Bending without Breaking: A Look at Hypermobility
When I was a young girl, I joined a pee-wee cheerleading team. It seemed like a great fit because I was outgoing, loud and full of energy. It wasn’t very many practices in that the coach started calling me out because my arms didn’t look “right” in the High V. The coach would tell me to straighten my arms- and I thought I was- but they were actually bending backward. That was when I learned that I was “double jointed”, in the elbows.
Joint hypermobility, often referred to as being “double jointed”, is a condition that allows a person to easily move some or all of their joints beyond the normal range of motion. People with hypermobile joints are able to move their limbs into positions others find impossible without any practice or stretching. I’m sure you’ve seen a few of these “party tricks” that seem worthy of Ripley’s Believe It or Not.
Understanding how a joint can be naturally more or less flexible from one person to the next requires a quick anatomy overview. There are two things that limit or increase the motion of a joint: the shape of the bones making up the joint or the ligaments holding it in place. The ball and socket joint is the most mobile joint and involves a domed bone that rolls inside a curved socket. The ball and socket joints in your shoulders and hips are what give your arms and legs such a wide range of motion. An unusually shallow joint socket would allow the domed bone more unrestricted mobility. Another contributing factor to joint hypermobility is a person’s genetic instructions for making the protein collagen. Collagen is found in the ligaments that link two bones to form a joint. If the collagen is weaker than it should be, ligaments will be more easily stretched and joints will be more loose and flexible.
Some people with hypermobile joints don’t even notice their increased flexibility, and some people- such as ballet dancers, gymnasts and musicians- may have learned to benefit from it. However, some people with joint hypermobility can experience a number of unpleasant symptoms as well, such as: pain and stiffness in the joints and muscles, clicking joints, joints that dislocate easily and recurring injuries. If you aren’t sure if you are hypermobile or not try taking this quick test. In general a score of 6 or higher out of 9 means your hypermobile. The higher the score, the higher the laxity.
Considerations for the Hypermobile
The nature of joint hypermobility means an automatic increased risk for injuries, such as dislocations and sprains due to joint laxity. Having the range of motion is one thing, but having strength and control in that range is another. Technical or complex moves like pistol squats or kettle bells swings need to be trained for appropriately and may take more time to work up to. Athletes with hypermobility also have a greater need for body awareness- so that they know what is right and wrong for their joints. A personal trainer or coach who is informed on joint hypermobility will decrease chances of injury by keeping you aware of your body’s movement patterns and warning you if you are in a compromised position. Working on stability in exercises and building strength in bigger ranges of motion will help relieve uncomfortable tension around a “loose” joint.
Passive stretching is usually what people turn to, to solve “tightness”, but in the case of hypermobility, it can exacerbate the problem. The reason muscles surrounding the hypermobile joint feel tight is because they are attempting to stabilize the joint to prevent injury. Instead of stretching, try foam rolling the area or getting a massage with a therapist experienced with hypermobility.
Massage can be very beneficial for those with hypermobile joints. It can reduce muscular tension and pain, improve proprioceptive awareness and combat joint fatigue. However, due to the sedentary nature of the general population, many therapists assume everyone getting on the table is incredibly tight and in need of some stretching. Obviously if the therapist is unaware of a client’s hypermobility, the treatment could go badly if too much stretching is done. Make sure you notify your therapist about any joint irregularity.