Step By Step Guide To Hypermobility

Step By Step Guide To Hypermobility

Hypermobility, often referred to as joint hypermobility syndrome, means your joints can move beyond the typical range of motion. While this flexibility can be advantageous for activities like gymnastics or dance, it can also lead to challenges such as joint pain, instability, and an increased risk of injury. Hypermobility can be in the form of Ehler’s Danlos Syndrome(EDS), Hypermobility Spectrum Disorder(HSD), Marfan, or other less common connective tissue disorders. Here’s a comprehensive guide on what steps to take if you’ve just discovered you’re hypermobile.

What Is Hypermobility?

Hypermobility occurs when the tissues that hold your joints together, such as ligaments and tendons, are too loose. This condition can be due to genetics, where the collagen in your body is more elastic than usual. Hypermobility can range from mild to severe, and it’s essential to understand how it affects your body to manage it effectively.

What Are The Symptoms Of Hypermobility?

I have written a whole blog about symptoms of hypermobility. Common signs include:

    • Joint Pain and Discomfort: Often felt in the knees, elbows, wrists, and ankles – Frequent Injuries: Such as sprains, dislocations, and strains.
    • Fatigue: Due to the extra effort required to stabilize loose joints.
    • Poor Posture: Resulting from the body’s attempt to compensate for joint instability.
    • Soft Tissue Injuries: Including tendonitis and bursitis. Understanding these symptoms can help you identify which areas of your body need the most attention and care.
    • Jaw Pain
    • Increase Heart Rate
    • POTS

You Are Hypermobile, Now What?

Don’t panic. We are in a much better place than we were even 5 years ago and there are a lot more providers and more awareness about joint hypermobility and other symptoms of connective tissue disorder. There are provider resources available on the EDS Society website as well as close Facebook groups.

Consult A Healthcare Professional

Typically, a rheumatologist, cardiologist, or orthopedist is the first line of providers to see. It is important to see one who is familiar with hypermobility. As a rehab. clinician, I diagnose hypermobility often as the first line of provider patients seek, so it is not uncommon to visit a provider who happens to know about hypermobility for one of its many presentations.

Depending on the symptoms, I often refer the patient to a genetic counselor for further evaluation to determine if Ehlers Danlos Syndrome (EDS) is present. I have written a blog on the difference between EDS and Hypermobility Spectrum Disorder (HSD) that I suggest you read.

Develop A Personalized Plan

Educate Yourself On Hypermobility

Educating yourself about hypermobility can empower you to make informed decisions about your health. Use websites on hypermobility, joint support, and FB groups, and get literature from healthcare professionals to name a few. Thankfully we have so many resources of information these days that you are in a MUCH better place than you would have been less than a decade ago! Understanding your condition can help you advocate for yourself and seek appropriate care and resources.

Personalized Exercise Plan

One of the best ways to manage hypermobility is through a personalized exercise plan. IMO, it is important to seek care from a rehab clinician such as a physical therapist or a rehabilitative chiropractor who knows about joint hypermobility since the treatment of the “Normie” is not the same as the “Bendy”.

baby doing a plank exercise

I use Developmental Kinesiology exercises, baby exercises since we are hard-wired to know them and they are very gentle on the joints yet highly effective in providing joint stability and functional mobility. These exercises provide core and strength training while providing balance and proprioception opportunities. I have spelled out the exercises for hypermobility in my blog, “best Exercises for Hypermobility” in detail.

I use these exercises to address all joints including the pelvic joint which is involved in pelvic floor dysfunction, yet another misunderstood and mistreated condition!

Prioritize Joint Protection

Protecting your joints is essential when you have hypermobility. Here are some strategies to help:

  • Avoid Overextending

Be mindful of your range of motion and avoid pushing your joints beyond their natural limits.

  • Use Braces and Supports

This is so important, and while I don’t necessarily generally recommend that to everyone, I certainly encourage my hypermobile patient to wear braces or supports during activities that put stress on their joints., when they have pain and need a bit more support or when they are having flare-ups.

