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?

Hypermobility And Pain Relief

Hypermobility And Pain Relief

Are you hypermobile and often experience joint and muscle pain? If yes, I’m glad you found this blog! Hypermobility is not a death sentence and you certainly don’t have to just live with pain for the rest of your life. In this blog, you will learn about hyper mobility, how that causes pain, exercises that help you with your hyper mobility, and lifestyle modifications that are necessary.

What Does It Mean To Be Hypermobile?

There are many different joints in the body and each joint has a range of motion that is considered normal, bear in mind that some joints have more range of motion than others. For example, the shoulder joint moves in many more planes of movement and has a greater range of motion compared to the knee joint.

Some people fall below what is a normal range of motion which is typically due to a musculoskeletal injury, or soft tissue restriction, and is common in those with a sedentary lifestyle. On the other end of the spectrum are people whose joints move well beyond what is considered normal and are considered hyper-mobile. 

Hypermobility most commonly affects the following joints:

  • Fingers
  • Elbows 
  • Wrists and
  • Knees 

At our clinic, we see patients with hyper mobility causing the mid-body, lower back, and pelvis instability which comes with a long list of issues as a result. This includes a lack of coordination and balance which can result in chronic joint pain, repeated dislocations, and pain.

How Does Hypermobility Affect Movement And Cause Pain?

In some cases, hyper-mobility can mean instability depending on the degree of excess range of motion and the joint. When a joint is unstable you are at an increased risk for musculoskeletal injuries such as:

  • Dislocation 
  • Lack of coordination and balance
  • Postural decline
  • Sprain
  • Strain 

These injuries impact the integrity of the joint itself including the surrounding ligaments, tendons, and muscles! For someone who is hyper-mobile this makes joint stabilization a priority to not only decrease pain but also prevent injury! 

In our clinic, we have found that Dynamic Neuromuscular Stabilization (DNS) is the best choice of exercise for our patients when it comes to improving joint stability, decreasing pain, and improving overall movement and posture. Think of DNS as a developmental exercise that allows all babies on this planet to develop what it takes to move from helpless infants to running toddlers without any weights, bands, stretching, or machinery.

As mentioned in my blog, “How to Get Rid of Pain”, “ DNS is designed to restore and stabilize musculoskeletal function by re-walking the path that we have all walked once as babies. All babies around the world are born and at around 3 months old start innately doing what it takes to develop strength in the muscles needed to lift the head and neck. This is the start of the developmental sequence and is also what it takes to start restoring function in dysfunctional adults, after breathing of course.”

Here is the video that explains it more:

Now you may be thinking, why not just wear braces to stabilize the area? While bracing may seem like a simple solution to lack of stability, braces can actually be doing more harm than good. Braces not only prevent excess movement, but they also limit the normal range of motion which creates a whole separate issue.

There is a map of movement in the brain called Homunculus that bracing negatively impacts. Think of this map as a blueprint of movement that your movements (or lack of) impact how clear the borders and the steps to the movement are. Bracing disallows certain movements that negatively impact the clarity of this map and the more unclear, the more chances of injury. (less clarity in the ‘how to’ means more injury)

This is why at our clinic we re-walk the steps to stabilize your joints using the body’s own natural built-in stabilizing system. The video below shows an example of a DNS Exercise that can be used to stabilize the shoulder joint! You can also visit our Youtube Channel’s Functional Movement Exercise Playlist with many more exercises. 

Is Hypermobility the Same As Ehlers-Danlos Syndrome?

Although hypermobility is commonly associated with Ehlers-Danlos Syndrome (EDS), the two terms are not interchangeable. According to the Cleveland Clinic EDS is, “A group of conditions that affect your cartilage, bone, fat and blood. A defect in collagen — the protein that adds flexibility and strength to your connective tissue — causes this syndrome.” Hyper-mobility can be a symptom of EDS in which case joint stabilization should also be emphasized in the management of this condition. 

What Should You Do If You’re Hypermobile?

When it comes to hyper mobility conditions, what matters the most is stabilization and the only stabilization exercise that makes sense to me is those that all of us are programmed to do and frankly have done before as infants between the ages 3-4. Those are the Dynamic Neuromuscular Stabilization exercises. At our clinic, we test everyone for functional mobility and postural neurology (to find the blueprint of movement) so we can immediately start the stabilization process. Contact us if you need help with your hyper mobility, its associated pain, and lack of stability.

