Hypermobility – where does it come from?
Hypermobility, otherwise known as joint laxity, is a complex of heterogeneous features, which is why it is often not easy to diagnose. Symptoms of hypermobility may vary, however, the issue concerns a significant share of the population (approximately 12-24% of all adults in Poland).
Hypermobility is manifested primarily by "flexible" joints, i.e. with an increased range of motion. It is usually caused by irregular structure of the connective tissue (which is found in articular cartilage, articular discs, tendons, and ligaments) resulting from dysfunctions within the collagen fibres which form it. Joint laxity may be local and concern a single joint, but it can also concern the whole body.
Symptoms of hypermobility
Hypermobility may manifest itself with many symptoms. It is usually associated with an increased range of joint mobility (e.g. hyperextension in the elbows or knees), but symptoms may also include:
- joint instability,
- susceptibility to injuries (including recurring injuries),
- pain which worsens after spending a long time in one position (e.g. when driving a car),
- incorrect posture (e.g. deep lumbar lordosis).
Hypermobile persons may also have problems with coordination, skin changes or disorders of the vascular system.
Hypermobility – how to exercise?
Unfortunately, hypermobility is an ailment that can’t be treated – changes in the collagen structure of the joint tissue are irreversible. However, with proper training and regeneration (i.e. proper diet and amount of sleep), it is possible to help our body stop the progress of pathological changes in the locomotor system. By strengthening the muscles, we will also strengthen and stabilise the affected joints and minimise the risk of injury.
5 tips for the hypermobile:
- Watch out for stretching
Hypermobile persons don’t need additional stretching in the area of affected joints. On the contrary – stretching may aggravate the dysfunctions, that’s why this type of training must be done very carefully. It is worth paying particular attention to compensation within other joints – if there is an excessive range of motion within a certain part of the body, there is a risk that other joints “make up” for the dysfunction by decreasing their range of motion. It is a good idea to consult stretching with a qualified physiotherapist.
- Strengthening, strengthening...
Excessive joint mobility requires the involvement of other structures within the locomotive system to ensure stability. That’s why hypermobile persons should make sure their workout includes muscle strengthening – the stronger they are, the more stable the joints will be. It is worth focusing on strength training using your own body weight, accessories (such as resistance bands) or small weights. Strengthening classes, such as Pilates, healthy spine, or gym training, will properly strengthen the muscles and stabilise the joints. Beginners can also choose swimming or aqua aerobic, as such activities let the body exercise without any load.
- Control your body weight
Hypermobile joints are exposed to greater loads. For this reason, physiotherapists pay particular attention to body weight control in the case of hypermobile patients – each additional kilogram increases the load on affected joints. If you struggle with hypermobility and have excessive body weight (BMI over 25 kg/m2), it is worth going on a reduction diet (with calorie deficit) or increase your daily physical activity. It doesn’t have to mean more workouts, at first, try not to drive directly to your workplace and walk instead (at least part of the way).
- Orientation is key
Proprioception is the sense of orientation in the arrangement of parts of your own body. It lets us know how our limbs are arranged without the need to look at them. That’s how we can, for instance, touch the tip of our own nose with a finger with our eyes closed or do a scale balance. Exercises improving proprioception are especially recommended to hypermobile people, who may have trouble controlling the arrangement of particular parts of their bodies. Training that improves proprioception will often include one-sided exercises performed while standing on one leg or on unstable ground. Such training is often done with large fitness balls, Bosu balls, or sensomotoric cushions.
- Avoid static body positions
Staying in static positions for a long time (e.g. doing sitting work or driving a car) has a negative impact on hypermobile persons. If prolonged staying in static positions is part of our daily life (e.g. at work), then it is important to remember about taking regular breaks during which you can move a little and break the routine. It is worth standing up from the seated position or doing several exercises to open the chest, if our arms are directed forward for a long time (e.g. while we’re holding the steering wheel or type on a computer keyboard).
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References:
1. Anna Mirska, Anna Karolina Kalinowska, Elżbieta Topór, Kamila Okulczyk, Wojciech Kułak. Łagodny zespół hipermobilności stawów (BHJS), 2011.
2 .Brzozowska E, Sajewicz E. Hipermobilność stawów - problem społeczny czy jednostkowy? Ocena częstości występowania zespołu hipermobilności stawów w losowo wybranej grupie kobiet - doniesienia wstępne, 2020.
3. Engelbert RH, Juul-Kristensen B, Pacey V, de Wandele I, Smeenk S, Woinarosky N, Sabo S, Scheper MC, Russek L, Simmonds JV. The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome., 2017.