Joint hypermobility affects approximately 10-20% of the population, with some individuals experiencing significant symptoms while others remain unaware of their flexibility. Understanding hypermobility and implementing appropriate strengthening strategies can dramatically improve quality of life. At M.O. Therapy in Markham, we specialize in helping hypermobile individuals build strength and stability.
Understanding Hypermobility
What Is Joint Hypermobility?
Joint hypermobility means joints move beyond the normal range of motion. This increased flexibility can affect some or all joints.
Key Points:
- Joints extend further than typical
- Ligaments and connective tissue are more lax
- Can be localized or generalized
- May or may not cause symptoms
Types of Hypermobility
Asymptomatic Hypermobility:
- Increased flexibility without symptoms
- Common in dancers, gymnasts, swimmers
- May be advantageous in some activities
- No treatment needed
Hypermobility Spectrum Disorder (HSD):
- Hypermobility with symptoms
- Joint pain and instability
- Affects function and quality of life
- Requires management
Hypermobile Ehlers-Danlos Syndrome (hEDS):
- More severe form
- Specific diagnostic criteria
- Affects multiple body systems
- Requires comprehensive care
The Beighton Score
A screening tool for generalized hypermobility:
- Pinky finger bends back >90° (1 point each side)
- Thumb touches forearm (1 point each side)
- Elbow hyperextends >10° (1 point each side)
- Knee hyperextends >10° (1 point each side)
- Palms flat on floor, knees straight (1 point)
Score of 5/9 or higher suggests generalized hypermobility.
Symptoms of Hypermobility Syndrome
Musculoskeletal
Joint Symptoms:
- Joint pain
- Joint instability
- Recurrent dislocations or subluxations
- Early-onset osteoarthritis
- Chronic pain
Muscle Symptoms:
- Muscle fatigue
- Muscle spasms
- Weakness
- Pain with exertion
Associated Features
Common Associations:
- Fatigue
- Anxiety
- Digestive issues (IBS)
- Autonomic dysfunction
- Poor proprioception
- Easy bruising
- Skin fragility
Why Symptoms Occur
Mechanism:
- Lax ligaments don't stabilize joints well
- Muscles work harder to compensate
- Leading to muscle fatigue and pain
- Poor proprioception increases injury risk
- Microtrauma accumulates
The Importance of Strength
Why Strengthening Matters
For hypermobile individuals, muscles must provide the stability that lax ligaments cannot:
Goals:
- Improve dynamic stability
- Reduce joint stress
- Decrease pain
- Prevent injuries
- Enhance function
- Build endurance
Strength vs. Stretching
Critical Point: Most hypermobile individuals should:
- Focus on strengthening, not stretching
- Avoid pushing into hypermobile ranges
- Work within functional ranges
- Build muscle control
Exercise Principles
Key Principles
1. Control Over Range:
- Work within mid-range of motion
- Avoid end-range loading
- Quality movement over flexibility
2. Slow, Controlled Movements:
- No ballistic or fast movements
- Mindful muscle activation
- Constant tension through movement
3. Proprioceptive Focus:
- Know where your joints are
- Body awareness training
- Balance work
4. Consistency Over Intensity:
- Regular moderate exercise
- Avoid boom-bust patterns
- Sustainable approach
5. Full Recovery:
- Allow adequate rest
- Don't overdo good days
- Pacing is essential
What to Avoid
High-Risk Activities:
- End-range stretching
- High-impact activities initially
- Explosive movements
- Heavy loads with poor control
- Prolonged static positions
Strengthening Program
Getting Started
Start Low, Go Slow:
- Begin with body weight or light resistance
- Master form before adding load
- Progress gradually
- Monitor symptoms
Core Stability
Essential Foundation:
Dead Bugs:
- Lie on back
- Knees bent, arms up
- Lower opposite arm and leg
- Keep spine neutral (no arching)
- 2-3 sets of 8-10 each side
Bird Dogs:
- On hands and knees
- Extend opposite arm and leg
- Don't hyperextend back
- Hold 3-5 seconds
- 2-3 sets of 8-10 each side
Modified Planks:
- Start on knees if needed