  • Maintain Good Posture:

Proper posture can help prevent undue strain on your joints and muscles. This is not because you are bendy but because we all need to have a good posture to allow our body parts to shine the most, to dogirl's side view what they are best at. Just as you know how to drive because you understand the principles of driving, it is smart to understand the principles of movement and work toward getting better at it each day. By doing so, we have no choice but to get better posture.

Take Regular Breaks

Avoid long periods of repetitive motion or standing to reduce joint stress. Adjust your daily demands based on your energy level each day.

Don’t Care!

Trying to meet other people’s expectations because you don’t want to be ‘flaky’ is not going to serve you well. Try to explain where you are at and what you are dealing with, and if those individuals don’t understand, then forgive them and move on!

Nutrition And Hydration

Proper nutrition and hydration play a vital role in joint health. Ensure you’re consuming a balanced diet rich in vitamins and minerals, and anti-inflammatory Foods like omega-3 fatty acids found in fish, nuts, and seeds to reduce inflammation. Depending on whether you have Mast Cell Activation Syndrome (MCAS)or not, you may want to consult a nutritionist familiar with MCAS and histamine.

Drinking plenty of water to keep your tissues hydrated and functioning optimally. Salt is most likely your best friend so taking electrolytes or water and salt is strongly recommended to increase blood volume, and lower the chances of Postural Orthostatic Tachycardia Syndrome (POTS) and flare-ups.

Listen To Your Body

Lastly, always listen to your body and trust your intuition. By taking these first steps, you can effectively manage hypermobility and improve your quality of life. Remember, early intervention and consistent management are key to living well with hypermobility.

If you are hypermobile and are ready to take the necessary steps to claim your life, contact me.

Dr. Shakib

Recommended Reading:

Should I Stretch If I Am Hypermobile?

How To Prevent Joint Injuries In Hypermobility: Expert Tips And Effective Strategies


Should I Stretch If I Am Hypermobile?

Should I Stretch If I Am Hypermobile?

Hypermobility is a connective tissue disorder with individuals having unusually flexible joints,  leading to various challenges. Hypermobility and Ehlers Danlos Syndrome are connective tissue disorders with some differences that I explained in a blog you may wish to read.  I am often asked by my patients with hypermobility if stretching is helpful or harmful so this blog is all about stretching and what I find to be beneficial for my hypermobile patients.

What Is Hypermobility?

Hypermobility, being described as “double-jointed,” happens due to a faulty protein called collagen, causing the laxity of ligaments as one of its presentations. This means that the bendy individual has more stretchy ligaments which means more unstable joints. That is why people with hypermobility may experience joint pain, and instability, and are at a higher risk of injuries. This is also the reason why you may describe yourself as ‘clumsy’ because it is the tension in the ligaments that allows the brain to be more precise with proprioception- the knowledge of where you are in space at any given time.

Why Is Stretching Important?

Generally speaking, stretching is a common practice to improve flexibility, enhance physical performance, and prevent injuries. I am against isolating an area to stretch though once holding a pose with the principles of movement in place, those areas that are tight will stretch and the weak ones will be challenged to get stronger!

Let me explain, your body parts have to be able to work with the rest of you so when holding a pose or going through a movement with the right principles in place, (Developmental Movement principles), then the tight area not only gets the opportunity to get stretched but also works with the rest of your body to learn the patterns of movement. This simple and common sense fact is what is missed in the world of physical rehab. in my opinion.

For those with hypermobility, the approach to stretching requires careful consideration to avoid exacerbating joint instability.

The video below talks about the principles of movement which is true for every case of instability, hypermobility, pelvic floor dysfunction, and joint stability.

Should Hypermobile Individuals Stretch?

This all depends on many factors that I will try to answer by categorizing the relevant questions I am asked often by my hypermobile patients.

