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?

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

 

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

What Are The Symptoms Of Hypermobility?

What Are The Symptoms Of Hypermobility?

Hypermobility, hypermobility spectrum disorders (HSD), and Ehlers-Danlos syndrome (EDS), all refer to connective tissue disorders, a condition that occurs later on in life but something you are born with. This blog is about the symptoms of hypermobility. From a musculoskeletal perspective, it is your joint’s excess movement and soft tissue laxity that impact how stable your posture and movement are. It means your pelvis, for example, connected to your lower extremities and spine, becomes easily unstable, leading to pelvic floor dysfunction. While there is a gene associated with EDS, the treatment and presentations of EDS and other forms of hypermobility are the same.

The Pelvic floor is the ‘floor’ of the house, with the pelvis being the ‘house’ so how can the floor be stable when the house is unstable? While every person with hypermobility and its versions has pelvic floor dysfunction, every person with pelvic floor dysfunction does not have joint hypermobility. In this blog, we are going to explore what the common signs and symptoms of hypermobility are so if you happen to be reading our website blogs because you have pelvic floor dysfunction, you get to see if the many other issues you may be experiencing that you are considering as separate problems are different faces of the same problem called hypermobility.

Who Gets Hypermobility Or EDS?

While more common in females than males, it is not gender or age-specific. As children or teenagers, we tend to ‘shine’ in activities such as ballet, gymnastics, cheer, acrobatics, and dance because of our abilities to go to the extreme range of motion but that comes with a price which is injuries and aches and pains in as early as teenage and early 20s to much later stages of life.

I look at hypermobility and movement like driving. Instead of driving at the crosswalk, bendy bodies go into the crosswalk, or past the crosswalk and into the intersection when stopping. That is where the spectrum of hypermobility changes.

What Are The Signs And Symptoms Of Joint Hypermobility?

The following list can be discouraging and that is not the purpose of this blog. It is so you see that so many of your symptoms that you might have considered as separate problems are different chapters of the same problem. While the condition does not go away, managing your health is the focus of this blog and all blogs that I write. What matters is to make sure you seek care from those clinicians who treat the hypermobile population or at least show interest in wanting to learn more to help the bendy friends.

While there are so many people with hypermobility who don’t know they are hypermobile, the ‘generic’ treatments do not apply to you as a bendy person. What works for the other population may be damaging to you. Please make sure to contact my office for a provider near you and also consult the EDS Society for the list of providers.

  • Joint Hypermobility

Joints are generally lax and easy to hyperextend. This is from the laxity in the connective tissues such as ligaments.

  • Pelvic Floor Dysfunction

This is because the pelvis, just like all the other parts, is not stable because the connective tissue is loose, and the support structures and proprioception are not as strong. Also because the soft tissue, including the internal organs, is too ‘loose’, it is easier to have prolapse or excess movement of the internal organs. This means it is easier for the bendy person to have prolapse and incontinence though they are not the only presentations of pelvic floor dysfunction. Please make sure to read my blog on this subject.

  • Joint Pain

There does not need to be an incident related to the pain and it can be something as simple as getting out of pain. This can happen in the ankles and hips, shoulders and wrists, back and knees. Joint pain is the most common complaint of the bendy population,

  • Dislocations And Subluxations

Subluxations are excess movement just before dislocation. It is common to see rib and jaw subluxations, and shoulder and hip subluxations without any apparent reason.

  • Jaw Pain And Tooth Grinding

I see so many cases of jaw pain and this happens because of the excess movement at the jaw joint. The pain happens because the ‘disc’ that has blood vessels and nerve ending between the ‘ball’ and socket’ of the TMJ gets pushed on and does not glide with the bones. It is also common to see the jaw locking in the open position which is then an emergency room visit to numb the area to put the joint back in place.

  • Rib Cage Pain

Oftentimes, because of the excess movement on the joints, the connection between the ribs and the spine in the back or the sternum in the front is easily subluxated causing pain on both or one side with movement, when sleeping or at rest. That is why breathing biologically is so important for the bendy population.

  • Headaches

The connection between the skull and the neck is commonly weak and unstable in the hypermobile population. This is referred to as CSI or CranioSacral Instability. This can cause headaches in the form of tension and when coupled with blood vessel complications, can also show up as migraine headaches.

  • Foot And Ankle Pain

Once again, all joints in hypermobility and EDS are involved and when it involves the foot and ankle, given that they have to balance the structure above (the body), it is so common to have sprained foot and ankle or pains in those areas. At my clinic, we focus heavily on the feet and ankle stability and the device I like almost all of my patients have is ToePro.

