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