- Keep body in straight line
- Don't sag or pike
- Hold 15-30 seconds
- Build duration gradually
Lower Body
Key Exercises:
Glute Bridges:
- Lie on back, knees bent
- Squeeze glutes, lift hips
- Don't hyperextend back
- Hold 3-5 seconds at top
- 2-3 sets of 10-15
Squats (Modified):
- Don't go below parallel
- Control throughout
- Keep knees over toes
- 2-3 sets of 10-15
Step-Ups:
- Moderate height
- Push through heel
- Control the lowering
- 2-3 sets of 10 each leg
Clamshells:
- Side-lying, knees bent
- Open top knee
- Keep feet together
- 2-3 sets of 15
Upper Body
Shoulder Stability:
Wall Push-Ups:
- Don't lock elbows
- Control throughout
- Progress to incline, then floor
- 2-3 sets of 10-15
Rows:
- Band or light weights
- Squeeze shoulder blades
- Control the return
- 2-3 sets of 12-15
External Rotation:
- Band or light weight
- Elbow at side
- Rotate outward
- 2-3 sets of 15
Balance and Proprioception
Essential for Hypermobility:
Single-Leg Stance:
- Start near wall for support
- Progress to unsupported
- Close eyes for challenge
- 30 seconds each leg
Tandem Standing:
- Heel to toe position
- Hold 30 seconds
- Progress to eyes closed
Balance Board/Cushion:
- Start with bilateral stance
- Progress to single leg
- Add movements as tolerated
Cardiovascular Exercise
Recommendations
Good Options:
- Swimming (joint-friendly)
- Cycling (controlled range)
- Elliptical (low impact)
- Walking (accessible)
- Rowing (with good form)
Considerations:
- Start with low impact
- Build gradually
- Monitor joint symptoms
- Stay hydrated
Daily Management
Pacing
Essential Strategy:
- Balance activity and rest
- Avoid boom-bust cycle
- Plan for recovery
- Don't overdo good days
Postural Awareness
Key Points:
- Avoid prolonged positions
- Don't lock joints
- Support body when possible
- Regular position changes
Joint Protection
Strategies:
- Use supports when needed
- Avoid carrying heavy loads
- Protect vulnerable joints
- Use ergonomic aids
Common Challenges
Fatigue
Management:
- Regular rest breaks
- Prioritize activities
- Energy conservation
- Sleep optimization
Pain
Approaches:
- Appropriate exercise
- Heat or ice as helpful
- Pacing activities
- Manual therapy
Anxiety
Common in hypermobility:
- Address with appropriate support
- Exercise can help
- Relaxation techniques
- Professional help if needed
Treatment at M.O. Therapy
Physiotherapy
Our physiotherapists specialize in hypermobility:
Assessment:
- Comprehensive evaluation
- Identify problem areas
- Functional assessment
- Goal setting
Treatment:
- Individualized strengthening program
- Proprioceptive training
- Pain management
- Education and support
Massage Therapy
Our RMTs help with:
- Muscle tension relief
- Pain management
- Relaxation
- Recovery support
Chiropractic Care
May include:
- Gentle assessment
- Supportive care
- Movement optimization
- Complementary treatment
Frequently Asked Questions
Is hypermobility something I'll grow out of? Hypermobility tends to decrease somewhat with age but usually persists to some degree. The good news is that symptoms can improve significantly with appropriate strengthening and management.
Should I stop all exercise if I have hypermobility? No, exercise is essential for managing hypermobility. The key is choosing appropriate exercises, focusing on strengthening and stability, and avoiding high-risk activities.
Can hypermobility be cured? Hypermobility itself cannot be cured, but symptoms can be effectively managed with appropriate strengthening, lifestyle modifications, and support.
Is yoga good for hypermobility? Traditional yoga that emphasizes stretching may not be ideal. Modified yoga focusing on strength and stability, with an instructor knowledgeable about hypermobility, can be beneficial.
Book Your Assessment
If you have hypermobility and want to develop an effective strengthening program, M.O. Therapy in Markham can help. Our team understands hypermobility and will create a personalized plan for you.
Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.