Hypermobility: Recommended Sports, Activities to Avoid, and Safe Exercise Principles

What sports are good for hypermobility?

Individuals with hypermobility can safely and effectively participate in many sports, particularly those emphasizing controlled movements, strength, stability, and proprioception, while minimizing high-impact, extreme range-of-motion, or unpredictable joint loading.

Understanding Hypermobility in Sport

Hypermobility, often referred to as "double-jointedness," is a condition where joints move beyond the typical range of motion. While it can sometimes be an advantage in activities requiring extreme flexibility, it also means the connective tissues (ligaments, joint capsules) that stabilize joints are more lax. This laxity can increase the risk of sprains, dislocations, and chronic pain if joints are not adequately supported by strong muscles.

For individuals with hypermobility, engaging in physical activity is crucial. Exercise helps to:

• Build Muscular Strength: Strong muscles act as dynamic stabilizers for lax joints, providing essential support.
• Improve Proprioception: Enhanced body awareness helps individuals control their joint positions and avoid overextending.
• Reduce Pain and Fatigue: Regular, appropriate exercise can alleviate common symptoms associated with hypermobility, such as joint pain and muscle fatigue.

However, choosing the right sports and activities is paramount to prevent injury and optimize long-term joint health.

Key Considerations for Sport Selection

When selecting sports or physical activities for individuals with hypermobility, prioritize those that align with these principles:

• Low Impact: Minimizes repetitive stress and jarring forces on joints, which can exacerbate laxity or cause micro-trauma.
• Controlled Movements: Activities where movements are deliberate and can be performed with strict form, reducing the likelihood of sudden, uncontrolled joint positioning.
• Strength & Stability Focused: Sports that inherently build muscular strength and endurance around joints, providing vital support.
• Proprioception Enhancement: Activities that challenge and improve body awareness, balance, and the ability to sense joint position in space.
• Predictable Load: Sports where the forces on the joints are consistent and anticipated, rather than sudden and unpredictable.
• Adaptability: The ability to modify exercises or movements to suit individual joint limitations and avoid excessive range of motion.

Recommended Sports for Hypermobility

Several sports and activities are generally well-suited for individuals with hypermobility, offering benefits without excessive risk:

• Swimming and Aquatic Exercise: The buoyancy of water reduces the load on joints, allowing for a full range of motion without high impact. It's excellent for cardiovascular fitness, muscular endurance, and overall joint mobility. Focus on proper stroke technique to avoid excessive joint hyperextension.
• Cycling: A non-weight-bearing activity that provides a great cardiovascular workout and strengthens the lower body. It allows for controlled, repetitive leg movements. Proper bike fit is crucial to prevent knee or hip strain.
• Strength Training (Resistance Training): This is arguably the most important activity. By building strong muscles around joints, you create a protective "splint." Focus on:
  • Controlled movements: Prioritize strict form over heavy weights.
  • Moderate loads: Progress gradually.
  • Compound movements: Squats, deadlifts, presses (with appropriate modifications) build functional strength.
  • Eccentric control: Emphasize the lowering phase of lifts to build strength throughout the range of motion.
  • Isolation exercises: Can target specific muscle groups to enhance joint stability (e.g., rotator cuff exercises for shoulder stability).
• Pilates and Modified Yoga: These disciplines are excellent for developing core strength, improving body awareness, balance, and controlled flexibility. For hypermobile individuals, the emphasis should be on active stability within the available range of motion, rather than pushing into passive end-range flexibility. Avoid poses that encourage hyperextension or extreme passive stretching.
• Walking and Hiking (on even terrain): Low-impact activities that build lower body strength and cardiovascular fitness. Choosing even, predictable surfaces reduces the risk of ankle or knee sprains.
• Tai Chi and Qigong: These ancient practices involve slow, deliberate movements, promoting balance, flexibility, and mental focus. They are low impact and excellent for improving proprioception and controlled body mechanics.
• Rowing (Ergometer): Provides a full-body, non-impact workout. The controlled movement pattern strengthens the legs, core, and upper body. Focus on proper technique to avoid back strain or knee hyperextension.

Sports to Approach with Caution or Potentially Avoid

While some individuals with hypermobility may participate in these sports with careful management and significant strength training, they generally carry higher risks:

• High-Impact Sports:
  • Running (especially on hard surfaces): Repetitive impact can stress lax joints. Trail running or softer surfaces may be better, but still require strong joint stabilizers.
  • Jumping activities: Basketball, volleyball, plyometrics can lead to joint jarring and instability.
  • Contact Sports: Football, rugby, hockey carry a high risk of unpredictable forces, collisions, and joint trauma (e.g., dislocations).
  • Gymnastics and Cheerleading: Often involve extreme ranges of motion, high impact landings, and significant joint loading, increasing the risk of injury.
• Sports Emphasizing Extreme Passive Flexibility:
  • Competitive Dance (certain forms) or Contortionism: These activities can encourage pushing beyond safe physiological limits for hypermobile joints, potentially leading to instability and pain.
• Sports with Repetitive, Uncontrolled Twisting/Pivoting:
  • Tennis, Squash, Badminton, Soccer: These sports involve sudden changes in direction, rapid pivoting, and rotational forces that can place significant stress on knees, ankles, and hips. While not entirely off-limits, they require exceptional strength, proprioception, and careful training.

General Principles for Safe Sport Participation

Regardless of the chosen activity, individuals with hypermobility should adhere to these fundamental principles:

• Prioritize Strength and Stability: Always make strengthening the muscles around your joints a cornerstone of your fitness routine.
• Focus on Form Over Range: Never push into hypermobile end-range passively. Work within your active range of motion, where muscles can control the movement.
• Listen to Your Body: Pain is a warning sign. Do not push through joint pain. Distinguish between muscle fatigue and joint discomfort.
• Gradual Progression: Slowly increase intensity, duration, and resistance. Avoid sudden jumps in training volume.
• Thorough Warm-up and Cool-down: Prepare your joints and muscles for activity and aid recovery afterward.
• Professional Guidance: Consult with a physical therapist, exercise physiologist, or a personal trainer knowledgeable about hypermobility. They can provide a personalized assessment, help you choose appropriate activities, and design a safe and effective exercise program.

Conclusion

Hypermobility does not mean exclusion from an active lifestyle or sports. By making informed choices about activities that emphasize controlled movements, prioritize strength and stability, and minimize high impact or unpredictable forces, individuals with hypermobility can safely and effectively engage in a wide range of sports, enhancing their physical health, well-being, and long-term joint integrity. Always seek professional guidance to tailor your fitness journey to your unique needs.