Dr. Shakib

What Are The Treatment Options for Ankle Pain Caused by Hypermobility?

What Are The Treatment Options for Ankle Pain Caused by Hypermobility?

Hypermobility is an excessive range of motion in joints. It is different from being flexibile and can cause discomfort, injury, and pain in the affected joints, including the ankle. Ankle pain is a common complaint amongst hypermobile individuals and the instability leads to falls and further injuries. In this blog, we will explore the causes, symptoms, treatment, and best exercises for hypermobility and ankle pain.

What Causes Hypermobility In The Ankles?

Hypermobility can be caused by a genetic predisposition or an underlying medical condition such as Ehlers-Danlos Syndrome(EDS). In cases of EDS or Hypermobile Spectrum Disorders (HDS), excess activation of mast cells cause looseness of the ligaments. This looseness results in joint instability.

Now, certain activities that require repetitive ankle movements in extreme ranges, such as ballet, gymnastics, dance, and cheer certainly feed the problem. These activities over-encourage the ligaments to be pushed to the extreme. This causes injuries that linger for a long time if not, a lifetime.

Whether you have EDS or another hypermobile condition, instability in the feet and ankles is something that should be addressed sooner rather than later. Our feet and ankles are our base and are what connect us to the ground. If that connection is unstable then everything above is going to be impacted.

Symptoms Of Hypermobility In Ankles

Symptoms of hypermobility include joint pain, fatigue, and frequent dislocations which can vary from person to person. Depending on the severity of the hypermobility and the joints affected symptoms may vary. In the case of ankle hypermobility, some of the common symptoms include:

  • Ankle pain
  • Swelling
  • Instability
  • Foot pain
  • Repetitive rolling of the ankle and
  • Feeling of the ankle giving way or buckling

As mentioned above, issues in the feet and ankles impact the structures above which can also result in overall poor posture, dysfunctional movement, knee issues, hip pain, lower back problems, and more.

Treatment Options for Hypermobile Ankles

The best treatment for hypermobility and ankle pain must focus on stabilizing the ankle joint and strengthening the deep muscles of the feet. And that’s not accomplished with ankle braces! Also, in treatment, it is important to not disregard the structures above the ankles but should include functional movement of the whole body.

Let’s talk about braces here! No brace is going to provide support to fix a problem. The only brace that provides value, in my opinion, is worn in bed to support the degree of extension at the foot and ankle which is accentuated by the weight of the blanket over the feet while sleeping. This brace simply limits how far extended and outwardly rotated the foot can get both movements being excess in hypermobile persons.

Now, regardless of the physical rehabilitation provider (Chiropractor or physical therapist) the following needs to happen when it comes to the treatment of hypermobile ankles and feet:

  1. Functional Movement such as Dynamic Neuromuscular Stabilization (DNS). This is movement according to the natural design and addresses the ankles, not in isolation, but in full body movements. Remember, the feet and ankles serve as the base for the rest of the body and are not an isolated issue.
  2. Postural Neurology: The brain controls every function in the body! With lack of function, certain parts of the brain, in regards to movement and posture can actually shrink. The good news is we can activate weak parts of the brain with specific exercises including proprioception, balance, and stability.
  3. Biological Breathing: Would you believe that almost every patient that walks into my office is not breathing correctly? This dysfunction directly affects movement and posture resulting in compensatory patterns and negatively impacting stabilization.

Exercises for Ankle Hypermobility

The best exercises for ankle hypermobility are those that include how the ankle functions with the rest of the body, not just in isolation. Here are some specific exercises that may help:

Ankle Hinge:

 Single-Leg Stand:

This is exactly what it sounds like! You practice standing on one leg at a time focusing on the whole foot and toes being engaged into the floor. The entire spine must be neutral and done with proper breathing. This is going to work on your balance and ankle stability while the rest of the body plays its part. This is a great exercise to work into your daily routine with an activity like brushing your teeth.