  • “Clumsiness” And Poor Proprioception

Most bendy persons call themselves clumsy while as children or teenagers, they have a history of performing tasks that others simply could not do. The clumsiness happens because the joints are not stable and the poor proprioception, while still being studied, in my opinion, comes from not being stable enough in any given position, long and often enough to establish what it takes to end with a stronger proprioception.

  • Soft Or Stretchy Skin

Because hypermobility is a connective tissue condition, it is easy to have more elastic skin.

  • Muscle Weakness

Weakness in the muscles happens because all soft tissue is more lax and joints don’t have the full collection of nature’s best tools needed for stability. This means that muscles are pulled into the picture out of sync. sometimes much longer than they are designed to be and for tasks that are not the specific muscles’ tasks. Weak muscles happen as a result of being overworked and tired or not being used enough so they are not conditioned. In the world of pelvic floor dysfunction, this can mean too tight or too ‘weak’ of the pelvic floor.

  • Fatigue

The level of ‘chaotic’ order of use of the body only means tiredness and fatigue. Lack of sleep does not help the matter either. Also, there seem to be low levels of testosterone in women that should be measured since the low levels cause a lack of energy, fatigue and not building muscles.

  • Allergies

Mast Cell Activation is a common finding among the hypermobile and as a part of its activation, histamine is released. Histamine leads to allergies so a ‘bug’ bite can easily turn into a blister that lasts a long time before it heals.

  • Increased Healing Time

This again happens as a result of mast cell activation and soft tissue involvement.

  • Bruising

Blood vessels are soft tissue and with the involvement of the blood vessels and their rupture, it is easy to get a bruise.

  • Digestive Issues

Gastrointestinal problems are common as a result of dysautonomia which is a common finding of the bendy population. Dysautonomia is when the sympathetic and parasympathetic nervous systems do not control each other so if for instance, the stomach acid is produced for digestion, it is not downregulated by the parasympathetic nervous system when enough of it is produced to digest the food. Dysautonomia impacts all functions of the body and requires the autonomic nervous system to control the functions.

  • Constipation

A great example of dysautonomia is constipation which is a multidimensional issue. So while movement of the food along the intestine is an autonomic nervous system function, it is also controlled by the function of a muscle called puborectalis. When that muscle is tight, it does not relax enough for the fecal material to go down the colon to exit. The tightness can easily happen as a result of pelvis instability. Most often people think of constipation as a nutrition-related issue and while nutrition plays a role, it is not the only factor to consider.

  • Orthostatic Intolerance Or POTS

Postural orthostatic tachycardia syndrome, or POTS, is an increase in heart rate when standing up from a lying position which can cause dizziness and nausea. This is a result of dysautonomia discussed before. POTS is another common presentation among the hypermobile population.

  • Flat Feet Or Pronated Arch

The arches of the feet may be flattened or collapsed because of joint instability.

  • Anxiety

Another presentation of dysautonomia is anxiety which unfortunately gets treated with psychiatric medications while it is the lack of control of the parasympathetic vs sympathetic nervous system.

  • Heat And Cold Intolerance

Here comes another way dysautonomia can show up: controlling the constriction vs dilation of the blood vessels is the function of the autonomic nervous system which is impacted by hypermobility.

  • Swelling In Hands And / Or Feet

When blood vessels dilate but don’t constrict accordingly, the hands and feet can get swollen.

  • Daily Aches And Pains

With all that I listed, you can see how so many functions of the body are compromised and how the unstable joints can be taxing to the supportive structures causing aches and pain. The question to the bendy population is not if they have no pain but how intense their pain is each day.

There seems to be a high incidence of scoliosis and neurodivergence such as ADHD, and autism but I don’t necessarily see that across the board.

What To Do Next If You Are Hypermobile?

If you are hypermobile regardless of if you have pelvic floor dysfunction or not, please make sure you seek care from clinicians who have experience working with the hypermobile population. We are connected to other providers and chances are we may know someone in your area that treats hypermobility. Once again, you can use the directory on the EDS Society for a provider near you. Look on social media and ask around; whatever you do, make sure you educate yourself about your condition and be an advocate for yourself.

Please contact me regardless as I may be able to point you in the right direction; of course, for those close to me, do not hesitate to contact my office for an appointment and those from other states or far away, contact me for a coaching session. 

Dr. Shakib