How to Train Hypermobile Joints
By David Drinks
Can you put your palms flat on the ground from a standing position? Is your party trick showing people how you can bend your elbows in weird positions and hyperextend your arm?
If so, then you probably have some level of what we call joint hypermobility.
Joint hypermobility simply means that your joints have more mobility than average. The question is, is this a good thing or a bad thing?
The positive side of being extremely flexible is that you can show it off! Many people stand in awe of those who have extreme flexibility. We tend to ooh and ahh over people who can bend their bodies to extremes.
Often, hypermobility is construed as a sign of beauty in movement. It’s visually pleasing to see the dancer who can put their leg straight up over their head or drop into a split on command and pain-free. It’s awe-inspiring to see the Cirque du Soleil performer who can contort their body in odd directions and do amazing things on stage.
And that’s the big positive of having hypermobile joints. It’s a competitive advantage if you want to live in a world that requires it. For example, if you want to be a ballet dancer or an acrobat, having super-flexible joints can be a competitive advantage. That’s analogous to being a 7-foot-tall basketball player – that affords you a competitive advantage in that sport!
However, there is often a trade-off between a physical characteristic that makes you good at a given sport or athletic endeavor and health.
The 300-lbs. football lineman is well-suited for their job of blocking opposing linemen, but does that make them the healthiest person in the world? Nope.
Similarly, the hypermobile individual is well-suited to activities like dance, acrobatics, gymnastics, and stunning party tricks! However, there is a trade-off for this extreme flexibility, and it is usually joint health.
I think there is a common misconception that many people have which says, the more flexible you are, the healthier you are. They think that more flexibility equals less joint pain, but that’s simply not the case.
Unfortunately, where this thinking causes problems is the case where a hypermobile person who is already experiencing some pain seeks out activities that will promote even more flexibility. It’s not uncommon for flexible people to seek out activities like yoga to “stretch out” painful joints.
Ironically, the most hypermobile people are often the ones that feel like they just can’t get enough stretching. When their back hurts, they just need to torque it around a couple of times. The knee is in pain? Just stretch the heck out of it and it should feel better soon!
The problem with this mindset is that stretching an already unstable joint is just like adding more fuel to the fire. In many cases, it feels better in the short term, but it creates more instability around the joints in the long term.
So, how do you know if you have joint hypermobility and what can you do to better protect your joints? Let’s talk about it!
Diagnosing Joint Hypermobility
Fortunately, you don’t have to be a doctor to determine if you have hypermobility. You can do some relatively simple tests to determine your level of joint hypermobility and find out if your joints tend toward mobility or stiffness.
To test your hypermobility, you can perform something called the Beighton score. The Beighton score involves a series of 5 easy tests for various joints in your body to determine the level of inherent mobility you have throughout the body.
Here’s a demonstration:
As described in the video, there is a maximum score of 9 on the test. If you receive a positive test on 4 or more tests then it’s likely you have at least a moderate level of joint hypermobility. If you receive a 9 out of 9, then maybe you should re-think your career and become a Cirque du Soleil performer??
To give you another example of how you can easily perform this test in a more rudimentary way, check out this video:
What to Do If You Have Hypermobile Joints?
First, I think it’s important to say that feeling tight in your muscles all the time is not necessarily a sign that you don’t have joint hypermobility. As I mentioned earlier, it’s often the people who have the most hypermobility at their joints who feel tight and who feel like they need to stretch all the time.
This is the case because your body is trying to be smarter than you. Your body realizes that you have instability at your joints. The passive stability normally present from the joint capsule, the ligaments, and the other structures in the joint, is not as present and so you have to make up for that somehow. Your body often does this by laying down trigger points and holding neural tension throughout the muscles of the body.
The trigger points and neural tension often leads to increased muscle tone and the feeling of being “tight” all the time. In reality, it is just your body compensating for a lack of stability elsewhere.
So, how do we combat this feeling of tightness? Well, one solution is to stretch all the time. Again, however, that can be dangerous because it is often like adding fuel to the fire. It feels good because your muscles temporarily calm down and release tone, but it often increases the instability at your joints.
It’s that instability at the joints that is often a cause of pain and injury.
In fact, according to Dr. Stuart McGill - who is a former professor and researcher of spine biomechanics at the University of Waterloo, and one of the most prolific writers and presenters on back pain - a more flexible spine predisposes you to injury rather than protecting you from it. When speaking about low back pain in an interview, McGill said, "Statistically, those who have more range of motion in their back have a greater risk of back disorders in the future. So, having a flexible spine is not protective, in fact, it's quite the opposite."
You can check out the whole interview with Dr. McGill here:
That feeling of needing to stretch more, and the desire to stretch out the back and other joints of the body is often deceptive. It provides transient relief of muscle tension but ultimately leads to greater problems down the road.
A better way to resolve this feeling of tightness is to perform more self-massage with a foam roller, or another implement. This is a good way to decrease muscular tone without stretching the joints and adding to the instability.
Remember, though, that the root cause of the problem is the hypermobility of your joints. So, if you stop at just doing more massage work, it’s just like throwing a band-aid on the problem and ignoring the root cause.
So, what’s the real secret to maintaining healthy joints if you’re a super-flexible person? The key is understanding joint stability and how you can get more of it!
