunction, and message to healthcare providers.

How Is Hypermobility Treated?

The treatment for hypermobility typically involves a combination of strategies aimed at managing symptoms and improving joint stability. This may include physical therapy, occupational therapy, chiropractic treatment, pain management, orthotic devices, lifestyle modifications, joint-specific interventions, and education/self-management. What you should know is that whomever you see for hypermobility treatment should know and treat hypermobility. What applies to the ‘Normie’ does not apply to the Zebras!

How Can Physical Therapy Help With Hypermobility?

Physical therapy plays a crucial role in managing hypermobility by strengthening muscles, improving joint stability, and enhancing flexibility. What matters the most is that the therapist KNOWS about joint hypermobility and treats hypermobile patients and you can get hurt doing the therapy done for the non-hypermobile patients. Physical therapy modalities can be performed by a physical therapist and chiropractors whose focus in practice is functional mobility and postural training.

Can Occupational Therapy Benefit Those With Hypermobility?

Yes, occupational therapy can be beneficial for individuals with hypermobility, especially those experiencing difficulties with daily activities. Occupational therapists can provide strategies and adaptive equipment to help individuals perform activities of daily living more comfortably and efficiently. These methods can also be used by physical therapists and chiropractors who treat hypermobility with a focus on the whole body.

Can Chiropractic Care Help With Hypermobility?

Chiropractic care focuses on the diagnosis and treatment of musculoskeletal disorders, including hypermobility. Not every chiropractor is the right chiropractor for hypermobility and you should only consider upper cervical chiropractors and those treating hypermobility. With Cranio-cervical instability and the potential CSF leak, adjustment of the neck and the rest of the spine can be questionable.

What Are Some Joint Protection Techniques For Hypermobility?

In my practice the majority of my patients are hypermobile. I have found that while each person may have their default movement patterns that are dysfunctional, the best protection is to engage bigger muscle groups to make up for the lax ligaments.

It is important to understand what the tendencies are, learn what to replace them with, and avoid doing activities the wrong way. That is like needing to move your house items and learning to bubble wrap your treasured belongings instead of just putting them in a box and closing them.

At my clinic, my patients learn the basic foundations of movement and understand their bodies, their tendencies, and the how-to’s and that has been the biggest tool to avoid injuries and stay active.How Is Pain Managed In Hypermobility?

Pain management for hypermobility may involve the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or other pain medications to alleviate joint discomfort. Additionally, techniques such as heat therapy, ice packs, and massage can provide temporary relief from pain and stiffness. At times procedures such as Prolotherapy, PRP, and Stem Cells have also been helpful and the results vary from case to case. I refer my patients to the doctor that is local to my clinic who does these injections and is familiar with hypermobility. It is best to ask your rehab. clinician for a potential referral if it suits your issue.

Are Orthotic Devices Helpful For Hypermobility?

Most hypermobile patients have flat feet when standing up or have an already existing bunion. My goal as a rehab. clinician is to bring the function back to the movement and for that reason, I am a big fan of developmental kinesiology exercises such as Dynamic Neuromuscular Stabilization. While I am not a fan of orthotics as the only way to overcome feet issues, I do recommend hard orthotics that can be put in and taken out of shoes vs built-in orthotics in shoewear. That is because the loose ligaments of the foot bones are the reason behind flat feet when standing up and there is no way around that.

I also suggest shoes that are slightly above the ankle to protect the area and compression socks. You can find the hypermobility products that I share with my hypermobile patients on my website.

What Lifestyle Modifications Can Help Manage Hypermobility Symptoms?

Maintaining a healthy weight, practicing relaxation techniques to manage stress and anxiety, and getting an adequate amount of sleep, proper intake of electrolytes can all help manage symptoms of hypermobility and flare-ups and improve overall well-being. Learning how to get out of bed, how to sit and stand, how to open doors and load dishwashers, and how to sleep are some of the examples of what I go over with my patients to avoid or manage hypermobility flare-ups.

 

classroom full of attendees listening to a speaker

If you are hypermobile, the first step toward health is to find providers who are familiar with hypermobility. If you are not happy with your rehab. team, contact us today. We know your challenges and most likely have the solution for you.

Dr. Shakib

Recommended Reading:

The Difference Between Flexibility, Hyper-mobility & Instability

TMJ and Hypermobility

 

TMJ and Hypermobility

TMJ and Hypermobility

When it comes to hypermobility, all joints are impacted including the TMJ or Temporo-mandibular joint. Up to 75% of individuals with EDS experience TMJ symptoms, such as pain, clicking, or limited jaw movement. So often I hear people claiming their TMJ ruining their lives or their TMJ is getting worse day by day. In this blog, I will go over a brief anatomy of the TMJ, and why some clickings are painful and some are not. The common treatments and things you can do on your own to avoid pain and locking of this joint.

