Exceptional athletes such as Michael Phelps and Simone Biles have drawn extra attention to the subject of hypermobility in recent years, as their increased flexibility has helped them to perform seemingly superhuman physical feats.
However, for some people, hypermobile joints can be a source of clumsiness, pain and recurrent injury. Should hypermobility be something that you celebrate, or something that concerns you? Whilst there are some conditions for which hypermobility is a small part of more serious problems, for many hypermobile people the answer is somewhere in the middle.
People who are hypermobile have joints which stretch beyond the range of your average person. Hypermobility is caused by softer-than-usual collagen – the tissue that forms our tendons and ligaments. This means the ligaments of a person with hypermobile joints are less rigid and stretch more easily.
General joint hypermobility can be assessed with a simple test called the Beighton scale. If your score based on five different movements exceeds the normal for your age and sex, then you can be called hypermobile.
If you think you might be hypermobile, we can perform a Beighton test for you at WLP. To book your appointment, email info@westlondonphysio.co.uk or call us on 020 7937 1628.
Hypermobile people have difficulty finding effective neutral resting positions for their joints and maintaining stability during motion, which can potentially be dangerous when lifting a heavy weight or during powerful movements like throwing or jumping.
The arrangement of muscles, tendons and ligaments in our body are adapted to control movement in certain ranges and directions.
Our ligaments provide us with proprioception, which is your awareness of the position of your body in space. It’s the reason you can accurately position your limbs when they’re not in sight (i.e., stand on one leg with your eyes closed) and should tell your body to utilise certain muscles to maintain stability if we are stretching too far.
Failure of the proprioception system can result in straining or tearing ligaments, like when you roll your ankle when running or twist your knee skiing.
The stretchiness of ligaments and range of motion in people with hypermobility can muddle their proprioception, meaning their muscles don’t respond as quickly or accurately to ligaments being stretched, which increases risk of injury.
Pain, swelling and scar tissue associated with ligament and joint injuries can further affect proprioception, increasing risk of future injuries. Serious or recurrent ligament or joint injuries can result in decreased strength of muscles around the injured joint due to the inactivity which results from a person being in too much pain to move.
Lacking strength will make somebody more likely to get injured and therefore a vicious cycle of re-injury and inactivity can be created in a hypermobile person.
Poor proprioception can also make it difficult to hold one position for a long time, like standing on the tube or sitting at a desk, which can result in people with hypermobility adopting mechanically inefficient positions for their muscles, which can become tight, sore and painful as a result.
This pain can lead to muscle weakness, making it harder to maintain a position for a long time and leading to the same vicious cycle mentioned above.
Despite all the doom and gloom so far, the vast majority of people with hypermobile joints don’t need to avoid any activities. In fact, being active is essential to maintaining muscle strength and joint proprioception to improve your control of your joints and prevent you from getting injured.
If you are hypermobile and struggling with pain or joint instability during exercise, it’s very important that you work with a physiotherapist or trainer who is aware of your hypermobility. They can assess your individual problem areas and prescribe exercises to improve them, gradually getting you on track to achieving your exercise and lifestyle goals.
Hypermobility can increase the injury risk of activities such as lifting weights, hopping and jumping due to instability in shoulders, knees and ankles. If you want to improve your stability, don’t throw yourself into intense physical activity or follow generalised exercise advice without supervision.
Learning to appropriately control your joints can require very gradual and precise training, which is far safer when guided by a medical professional.
When you are stronger and have good control of your hypermobile joints, hypermobility can provide increased flexibility with very few downsides and plenty of positives – which is demonstrated by the likes of Phelps and Biles. Hypermobility doesn’t have to be a problem if you train the appropriate muscles and progress your strength and movement to make sure you have the control to match your extra flexibility.
If your hypermobile joints are causing you trouble or you are worried about trying new or intense exercise, book an appointment with me today by calling 020 7937 1628 or emailing info@westlondonphysio.co.uk, and I’m always happy to answer questions at liam@westlondonphysio.co.uk.
Liam McCloskey
Musculoskeletal Physiotherapist BSC(PHYSIO)(HONS) MCSP HCPC