Most often, people who are naturally flexible to the point of having some level of joint hypermobility are so because they naturally don’t develop collagen as well as other people. Collagen is the main structural protein found in connective tissue in the body, and thus it is what provides stability to structures like bones, tendons, ligaments, and cartilage.
Without adequate production of collagen, you simply don’t have the same inherent stability in the joints of your body.
There are varying degrees of this lack of collagen production seen in people, sometimes being inherited genetically – in conditions such as Osteogenesis Imperfecta and Ehlers-Danlos Syndrome – and other times acquired with age – as in Osteoporosis.
So, you can see that being able to put your hands flat on the floor from a standing position, doesn’t just mean that you have flexible muscles. It also likely means that you have less collagen production than someone who can’t do this, and that’s not always a good thing.
While having flexible joints allows you to do things that most people can’t, if it’s left unchecked, it will also lead to problems with joint instability, such as dislocations, torn connective tissue (like ligaments, menisci, or discs in the spine), or the early onset of arthritis. The bottom line is that there’s a level of flexibility that is necessary and positive to health, but beyond that, too much flexibility tends to cause more problems.
The key then, when it comes to training an already flexible body is not to add unnecessary stretching.
Instead, the goal should be to maintain the inherent flexibility while adding active stability from the muscular system. Training your muscles to actively stabilize your joints can make up for a lack of passive stability due to lower collagen development.
Training Muscular Stability
There are many options when it comes to training your muscles to increase joint stability. However, the first key to improving joint stability is usually not what you add, it’s what you take away from your routine.
I mentioned the dangers of excessive stretching earlier, so one of the primary things to stop doing is stretching all the time. Some gentle stretching can certainly be incorporated into a routine but cranking on your muscles and joints excessively to “stretch out the pain” is not the answer.
The other thing to remove from your routine is the amount of time you spend “hanging” on passive joints for support. Often, this occurs when you let your muscles relax and you lock out your joints to their end range of motion.
This is common at the knee joint, where people lock at the knees while standing instead of using the thigh muscles to support the joint. Similarly, people often hang on passive stability at their spine by letting their core muscles relax while sitting and slouching forward. Even while standing, many people allow their core muscles to relax, their pelvis to tip forward, and their low back to arch excessively. This lack of muscular stability in everyday life, and while exercising can add up to excessive stress and strain on the structures within your joints.
So, training your muscles to maintain stability while exercising, and while hanging out in everyday life can save your joints.
Next, we need to up the game on muscular stability work in your workouts!
If you don’t have passive stability from your joints due to hypermobility, then you need to have pristine active stability coming from your muscles.
To ensure you get this stability from your muscles, you do need your muscle to be strong. A well-designed strength training routine can make sure that your muscles have enough strength to provide the stability that is required.
However, you can’t stop at just strength training. Stability training comes from teaching your muscles how to engage isometrically and synergistically around your joints to stiffen, brace, and stabilize the joint.
You can think of it as a back brace, an ankle brace, or a knee brace. Sometimes, people utilize these external supports for their joints when they are in pain or in need of extra stability to prevent further injury.
However, you shouldn’t always have to rely on external supports from various joint braces. Instead, you should train your muscles to perform the same job. The plus side is that your muscles can do an even better job of providing stability because they can kick in to provide just the right amount of stability at the right time, while still allowing the mobility that is needed at the joint!
Plus, then you don’t have to worry about an ankle brace cramping your fashion style!
So, to increase joint stability, you need a mix of static and dynamic motor control exercises that can teach your muscles how to kick in isometrically to stabilize against unwanted movement.
A great example of a static stability exercise is a plank:
Planks train all of the muscles around your spine to stiffen and stabilize against unwanted movement. Exactly what you need!
Another great way to work on static stability for the lower body is to perform exercises in a kneeling position, especially half-kneeling. This setup limits the stability that you can get from your feet and forces the muscles around your core and hips to stabilize against any unwanted motion.
Lastly, you’ll want to build on static stability with exercises that promote dynamic motor control. These are exercises where you’re moving the joints through a range of motion while simultaneously preventing an unwanted range of motion.
Most jumping exercises, when done with a focus on a stable, controlled landing are good dynamic stability exercises.
Other great options are single-leg exercises like split squats, single-leg RDLs/hip hinges, and tap downs:
Single-Leg RDL with Overhead Reach
Lateral Heel Tap off Step:
All these single leg exercises promote good stability around the ankle, knee, and hip while the body is moving. That’s a super important quality to possess for real-life stability and control of your joints!
So, to wrap it up today, if you find yourself with excessive joint hypermobility, don’t panic! Just understand that your joints don’t have as much passive stability from the ligaments, joint capsule, and other structures within the joint.
Because of that, you should be aware of the dangers of excessive stretching and collapsing onto your joints in everyday life movements. Instead, you can focus on some massage work to decrease muscular tension, while simultaneously hitting the strength and stability training hard for your muscles!
If you’ve had one joint that has caused you problems in the past, place special attention on exercises that can add stability to the muscles around that joint.
Otherwise, learn how to engage in a safe and effective strength and stability training routine that can keep your joints strong and healthy for the long haul!
If you want to develop a sound training program to keep your joints healthy, then get in touch with one of our exercise specialists at The Med Gym. We can develop an exercise routine that is just right for your body, and ensure that it is performed properly!
Contact us here to set up a free consult today!