What Is The Anatomy Of The TMJ?

The TMJ is a complex joint connecting your jawbone to your skull. It consists of muscles, ligaments, a disc, and the bones of the jaw. TMJ is involved in the opening, closing, and side-to-side motions of the jaw and is crucial for activities like chewing, talking, and yawning. This joint is a ball and socket joint, like your shoulder and hip joints, and can dislocate or sublux. just like those joints.

Why Is My TMJ Clicking?

Clicking or popping sounds in the TMJ are common and while considered usually harmless by dentists and many clinicians, I disagree. Just because they may be not painful, does not make it harmless!!

pic of the skull with the anatomy of the TMJ

When painful it could indicate underlying issues with one reason being the displacement of the disc within the joint, causing irritation and inflammation. This disc is to follow the movement of the ball moving inside the socket but sometimes it gets pinched inside the joint, causing pain. Conditions like arthritis can cause pain which is typically caused by misalignment of the ball inside the socket and lack of proper joint movement. Remember the ‘harmless’ clicking that I disagreed with? This is why I disagree because these misalignments over time don’t necessarily cause any pain!!

What Other Anatomy Influences The Jaw?

The TMJ is heavily influenced by the neck and upper body through a network of muscles and nerves. Poor posture, such as slouching or forward head posture, can disrupt this interconnected system, leading to TMJ dysfunction and discomfort.

diagram of the neck and jaw

 

When posture is compromised, it can change the alignment of the spine, affecting the muscles and ligaments that support the head and jaw. This, in turn, can increase stress on the TMJ, contributing to pain and dysfunction.

What To Do For TMJ Treatment And Pain Avoidance

While Hypermobility Spectrum Disorder (HSD), Ehlers-Danlos Syndrome (EDS), and other connective tissue disorders are for life, there are measures you can take, and conditions you can pay attention to so your TMJ can be less painful and more under control. Following is what I remind my patients to consider preventatively and when in pain.

  • Dental Visit

Make sure to ask for small child blocks for all dental work. Lockjaw can happen at the dentist’s office when the jaw is open for too long and it locks in the open position.

Get your molars checked to make sure they are closing properly. When they don’t close on top of each other malocclusion can cause tension in the neck and your whole posture.

Not all dentists know how to check for Tongue tie so this may be a visit to an orofacial functional therapist. Some people benefit from this minor procedure and some do not see any long-term benefit.

  • Postural Improvement

Your posture plays a role in the position of your neck and your head and neck, in turn, impact the position of your jaw. Forward neck is a big player in this decline in the position so all exercises that assist in postural improvement become steps in the right direction. I only use Developmental exercises such as Dynamic Neuromuscular Stabilization or DNS.

  • Breathe Biologically

The number one step in the right direction for everything movement-related is biological breathing which is how we all breathed as infants to the first few years of life before it changes based on our injuries. Here is what biological breathing is done.

  • Jawning

Drop the head down when yawning, coughing, and sneezing. This minimizes and most likely prevents open lockjaw.

  • Food

Often when the jaw is in pain, we avoid eating solid foods but chewing is better than grinding so cut your solid food into smaller pieces and don’t eat salad so much!!

When eating, make sure you keep your mouth clothes and do not put your elbows on the table. The second part has to do with better posture of the neck and midback.

  • Tongue Exercise For Jaw

Dr. Mew is a dentist whose license was actually under review for being against orthodontics! He and his dad noticed the decline and problems caused by the practice of orthodontics and the impact it has on the face and jaw. The practice of orthodontics purely started based on cosmetics and nothing more. Dr. Mew suggests the following:

  1. Relax and close your lips.
  2. With your lips sealed and teeth in contact, lift your tongue and press it against the roof of your mouth.
  3. Repeat these steps multiple times as regularly as possible.

Chew Gum And Close Your Mouth When Eating

This will practice chewing and use the muscles of mastication, which allows better positioning of the jaw. The saying ‘if you don’t use it, you lose it’ certainly applies here.

Sitting To Standing Alert

Due to craniocervical instability, I suggest my patients with hypermobility drop their chin down and hinge their torso at the hips to sit and stand. This allows limited movement of the head over the neck which in turn takes some of the stress at the TMJ.

