Hypermobility: Understanding, Management Strategies, and Exercises

How do I stop being hypermobile?

Hypermobility is a genetic characteristic related to collagen structure, meaning you cannot "stop" being hypermobile. Instead, the focus shifts to managing its effects by building strength, improving proprioception, and adopting movement strategies that enhance joint stability and prevent injury.

Understanding Hypermobility: A Physiological Reality

Joint hypermobility refers to the ability of a joint to move beyond its normal range of motion. This increased laxity is primarily due to differences in the composition and structure of collagen, the main protein in connective tissues like ligaments, tendons, and cartilage. Since collagen is a fundamental component of your body's architecture, hypermobility is not a condition that can be "cured" or "stopped" in the conventional sense; it is a physiological trait.

It's crucial to distinguish between:

• Asymptomatic Joint Hypermobility: Where individuals have increased joint range of motion but experience no pain or functional limitations. Many athletes, particularly in gymnastics or dance, exhibit this.
• Symptomatic Hypermobility (Hypermobility Spectrum Disorder - HSD or Hypermobile Ehlers-Danlos Syndromes - hEDS): Where hypermobility is accompanied by chronic pain, fatigue, frequent dislocations or subluxations, and other systemic issues related to connective tissue laxity.

For most individuals, hypermobility is a characteristic, not a disease. The goal is not to eliminate it, but to learn how to live with it effectively, minimize potential negative impacts, and optimize your body's function.

Why You Can't "Stop" Being Hypermobile

The fundamental reason you cannot "stop" being hypermobile is rooted in your genetic makeup and the inherent properties of your connective tissues. Ligaments, which connect bone to bone and provide joint stability, are primarily composed of collagen. In hypermobile individuals, this collagen may be more extensible, allowing for greater stretch and thus greater joint range of motion. This is a structural reality, not something that can be reversed through exercise or medical intervention.

Strategies for Managing Hypermobility and Optimizing Function

While you can't change your underlying joint structure, you can significantly influence how your body functions and feels. The primary strategy for managing hypermobility is to shift the focus from flexibility to stability and strength.

• Prioritize Strength Over Passive Flexibility: Hypermobile individuals often have excellent passive flexibility, but this can sometimes come at the expense of joint stability. Instead of stretching further, concentrate on building robust muscular strength around your joints. Muscles act as dynamic stabilizers, providing the support that lax ligaments may lack.
• Develop Proprioception and Neuromuscular Control: Proprioception is your body's ability to sense its position and movement in space. For hypermobile individuals, this sense can sometimes be diminished, leading to a reduced awareness of joint end-ranges and increased risk of injury.
  • Training Focus: Incorporate exercises that challenge your balance and coordination, requiring your muscles and nervous system to work together to stabilize joints.
• Strengthen Key Stabilizing Muscle Groups:
  • Core Muscles: A strong core (abdominals, obliques, spinal erectors, pelvic floor) provides a stable base for all limb movements, reducing stress on peripheral joints.
  • Gluteal Muscles: Strong glutes are critical for hip, knee, and ankle stability, especially during walking, running, and squatting.
  • Scapular Stabilizers (Shoulder Blades): Muscles like the rhomboids, trapezius, and serratus anterior help anchor the shoulder blade, providing a stable platform for the highly mobile shoulder joint.
  • Muscles Surrounding Specific Joints: Focus on strengthening the muscles directly crossing hypermobile joints (e.g., quadriceps and hamstrings for knee stability, rotator cuff for shoulder stability).
• Embrace Low-Impact Exercise: Activities that minimize repetitive jarring or high-impact forces are generally safer and more beneficial.
  • Examples: Swimming, cycling (stationary or outdoor with proper fit), elliptical training, brisk walking, Pilates, and controlled strength training.
• Focus on Controlled, Deliberate Movement: Pay close attention to your body during exercise and daily activities. Avoid "locking out" your joints into hyperextension. Learn to move with a slight bend or "soft" joint, allowing your muscles to engage and support the joint throughout its range.
• Learn Proper Movement Mechanics and Posture: Understand how to maintain neutral joint alignment during functional movements (e.g., squatting, lifting, carrying). This reduces strain on ligaments and encourages muscular engagement.
• Pain Management and Injury Prevention:
  • Avoid Passive Stretching: While some gentle, active range-of-motion exercises can be beneficial, prolonged passive stretching can overstretch already lax ligaments.
  • Pacing: Listen to your body and avoid overdoing it. Fatigue can compromise muscle function and increase injury risk.
  • Supportive Gear: In some cases, a physical therapist may recommend supportive footwear, braces, or taping for specific activities to provide external stability.

Exercises to Prioritize

Here are examples of exercise categories and specific movements beneficial for hypermobile individuals:

• Core Stability:
  • Planks (forearm or high plank): Focus on maintaining a straight line from head to heels, engaging abdominals and glutes.
  • Bird-Dog: Slow, controlled movement, maintaining a stable trunk.
  • Dead Bug: Excellent for core control without spinal loading.
• Gluteal Strength:
  • Glute Bridges: Focus on squeezing glutes at the top, avoiding hyperextension of the lower back.
  • Clamshells: Targets hip abductors and external rotators.
  • Single-Leg Deadlifts (modified): Focus on balance and hip hinge, not heavy weight.
• Shoulder Stability:
  • Band Pull-Aparts: Targets upper back and scapular retractors.
  • Face Pulls: Strengthens posterior deltoids and external rotators.
  • Wall Slides: Improves scapular control and overhead mobility without joint strain.
• Knee Stability:
  • Wall Sits: Builds quadriceps endurance without dynamic joint movement.
  • Leg Press (controlled range): Allows for controlled strengthening of quadriceps and hamstrings.
  • Step-Ups/Downs: Focus on controlled descent and ascent, engaging glutes and quads.
• Proprioceptive Training:
  • Single-Leg Stance: Progress from stable ground to unstable surfaces (e.g., foam pad, wobble board) as tolerated, with support nearby.
  • Walking Heel-to-Toe: Improves balance and coordination.
  • Tai Chi or Pilates: Excellent for body awareness, controlled movement, and core strength.

What to Avoid

• Extreme Passive Stretching: As mentioned, this can exacerbate laxity.
• "Locking Out" Joints: Consciously avoid hyperextending elbows, knees, or other joints during movements. Maintain a slight bend.
• High-Impact Activities Without Proper Muscle Control: Activities like jumping, running, or contact sports may need to be modified or approached with extreme caution until sufficient muscle strength and proprioception are developed.
• Ignoring Pain: Pain is a signal. Do not push through sharp or persistent pain, as this can lead to injury.

When to Seek Professional Guidance

While self-management is key, professional guidance can be invaluable:

• Physical Therapist (PT): A PT specializing in hypermobility can provide a comprehensive assessment, identify specific muscle weaknesses or imbalances, and design a personalized exercise program. They can also teach you proper body mechanics and pain management strategies.
• Physician/Rheumatologist: If you experience persistent pain, frequent dislocations, or other systemic symptoms, consult a doctor. They can rule out underlying conditions like Hypermobility Spectrum Disorder (HSD) or Ehlers-Danlos Syndromes (EDS) and coordinate your care.
• Certified Personal Trainer (CPT) with Hypermobility Experience: Once you have a foundational understanding and clearance from a PT, a CPT can help you progress your strength training safely and effectively.

By understanding that hypermobility is a characteristic, not a curable condition, and by committing to a strategic program of strength, stability, and proprioceptive training, you can significantly improve your quality of life, reduce pain, and optimize your body's function.