Estimated reading time: 4 minutes When exercising with hypermobility, it is important to focus on different aspects of movement. It can be tempting to jump straight in with strengthening work. Without correct alignment, relaxation of tight muscles, and building of tissue tolerance, this strategy can frequently lead to strain and injury.
Patients frequently complain of being pushed too soon to do exercises they did not feel ready for. A study by Simmonds et al found that although physiotherapy is an integral part of hypermobility rehabilitation, some patients found it exacerbated their pain and symptoms.
My Integral Movement Method (IMM) has six principles I follow. Breath and Relaxation come before anything else. This can be particularly helpful in calming the nervous system down to turn down the pain dial. Proprioception and Stability come next, with Balance and Posture completing the approach.
Benefits of Exercise
We do know that regular and appropriate exercises can be hugely beneficial in hypermobility management. When we decondition, this can lead to muscle weakness which further impacts joint instability (2). This leads to more pain, which prevents us from moving, which can continue as a cycle – a hard cycle to break (3). You can read more about the benefits of exercise here including improved balance, improved proprioception, improved stability, better sleep, and more.
My clients and The Zebra Club members often report that when we start very gently and slowly with exercise, we also experience pain relief.
The exercises I recommend
Here are my top five best daily exercises for hypermobility. Of course, it is hard to be very specific about a top five when referring to a condition like EDS or HSD because everyone is so different and individual. These may not be suitable for everyone – so please adjust accordingly or check with your health practitioner if you have any concerns.
Exercise 1: Breathwork
Breathwork can be safely done lying down, side lying, sitting, or standing. I tend to start my clients lying supine. It is invaluable for several reasons. I explain more in my class about calming the nervous system
Exercise 2: Supine Arm Rolls
Arm rolls seem like a simple exercise but it tells me so much about how a patient loads their upper body in movement. It helps to establish shoulder and spinal stability in a safe way. You can reduce the range to 50% of your normal range to establish good shoulder joint control. My live shoulder stability class gives some different variations of this exercise.
Exercise 3: Windscreen Wipers
These are a favorite of mine for hip joint control and lower back mobility. It is all about the control and feeling the weight of the pelvis. It can be tempting to throw the legs from side to side without integration on this one – especially if we have very mobile hip joints. But learning to move from the pelvis is key. My recent Community Questions video on five daily exercises includes windscreen wipers if you would like to see a demonstration of this one.
Exercise 4: Bridges
I love bridges for many reasons. A bridge can be adjusted to different abilities starting with a pelvic hover into a full bridge. We can use bands and balls to make them more stable. They help people connect the foot-to-pelvis relationship in a safe way. My class on strengthening the posterior muscle chain has a good example of a bridge – although you can probably find bridges in many of my classes! Remember, we don’t want to squeeze the glutes when we do a bridge.
Exercise 5: Cats
Although it is not everyone’s favorite, I think it is important to add some load to the joints and the fascia through weight bearing exercises. This can be a challenging position for many hypermobile patients with wrist or knee pain, so I created a Story of Three Cats video which gives alternatives to four-point kneeling. CATS are a great mobility and stability exercise that loads the joints.
These five exercises move the body in different ways, calming and relaxing the system plus building awareness and mobility at the same time.
FAQ
Is walking good for hypermobility?
It can be good for hypermobility, provided it is done with safety considerations. It is a good low-impact activity that improves heart and circulation health. It can help with muscle strength in the lower limbs. But start low – some people may not be able to manage long walks and it is OK to start at your own pace. Maybe start with walking between lamp posts or letterboxes. Some people may need walking aids or orthotics to make walking a more enjoyable experience.
Can hypermobility get worse with age?
Hypermobility – in terms of joint laxity – can actually lessen with age as we naturally stiffen up, however, that does not mean the multitude of other associated symptoms improve. We may notice normal changes associated with aging. We may have degenerative changes in the joints causing osteoarthritis. Deconditioning may have led to muscle weakness giving us less support for our joints. Age-related decline in proprioception can make it harder to control joint movements, potentially leading to strain. Movement and exercise are ways we can support ourselves as we age. I think this is a poorly understood concept that needs more research.
How do you stretch with hypermobility?
Stretching with hypermobility should be approached with caution. We need to avoid over-stretching of lax joints and potentially destabilizing the whole system. Static stretches are not ideal if you have a big range and tend to hang on your joints. I prefer dynamic, controlled stretching. I have a video about stretching if you want to learn more. Remember, areas are tight for a reason. We don’t want to attack the tissues. Be gentle and controlled and focus more on whole-body integrated movements, rather than stretching single joints.
Here’s another 5 exercise routine I love:
Research and Literature Review by Catherine Nation, MSc, PhD
Works Cited
- Simmonds, J. V. et al. Exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers–Danlos syndrome – hypermobility type. Disability and Rehabilitation.
- Scheper et al. (2015) Chronic pain in hypermobility syndrome and Ehlers–Danlos syndrome (hypermobility type): it is a challenge. Journal of Pain Research.
- Buryk-Iggers et al. (2022) Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Archives of Rehabilitation Research and Clinical Translation
Jeannie Di Bon is a movement therapist, educator and author specializing in hypermobility, Ehlers-Danlos Syndrome and chronic pain. She is the founder of The Zebra Club app and the creator of the Integral Movement Method.
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