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 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 you 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 Strength Training for Hypermobility Requires a Specialized Approach
If you're hypermobile, you may experience challenges that the average exerciser does not. These challenges include:
Body Awareness
You may not feel the same muscles working that everyone else does with certain exercises
Joint Stability
You may experience instability or lack coordination where others don’t
Managing Joint Range of Motion
You may effortlessly move into large ranges of motion that others find challenging, but you may also have difficulty moving out of them
Some fitness professionals may be impressed with your "flexibility", but unless they also understand how to increase stability and strength to support your joints and connective tissues, the risk of pain and/or injury with exercise increases.
3 Ways Conventional Approaches to Strength Training Fail Hypermobile People
1. Conventional strength training programs often fail HYPERmobile individuals because they primarily focus on training HYPOmobile people—those with limited flexibility and joint mobility.
These programs tend to emphasize stretching and joint mobility work, with little to no focus on increasing body awareness and joint stability. While this is appropriate for HYPOmobile exercisers, this is neither a safe nor an effective approach to strength training for hypermobile individuals.
2. Conventional strength training programs often fail hypermobile individuals who need more warm-up and movement preparation before their main exercises.
Hypermobile people need strategies to help decrease unintentional muscular and neurological tension (such as muscle tightness, spasms, and increased sensitivity to pain) and learn how to create intentional, helpful stiffness where needed (I'll say more on "reacting and gripping" vs "responding and stabilizing" in the Exercises to Avoid section below). This usually means a more gradual and longer warm-up to prepare the body before the main strength training exercises are performed.
3. Conventional strength training programs often fail hypermobile individuals who have common co-occurring conditions like chronic fatigue or pain, Postural Orthostatic Tachycardia Syndrome (POTS), and/or Mast Cell Activation Syndrome (MCAS).
The recommended intensity, frequency, variety, and amount of exercise for the average person will likely be inappropriate and derail you from fitness success if you have one or more of these conditions. It's important to approach strength training for hypermobility with "structured flexibility"—having contingency training plans baked into the main fitness plan—so when flare-ups occur, the program adapts, allowing you to keep making progress without exacerbating symptoms.
4 Key Components of Strength Training for Hypermobility
Based on conventional fitness practices, which often overlook the needs of hypermobile people, you'd think hypermobility must be extremely rare, but that's not the case. In fact, it's believed that as many as 1 in 5 women are hypermobile. It can be incredibly frustrating to invest time and effort into exercising and not receive the fitness benefits—or worse, get exhausted and injured just for trying. You deserve much better. That's why understanding the key components of strength training for hypermobility is crucial.
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).
To Stretch or Not to Stretch if You are Hypermobile
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 receiving soft tissue work.
While stretching “tight” muscles can feel good and provide temporary relief, the tightness often returns, sometimes causing even more tightness or pain. This usually results in more stretching and the cycle repeating, which is counterproductive in the long run—especially if not coupled with stability and strength work—leading 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 their best!) to make up for lax tendons and ligaments.
And even though this isn't the most ideal strategy for creating stability, it may be the only one your body has—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. It may sound counterintuitive, but a “tight” muscle can also be a weak one and actually need strengthening, not stretching.
4 Exercises to Avoid if You Have Hypermobility
Understanding the key components of strength training for hypermobility is important, and it's equally important to know what exercises to avoid. Here are some exercises generally not recommended for hypermobile individuals—at least initially and/or without the appropriate coaching and training. Some exercises you may want to avoid with hypermobility include:
Avoid Excessive Stretching
Stretching with hypermobility can create even more instability in already unstable joints
Avoid Ballistic Movements
High velocity and acceleration movements can overwhelm the hypermobile joint's capacity to control the movement
Avoid High Impact Activities
The lack of stability in hypermobile joints make them especially vulnerable to injury from sudden, forceful impacts (this could also include contact sports)
Avoid Exercises That Push Joints into Extreme Ranges of Motion
Without training, it can be difficult to sense when the hypermobilie joint is out of a safe range of motion until it's too late
Instead, prioritize 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, softening the glutes, and feeling the body weight evenly distributed and balanced over both feet).
This is more of a holistic practice than a series of one-off actions and it needs to be done in a very systematic, layered and progressive way so that it is safe, effective and sustainable.
This doesn't necessarily mean you can never perform these types of activities if you're hypermobile. However, it does require following a careful, appropriate, and consistent training program designed specifically for you to best prepare your body for them. And strength training for hypermobility will be a critical part of that program.
4 Key Principles to Keep in Mind When Exercising and Strength Training 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 "off" stop —if it feels wobbly, unstable or painful, stop and modify or choose a different exercise
Don't overdo it — aim to leave each exercise session feeling like you could have done, rather than feeling like you did too much
Work with a Certified Personal Trainer Who Specializes in Strength Training for Hypermobility
Strength training is crucial for keeping hypermobile joints healthy and strong, but jumping into a program (especially one created for the general population) without preparation can lead to frustration, discomfort, and injuries.
From warm-up to exercise selection, volume, frequency and recovery strategies, a certified personal trainer who specializes in hypermobility can create and customize a program that meets you where you are and progress you gradually and sustainably toward your meaningful fitness goals. This helps you enjoy an even fuller life with fewer limits.
A Personalized Training Approach for Hypermobility
If you’re looking for a hypermobility personal trainer with specialized 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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