Bear Advanced Ankle Stability:

What To Do If You Have Hypermobility and Ankle Pain

If you know you are hyper-mobile, or suspect this, and want to find pain relief, full body stabilization, and postural correction all in one office, contact me.  Remember, you don’t have to be in pain to address the problem now.

Dr. Shakib

The Difference Between Flexibility, Hyper-mobility & Instability

The Difference Between Flexibility, Hyper-mobility & Instability

Hyper-mobility and flexibility are not the same and instability is where the difference girl with elbows hyper-extended in quadrupedlies. While some may mistake hyper-mobility as flexibility, especially in children, the difference is seen in movement and musculoskeletal function. In this blog you will learn how flexibility is a sign of health while hyper-mobility is instability, requiring extra measures to prevent injury and dysfunction. 

Flexibility vs Hypermobility 

Flexibility is a term that refers to the ability of a joint or joints to move without any restrictions. This requires muscles to lengthen allowing for movement. For example, if someone cannot reach and touch their toes this can be due to tight and short muscles of the hamstrings and tension in the lower back. Otherwise, someone whose muscles are overly tight, restricting mobility, may be considered inflexible.  

Hypermobility, however, refers to the excess laxity of the joints/ligaments. For example, this would be a person who:

  • Is considered “double-jointed”
  • Can hyperextend their elbows
  • And can manipulate their fingers beyond what the normal range of motion is

While being hypermobile, especially when you’re young, can seem like a cool thing and is sought after in certain sports, it can literally hurt you.

Hypermobility Affects Movement and Pain

When it comes to hypermobility, what is often ignored is the impact on movement, posture, and joint health. Because the ligaments and structure of a hypermobile joint allow for excess movement, the following must be considered:

  • Increased risk for joint dislocation
  • Postural instability 
  • Dysfunctional movement 
  • Increased risk of musculoskeletal injury 
  • Pelvic Floor Dysfunction 
  • Pathological breathing patterns 
  • Lack of coordination and balance 

When it comes to my practice, patients tend to come in with “unrelated issues” in their minds and we help connect the dots! At that point, it becomes obvious that their hyper-mobility either adds to their problem or is the root cause of their issue(s).

The most logical and effective way to create stability in otherwise unstable joints of the hyper-mobile individual is through  Dynamic Neuromuscular Stabilization and Postural Neurology. That is duplicating the methods with which the limber, helpless infant is able to become the strong, running toddler.

Hypermobility, Instability, and EDS 

Hypermobility can be present on its own or can be associated with other conditions such as Ehlers-Danlos Syndrome (EDS). If you have EDS, it is important to know the impact of hypermobility on your musculoskeletal system (bones, muscles, tendons, ligaments) and how its impact on movement can lead to pain. This is explored more in detail in the blog Ehlers Danlos Syndrome, Pain, and Posture.

Best Exercises for Hypermobility and Instability 

For someone who is hypermobile, full body stabilization exercises with attention to detail are crucial. You see, a hypermobile person can easily trick the untrained eye and appear to be performing the exercise correctly. This is because they have learned to function with joints in an extreme position, but it is holding a neutral position that becomes challenging. In fact, the biggest challenge is keeping stable in movement becomes the ultimate test.

Hyper-mobile individuals are no strangers to doctor’s offices; from gastrointestinal issues to headaches and neck pain. Even with injuries and re-injuries; they are typically great in sports such as gymnastics, cheer, ballet, and acrobatics. When it comes to those injuries, it is easy for them to see physical therapists and chiropractors and be treated the same way as others without hypermobility. That is where the continuous visits will continue.

Unless the rehab. provider, chiropractor, or physical therapist is familiar with functional rehabilitation such as Dynamic Neuromuscular Stabilization (DNS), those with hyper-mobility can suffer from pain, frustration, and disappointment.

Below is an advanced Dynamic Neuromuscular Stabilization exercise that when done correctly, points to the improvement of stability in our hyper-mobile patients and is a great milestone that we celebrate together.

Working with hypermobile individuals is different than those without hypermobility and there are specific ways to achieve the milestones of stability. Don’t hesitate to contact us when you are ready to start your adventure to a more stable world. You may also visit us on YouTube for Functional Movement Exercises and join our over 100K followers on Instagram for daily tips and tricks.

Dr. Shakib