When it comes to hypermobility, it is so important to make sure you seek care from providers who treat patients with hypermobility because the normie treatments can often actually cause further issues. If you have hypermobility and are interested in learning not only how to avoid the pain of joint hypermobility but also how to live your life mindfully and based on your hypermobility, contact me.

Dr. Shakib

Recommended Reading:

What Are Signs Of Hypermobility?

Hypermobility And Pain Relief

 

Is Joint Hypermobility The Same As EDS?

Is Joint Hypermobility The Same As EDS?

Joint hypermobility is a result of a connective tissue disorder impacting the joints specifically. Ehlers-Danlos Syndrome (EDS) is a connective tissue disorder impacting all connective tissues including the joints. Do you see the connection?

Joint hypermobility is one of the presentations of Ehlers-Danlos Syndrome which is one version of a connective tissue disorder. Joint hypermobility, therefore, is not exclusive to EDS. There are conditions such as Hypermobility Spectrum Disorder or HSD, Marfans, Scleroderma, and Sjogrens, that clearly are not EDS but still exhibit joint hypermobility.

What is important to note is that the hypermobility treatment for all of these conditions, which may have variations in other associated symptoms, is the same.

Is Joint Hypermobility The Same As Flexibility?

No. A person is flexible when their muscles, tendons and ligaments can stretch, can shorten, and can resume their neutral length when indicated. With joint hypermobility, the ligaments are too lax and don’t contract the same way. That is in fact, one of the reasons why the Bendy community’s proprioception, the knowledge of where you are in space at any given time, is not their strongest forte.

How Do I Know If I Have A Subluxated Joint?

When it comes to explaining mobility and stability to my hypermobile patients, I explain their joint hypermobility like driving a car and stopping at the crosswalk, vs going a little bit into the crosswalk, vs going more into the crosswalk, vs going past the crosswalk, vs going all the way into the middle of the intersection.

Hypermobility degrees vary from one hypermobile person to another. When you are ‘in the middle of crosswalk’ is when you have gone past subluxation and into the dislocation zone. Being on the end side of the crosswalk is where subluxation resides! This is when you are hypermobile and can tell if you are subluxated or not.

The picture below shows hypermobility of the left hip, knee, and ankle, pushing the limits toward subluxation but not there yet. She is in the middle of the crosswalk, so to speak! 🙂

woman on a bench doing a yoga pose with overextended knee

What Is The Treatment For Joint Hypermobility?

The treatment for joint hypermobility has to be done with the help of rehab. clinician who is familiar with EDS, HSD, and other connective tissue disorders that involve the joints. The Bendy and Normie treatments are NOT the same and will hurt the hypermobile individual.

I always tell my hypermobile patients who are the majority of my practice that when it comes to moving our house, we package our belongings differently. Sometimes we just through the items in a box, and tape it  and with some of our treasured belongings, we bubble wrap them carefully, mark the box and then tape it. We don’t abandon the valuable belongings because we don’t want to break them, nor do we skip the bubble wrapping, right? We are not any different and this goes for everyone and not just the hypermobile.

The focus of the treatment has to be the recognition of what is not safe, learning how our joints like to move and since the connective tissue, which means everything but your bones essentially, is lax, we need to bring in more of the right muscles working together to provide a safer move. THIS is where the rehab world fails also.

Once you understand the mechanics of movement, it is through repetition without compromising the principles of movement that you build strength. This goes for everyone btw.

Who Treats Joint Hypermobility?

All rehab clinicians who treat hypermobility are a good fit. Rehab clinicians are not just physical therapists but chiropractors and occupational therapists who do exercise with patients are great fits. The key is they must know how to treat hypermobility.

I am for instance a chiropractor by license and adjust patients on occasion though my hypermobile patients are not adjusted in certain areas (such as neck) unless I have clarity of certain presentations. The adjustments are NEVER the same as those of the Normies no matter what. With that said, my practice is fully focused on functional movement and postural stability. This is the reason why I see so many patients with joint hypermobility.

I do brain and body exercises that are NOT the same as a gym workout or generic exercises. I know that my hypermobile bodies behave differently and have specific needs. I do Developmental Exercises that are gentle and easy to do on the joints but challenging for my hypermobile patients. What I do in my practice as a chiropractor is not the same as a high majority of my colleagues.

How Do I Find The Right Clinician For My Hypermobility Treatment?

Consult the EDS Society provider list, call and interview the office. Do a web search, read the reviews, and contact the office. See if you can have a short time with the clinician; trust your gut feeling and make sure the provider understands the joint hypermobility presentations. Ask the related closed groups that you belong to and still go through the process to vet the provider.