Can Stretching Worsen Hypermobility?

You are not imagining the feeling of tension! This comes from the muscles having to do more than they were designed to do to hold the joint in place. Stretching joints in you overstretch the ligaments because your joints lack the structural support needed to prevent overextension. Excessive stretching can weaken the muscles and ligaments that provide this support.

What Types Of Stretching Are Safe For Hypermobile Individuals?

Not all stretching is created equal. Passive stretching, when someone else stretches your joints is not a good idea, and active stretching, when you do it yourself is much better but not all active stretching is the same!! Isolating the area to stretch is not a good idea either.

Dynamic stretching, involving controlled movements that mimic activities or sports, is safe because it improves muscle function and coordination. The ones that make sense are the movements we have learned by studying human babies or Developmental Kinesiology; the Developmental movement protocol I teach and follow is called Dynamic Neuromuscular Stabilization or DNS.

How Can Strength Training Complement Stretching?

For hypermobile individuals, incorporating strength training into their fitness routine is crucial. Strengthening the muscles around hypermobile joints can provide the necessary support and stability. Exercises that focus on the core, hips, and shoulders can significantly reduce the risk of injury. Combining strength training with stretching can create a balanced approach that maintains flexibility while ensuring joint stability.

bird dog pose on a cliff

Once again, the best and safest strength training exercises are those of DNS because think about it, if babies go from being helpless when they are born to becoming running toddlers, they have learned great strength, balance, and coordination in movement without getting any training.

We are hard-wired to move a certain way and those ways ARE the safest ways so why reinvent the wheel when the whole world shows that this method produces the best results over and over.

Best Practices For Stretching With Hypermobility

  • See The Right Provider

Before starting any stretching routine, make sure the rehabilitation provider you are seeing follows the methods of DNS. Not every physical therapist or Rehab. chiropractor knows DNS or treats patients with hypermobility.

It is so important to only see providers that treat patients with hypermobility or Ehlers Danlos Syndrome. The second best are those providers who are interested in treating patients with hypermobility and are eager to learn more.

  • Focus On Active And Dynamic Stretching

As mentioned earlier, active and dynamic stretching is preferable for hypermobile individuals. These types of stretches engage the muscles and support joint stability. Incorporate movements that involve muscle contraction and controlled motions with the whole body being involved in the move.

  • Avoid Overstretching

Pay attention to your body’s signals and avoid pushing your joints to their extreme limits. Overstretching can lead to joint instability and increase the risk of dislocations and injuries. Gentle, controlled stretches are more beneficial than forcing your body into extreme positions.

I can’t emphasize enough to seek the right provider who can help you see and understand what you are doing. You can consult EDS Society website for the list of providers near you.

  • Strengthen Surrounding Muscles

Complement your stretching routine with exercises that strengthen the muscles around your joints. Focus on low-impact, weight-bearing exercises. Start with the Developmental Exercises Once you understand and can follow the principles of movement, then exercises like Pilates or resistance training that target the whole body will be great. Strong muscles can help stabilize hypermobile joints and reduce the risk of injuries.

  • Use Proper Technique

Proper technique is essential when stretching. Avoid using momentum to force a stretch and instead move slowly and deliberately. Ensure that you maintain proper alignment and posture during stretches to prevent unnecessary strain on your joints.

Benefits Of Safe Stretching For Hypermobile Individuals

So is stretching okay if you are hypermobile? Yes, it is but keep everything I mentioned above in mind. Stretching when done as a part of a pose or baby movements provides the following benefits.

  • Improved Muscle Function
  • Enhanced Joint Stability
  • Reduced Pain and Discomfort
  • Better Posture and Alignment

If you are hypermobile, are ready to safely become active, or continue being active without injuring yourself, contact me.

Dr. Shakib

Recommended Reading:

How To Prevent Joint Injuries In Hypermobility: Expert Tips And Effective Strategies

Who Diagnoses Hypermobility?