If you have a body (hey that's you!), teach bodies to move, or help other people figure out what’s wrong with their body, this is what you should know about hypermobility.
1. People are not hypermobile. Joints are hypermobile. So, please don’t go labeling yourself as hypermobile unless you truly never sit down and flit around enough to drive even a Jack Russell terrier mad. If you came over to my house, I would show you that there are many joints in your “hypermobile” body that don’t move at all.
2. Hypermobility does not mean that you have long, loose muscles, but that a joint's ligaments are lax. Being hypermobile does not mean that your muscles are flexible.
3. Hypermobility isn’t really the correct name for a joint that has excessive range of motion. Hyperlaxity is. Unfortunately, Hippocrates created the term hypermobile, while grouping together a set of Persian bow and arrow warriors who had elbows that seemed to extend more than others. The name stuck. It is documented in the literature that the term hypermobility should be changed to hyperlaxity, but that it would take too much time and effort to correct in forthcoming texts. Conserving time and effort seems like a good reason to continue to mislabel ailments in the body. Hey kids! See if the “this takes too much time and effort” excuse works with your parents and teachers. Hey parents! See if the “this takes too much time and effort” excuse works with your boss. Or the tax man. Let me know how it goes.
4. "Double-jointed” is not a correct term. But I'm hoping you already knew that.
Where do hypermobile joints come from? The answer is -- nobody knows for sure. Many people create their own particular hypermobilities by constantly using a range of motion without muscular support or holding their body in a particular postural position. There are conditions like Ehlers-Danlos Syndrome (ED) that might include some joint hypermobility. There is also a general class of symptoms that are labeled Hypermobility Syndrome.
To receive a diagnosis of Hypermobility Syndrome you must have (___) number of joints that move beyond the “normal” range of motion AND joint pain in more than four joints for longer than three months.
Did you see I put the “___” there? It’s not because I don’t know, but because there is no standard amount of joints that give a Hypermobility Syndrome diagnosis. It’s not like it’s a science or anything. D'uh.
You don't have Hypermobility Syndrome if you have ED, because you can’t have two reasons for your issue. I didn’t invent the rules, it’s an insurance thang.
So, now that you know all of this, here’s some other stuff you should know:
1. Ligaments are the “seat belt” of a joint. They keep you connected to the rest of your parts and are what keep you from smashing through the proverbial “windshield” in a large-force collision.
2. The ligaments are not the brakes of a joint, the muscles are.
This is an extremely important point to understand. You might even want to read this point twice. Just like correct brake use in your car keeps you from needing the seatbelt, the muscles about each joint keep you from applying a load to the ligaments.
3. The ligaments are not the brakes of a joint, the muscles are.
(See how important I think this point is?) Just like correct brake use in your car are what keep you from needing the seatbelt, the muscles about each joint keep you from applying a load to the ligaments. Re-read this until you understand what I'm saying here.
What I am saying here? Even if your ligaments are flapping in the wind or you had them all surgically removed, it should not make one difference to the state of your joints as long as your muscles (correctly aligned, of course) are doing their job.
Ligaments are the backup system to large-force application, yet most of you out there reading this are driving (read: moving) your body around with no brakes (read: muscles). You don't have a clue how to use the brakes (read: muscles) so you depend on your seat belt (read: ligaments) to keep you connected.
Because our habitual body positions have negated the force generation within our muscles, our daily movement and exercise loads the ligaments instead, until they stretch out. Forever. You know that old ligament saying, don’t you? Once you go lax, you never go back. I just made that old saying up.
Ligament is not like muscle. It does not have elasticity. It cannot respond in resistance to a load. Which is why I cringe when I take a yoga class and see 94% of the people in class doing plank pose with their arms fully extended, elbows pointing to the right and left. Or doing 15 forward bends where the pelvis has hardly moved and the lumbar spine fully flexes, again and again, and again again. Click (here) for a picture of that.
People who see themselves as hypermobile tend to participate in stretching and flexibility programs because it is easy for them. The problem is, when entering into stretches, those with hypermobile joints actually rearrange their bones to bypass the stretch. People with hypermobile joints actually have very (very, very!) tight muscles. This may seem confusing at first, until you learn to see what each bone is doing during a movement. Flopping into a forward bend and putting both hands flat on the ground is 1) a sign of joint hypermobility and 2) a sign of extremely tight hamstrings. With every excessively mobile joint comes a set of extremely tight and non-circulating muscles.
Here are some things to know about hypermobility and exercise:
1. Exercise cannot increase the stiffness of a lax ligament.
2. If you have joints with excessive mobility, large forces, high velocities, and large loads should NOT be applied to your body. Running, sports with sharp cutting, fast throwing, or repetitive motions + joint hypermobility = A major musculoskeletal issue.
3. If you have hypermobility syndrome or another collagen issue, the primary focus of an movement program should be motor skill (learning how to isolate and control fine movements). Move well first, then move more.
4. No “zoning out” during exercise. Once you learn where your bones should be with each movement, you have to continue to monitor them throughout the bout. Eyes on your body parts (watch your hands, elbows, wrists, fingers, knees, ankles, feet) the entire time. You’re in charge of you.
If all of your ligaments are busted, does that mean that you shouldn't move? Of course not. But it means that, up until right now, the way you've been moving has been without braking and has cost you your ligament tissue. The joint issues you have are not a result of your collagen issue, but are caused by the manner by which you have moved. The good news: You can learn to create correct bony geometry which allows the muscles to participate, giving each joint the stability it needs for pain-free movement.