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Strength Training for Hypermobility: A Customized Approach


Side profile of smiling woman performing kettlebell goblet squat in living room


What is hypermobility?


Hypermobility is a condition characterized by joints that move beyond a normal range of motion with little effort (sometimes referred to as being “double jointed”). This can, but does not always, lead to pain, joint instability, and an increased risk of injury. Other conditions that are associated with joint hypermobility are Hypermobility Spectrum Disorder (HSD) and Ehlers-Danlos syndrome (EDS).  [For more information on EDS and HSD, visit the Ehlers-Danlos Society.] If you're hypermobile (this assessment can help your “rule in” joint hypermobility, but it’s incomplete for ruling it out–hypermobility can present differently in everyone), you've likely wondered why exercises and training recommendations for the average person never quite work for you.


Why Conventional Fitness Training Fails Hypermobile People


Maybe you don’t feel the the same muscles working that everyone else does with certain exercises, or you experience instability or lack coordination where others don’t. Perhaps you can effortlessly get into ranges of motion that others find challenging (you may even gravitate toward activities like dance, gymnastics, yoga or pilates). Conventional fitness programs often fail HYPERmobile individuals because they primarily focus on helping HYPOmobile people—those with limited flexibility and joint mobility. These programs tend to emphasize stretching and mobility work, with little to no focus on increasing body awareness and joint stability. This is neither a safe nor an effective approach to strength training for hypermobile individuals.


And if you also have common co-occurring conditions like chronic fatigue or pain, Postural Orthostatic Tachycardia Syndrome (POTS), and/or Mast Cell Activation Syndrome (MCAS), the intensity, frequency, exercise variation and volume recommended for the average person will likely be inappropriate and counterproductive to your fitness success.


If any of this sounds familiar, you may be surprised to know that you're not alone. Far from it. In fact, it's believed that 1 in 5 women are hypermobile. It can be frustrating to put the time and effort into exercising and not receive the fitness benefits—or worse, get exhausted and injured trying.


Understanding the Hypermobile Body


It's not uncommon for hypermobile people to hold muscular tension around areas such as the shoulders, neck, back and hips. While HYPOmobile people may need more soft tissue work like massage and foam rolling to increase muscle suppleness and increase their joint range of motion, HYPERmobile people need to be careful when stretching or getting soft tissue work done.


While stretching “tight” muscles can feel good and provide temporary relief, it’s often counterproductive in the long run especially when not coupled with stability and strength work. This can lead to worse outcomes with more discomfort and injury. When connective tissues are weaker, as is the case with many hypermobile people, it makes it harder to keep joints in place.  Your body will find a strategy to keep joints stable, which includes tightening and overworking muscles that are ill-equipped (but trying really hard) to make up for lax tendons and ligaments. And even though this may not be the most ideal strategy to get stability, it’s the only one your body may have--for now--and releasing this tension can leave your body vulnerable to injury because it no longer has that stability from the tension created in the tight muscles. And it may sound counterintuitive, but a “tight” muscle can also be weak and actually need strengthening, not stretching.


Hypermobility Exercises to Avoid


It's important to note that there are some exercises that generally not recommended for hypermobile individuals--at least initially and/or without the appropriate coaching and training. Some exercises to avoid with hypermobility include:


  • Excessive stretching

  • Ballistic movements

  • Exercises that push joints beyond a safe range of motion


Instead, focus on controlled movements that build strength within a stable joint range of motion. This means moving away from a “reactive and gripping” strategy (like standing with knees locked and squeezing the glutes) to a “responding and stabilizing” one (practice softening the knees, releasing the glutes and feeling the body weight evenly distributed and balanced over both feet). And we do this in a very systematic, layered and progressive way that is safe, effective and sustainable.


Key Components of Strength Training for Hypermobility


1. Breathing Hypermobile people often carry a lot of tension, which affects their breathing—and breathing affects tension. Proper breathing positively impacts not just the cardiovascular system but also the musculoskeletal, neurological, endocrine, and digestive systems. Dysregulated breathing patterns can be brought on by stress, illness or pain and affect the whole body. But with practice, breathing can be improved significantly and quickly, bringing the body into a more harmonious, relaxed state. A relaxed body is a receptive body ready to learn new movement patterns and stabilizing strategies.


2. Proprioception Proprioception is the ability to sense the position and movement of your body and its parts in space (it's like an internal compass or GPS). It’s crucial for balance, coordination, and protecting joints from injury. With hypermobility, proprioception can be impaired, making it difficult to sense the end range of joint motion. This can lead to an increased risk of injury as the individual may not be aware of their joint's limits. For example, while it may be easy for someone with hypermobility to get into a deep squat due to their increased range of motion, generating the force to ascend out of the squat can be challenging without consistent practice and strength training. By improving proprioception through specific exercises and training, body awareness increases, which is essential for performing complex movements and preventing injuries.


3. Stability Stability work consists of exercises to help with engaging appropriate systems of muscles and connective tissues in the right order of operations. This is often where conventional fitness programs start when addressing hypermobility. However, without the breathing and proprioception pieces, stability work isn’t as effective because it’s hard to sense the working muscles and joints in space.  These exercises are crucial for managing joint instability, from subtle joint laxity to more pronounced subluxations and dislocations. It’s also necessary for managing reactive tension and systemic fatigue as a result of unconscious gripping of muscles. 


4. Strength Strengthening the connective tissues and muscles is a primary goal for hypermobility training and it's a prerequisite for general strength training for overall health and and fitness. This is where you perform exercises moving heavy (for you) weight that increase muscle and bone strength, improve cardiometabolic and cognitive health (and more!). This can be accomplished with bodyweight initially (or even supported bodyweight), and gradually over time increasing the resistance with bands, dumbbells, barbells (even a full suitcase can come in handy when traveling).


Key principles to keep in mind when strength training and exercising with hypermobility:


  • Work within a shorter range of motion you can control before progressing the exercise

  • Perform fewer repetitions and add more sets when increasing volume (i.e. do 6 sets of 5 reps instead of 3 sets of 10 reps)--and start with fewer sets

  • If it feels wobbly, unstable or painful, stop and modify or choose a different exercise

  • Aim to leave each exercise session feeling like you could have done more rather than feeling like you did too much


A Personalized Training Approach for Hypermobility


Strength training is crucial for keeping hypermobile joints healthy and strong, but jumping into a program without preparation can lead to frustration, discomfort, and injuries. From warm-up to exercise selection, dose, and recovery strategies, you need a program that meets you where you are and progresses you gradually and sustainably to your fitness goals, enabling you to live a fuller life with fewer limits.


If you’re looking for a hypermobility personal trainer with advanced training in movement strategies for hypermobility and Ehlers-Danlos Syndrome (EDS), visit my website to learn more about how we can work together virtually or in Del Mar, CA and to book your complimentary consultation.


 

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