If you have Ehlers-Danlos Syndrome, Hypermobility Spectrum Disorder, Mast Cell Activation Syndrome, or other connective tissue disorders causing joint hypermobility, contact me for a Solution Session or Telehealth Coaching.

Dr. Shakib

What Are Signs Of Hypermobility?

What Are Signs Of Hypermobility?

While joint flexibility can be impressive, it is commonly confused with hypermobility. Hypermobile individuals have quite a range of motion in their joints but with a set of challenges and potential health implications. In this blog, I will cover what hypermobility is and how to recognize its presence in yourself or others.

What Are Common Signs Of Hypermobility?

Recognizing hypermobility is the first step toward understanding what to do for hypermobility treatment. FI has listed some of the common signs of hypermobility that you may recognize:

  • Joint Hyperextension

Your joints can bend beyond the normal range of motion, which most refer to as “double-jointedness, especially in the knees, elbows, fingers, and thumbs.

  • Joint Pain

Chronic joint pain, especially in large joints like the knees, hips, and shoulders, is a common symptom of hypermobility. This is most often a result of the laxity in the ligaments which is important in the stability of the joints. The fact that the Bendys’ ligaments don’t contract like the Normies, is one of the reasons why the hypermobile population typically has a weaker proprioception (knowledge of where you are in space at a given time). That is the reason why typically the ‘stop’ point of a joint in the hypermobile population is beyond what it should be, causing pain.

  • Joint Instability

Thumb being pressed showing hyperextensionHypermobility can lead to joint instability, making it easier for joints to dislocate or subluxate (partially dislocate). Again, ligament laxity and weaker proprioception play a role here. I have written a blog on hypermobility treatment that addresses this issue a bit more which I am including at the bottom of this blog.

  • Soft Skin

Most often the skin is softer because hypermobility is a connective tissue condition where the collagen makeup is different. This impacts all soft tissue including the skin. In my practice, every hypermobile patient I see has soft and sensitive skin. This means that when using sports tape, it is best to use the sensitive skin tape and remove it with an adhesive remover vs pulling it off!

  • Easy Bruising

Connective tissue includes blood vessels and because it is altered in hypermobility, it is much easier for the blood vessels to rupture and cause bruising.

  • Muscle Weakness

We typically test muscle strength by muscle testing and I know typically the claim is that muscles are weaker in the hypermobile population. I do question the lack of ‘strength’ being the muscles being weaker though. We know that the ligaments are lax so how is a muscle going to show off its strength if its connections are weak? I do see that in my practice which is fully catered to my hypermobile patients with the specific hypermobile protocols that we do, I see strength in the muscle performance. The key is to ‘frame’ the movements differently given what the hypermobile body has to offer.

  • Fatigue

The body spends quite a bit of energy trying to stabilize the joints and balance the body. With hypermobility, this most likely becomes the reason behind chronic fatigue.

  • Delayed Motor Development In Children

It seems that children with hypermobility have delays in developmental milestones such as sitting, crawling, and walking. Hypermobility is a connective tissue disorder where the collagen makeup is different. This can be from some types of Ehlers-Danlos Syndrome where the genes are identified or Hypermobility Spectrum Disorder and other types of connective tissue conditions.

  • Recurrent Joint Dislocations Or Subluxations

Frequent joint dislocations or subluxations, especially in the shoulders, knees, and fingers, are typical in hypermobile individuals. This is a common problem with a rather easy fix that requires you to be mindful of movements. We all need to understand that ‘bubble-wrapping’ our treasured belongings when moving is a smart thing to do regardless of hypermobility.

  • Joint Clicking Or Popping

Noisy joints, such as clicking or popping sounds, can occur due to joint laxity. I don’t worry about the clicking or popping since the noise is simply the release of nitrogen, oxygen, and carbon dioxide from the joint fluid. If the clicking and popping has pain, then we should look into it.

  • Flat Feet Or High Arches

Hypermobility affects all joints including the feet and its many little bones. In most cases, I see flat feet happen when standing; that is when the ligaments connecting the little bones relax and the arch collapses. In cases of high arches, I see over-compensation when walking and I only see high arches when standing to avoid pain.

  • Gastrointestinal Issues

You may experience GI symptoms such as irritable bowel syndrome (IBS) or gastroesophageal reflux disease (GERD). The motility issue is from dysautonomia and also from the laxity of connective tissue. It can also be from the weak postural stabilizers and pelvic floor dysfunction. I have written blogs on hypermobility and pelvic floor dysfunction that I will include below.

  • Cardiovascular Symptoms

Mitral valve prolapse or aortic root dilatation is common especially a specific subtype of a hypermobility condition called cEDS. It is good to have a good heart health lifestyle in general anyway! Just because there is an increased chance does not mean that you are doomed so live life the right way, the preventative way- and get checked regularly depending on where you are at with your heart health.

What Are Less Common Signs Of Hypermobility?

The following list of less common signs of hypermobility will still allow you to recognize hypermobility so you can better understand the why behind your symptoms and ‘bubble wrap’ your movement safer and better while addressing the non-joint related symptoms with a clinician and health care provider who understands hypermobility.

  • Autonomic Dysfunction

In my practice, I see many patients with different levels of dysautonomia, which is a dysfunction of the autonomic nervous system. This is part of your nervous system in charge of things in your body that you don’t have much control over, like digestive movements, blood vessel constriction/dilation, and heart beat. Symptoms of dysautonomia can include POTS which can be feeling dizzy when getting up to even fainting, lightheadedness, palpitations, and temperature dysregulation.

Managing stress plays a big role in the intensity and frequency of the presentations here so taking the right electrolytes makes a difference. You can take a look at my favorite products on my website.

  • Chronic Pain Syndromes

While joint pain is common in hypermobility, some individuals may also experience widespread chronic pain conditions such as fibromyalgia or complex regional pain syndrome (CRPS). In my practice, I have seen a few CRPS patients who were not hypermobile and I have never seen a hypermobile person with CRPS. Fibromyalgia is a whole different blog and what my view on that is!

  • Temporomandibular Joint (TMJ) Dysfunction

Hypermobility impacts all joints including the temporomandibular joint or TMJ. This in part is related to cranio-cervical instability, and neck and breathing issues that exist. I see plenty of patients with TMJ issues who are not hypermobile and while Craniocervical instability is rather unique to connective tissue disorders, instability of the head over the neck is seen in plenty of non-hypermobile patients.

  • Neurological Symptoms

Your nerves are soft tissue that does not like to be compressed or stretched. They are capable of both but don’t like them over a long time or to the extreme. Because hypermobility is a connective tissue disorder, and the joints, muscles, and all tissues including the internal organs are more ‘loose’, they can put pressure (from let’s say muscles lagging and buckling over the nerve passing through) or overly stretch because the joints are loose. Other presentations end up putting undue stress on the nerves causing issues with pain and nerve symptoms.

  • Psychological Symptoms

Chronic pain and physical limitations associated with hypermobility can contribute to psychological symptoms such as anxiety, depression, or mood disorders. This can also be another presentation of dysautonomia.

  • Dental Issues

Some hypermobile individuals have thin enamel over their teeth which makes them get dental cavities more often. Many are also mouth breathers which dries up their saliva which protects our teeth. Because hypermobility is a connective tissue disorder and our gums are connective tissue, it is easy to see the gums receding causing issues with oral health.

  • Vision Problems

Certain eye conditions, such as myopia (nearsightedness), astigmatism, or retinal detachment, because our eyes are also connective tissue.

  • Skin Disorders

While soft skin is a common sign of hypermobility, stretch marks and scar tissue are seen in some hypermobile individuals.

  • Endocrine Dysfunction

There seems to be a relationship between hypermobility, adrenal insufficiency, and thyroid dysfunction. Is it because autoimmunity is common among the hypermobile population and the common type of autoimmunity is Hashimotos? Adrenal glands are in charge of fight or flight and stress management so it seems to not be surprising that it is commonly seen among the hypermobile population.

The correlation between the two seems to exist but how they are related is still not clear. Perhaps when we understand why ADHD exists and what causes it, we can connect the dots here!

If you have hypermobility, it is so important to make sure you see clinicians and health care providers who know and treat hypermobility. For instance in my world which is physical medicine, my treatment for the Bendy population is very much customized to the group; while I see mostly hypermobile patients, I know how to avoid injuries while trying to treat the painful joints and weak posture. The agenda has to go beyond pain to prevent injuries which has its unique protocol.

If you are hypermobile or think you may be hypermobile, contact me and if you are in another state or country, contact me here for telehealth coaching related to your joint instability, postural imbalance, and pelvic floor dysfunction stemming from that.

Dr. Shakib

Recommended Reading:

Hypermobility And Pain Relief

Pelvic Floor Dysfunction In The HyperMobile Population