Core Strength In Hypermobility

Estimated reading time: 7 minutesIf you have hypermobility, chances are someone has told you that you need to strengthen your ‘core’. This generally involves exercises like sit ups, superman, planks, and wall squats.

Hands up who’s been given these as part of a ‘core’ programme? I’m not against those exercises per se – in fact, they can be great stabilizing and strengthening exercises. However, it is how we approach them that is key.

What exactly is meant by ‘core’ exercise or ‘core stability’ and is it a good strategy for hypermobility?

I first learned about core stability in my early Pilates training in 2007. It was a common instruction back then to ‘engage your core’, brace your abs, or draw the navel to the spine and hollow the abdominal area.

Thankfully, in some schools, we have moved away from that approach now.  Pilates has historically been one of the biggest promoters of ‘core stability’. I find it interesting that Joseph Pilates himself never instructed clients to ‘hollow’ or ‘brace’.

He referred to a ‘powerhouse’ and his method was different from rigid bracing (which creates stiffness) or extreme hollowing (which can over-recruit the transverse abdominis muscle).

His approach was focused on dynamic control, fluidity, and full-body integration as opposed to static core engagement.

In this blog, I would like to explore the concept of core stability and how I approach it differently for my hypermobile clients and Zebra Club members.

The Myth of Core Stability

I want to be clear. I am not saying that the deep abdominal muscles, lumbar stabilizers, and pelvic floor muscles should not be working when we move or exercise. Of course not.

Those muscles are there for a reason and are designed to perform a specific role in our bodies.

What I am saying is that the way that we approach the activation of these ‘core’ muscles is vitally important for whole body health. Especially when dealing with hypermobility. I want to promote fluidity within the pelvis rather than bracing and holding these muscles in a contraction whilst we move.

In his critical review “The Myth of Core Stability,” Eyal Lederman highlighted doubts that have been raised as to whether core stability training can actually strengthen the core muscles (1).

For example, in chronic low back pain patients, a study found that after 4 weeks of traditional ‘core’ stability exercises, there was no significant improvement in muscle endurance.

A major issue with core stability (CS) training is the single muscle/core activation approach. A Key principle of CS is to teach patients how to isolate the Transverse abdominis muscle (TrA) from the rest of the abdominal muscles or to isolate the ‘core’ muscles from ‘global’ muscles.

Do we honestly think that that is even possible? Even with extensive training, it would be impossible to activate a single muscle. How do you know you are isolating individual muscles? Everything in the body is connected.

One muscle runs into another muscle, and they are all connected by an intelligent fascial network. I discuss this in my podcast interview with fascia researcher Julian Baker. There is not a little package of ‘core muscles sitting isolated within the body.

Lederman goes on to say, “It is doubtful that there exists a ‘core’ group of trunk muscles that are recruited to work independently from all our other trunk muscles during daily activities or exercise.” 

He concludes that “There may be potential danger of damaging the spine with continuous tensing of the trunk muscles during daily and sports activities. Patients who have been trained to use complex abdominal hollowing and bracing maneuvers should be discouraged from using them.”

A softer approach to stability where the body and muscle activation respond to the load placed upon it naturally is a safer option.

We do want those muscles to activate, but we want them to activate in response to what we are doing. If I am lying on my back doing a pelvic tilt, I do not need maximum recruitment of my pelvic floor or abdominal muscles.  If I am performing a plank or lifting weights, that requires more recruitment because there is greater force going through my system.

The core and the pelvic floor

We can’t talk about “the core” without addressing the pelvic floor muscles(PFM).

The diaphragm, pelvic floor muscles, and abdominal muscles all work together to control and change intra-abdominal pressure (IAP). The pelvic floor muscles ideally should be able to help control the IAP when we talk, move, breathe, cough, and move our arms and legs (2).

Therefore, if we are constantly contracting the PFM whilst moving, we are interfering with the natural workings of the muscle system and impacting our intra-abdominal pressure (IAP).

I think this is particularly important in hypermobility when many of us are prone to hernias, prolapses, and muscle strains. I would want to avoid artificial and unnecessary bracing that will interfere with IAP.

Hypermobility and the “weak core”

When discussing core work, we need to examine IAP and understand how that works at a basic level.

In the thoracic cavity, there are three layers of anterolateral abdominal muscles (external oblique, internal oblique, and transverse abdominis) and rectus abdominis muscles.

The PFMs form the base of the thoracic cavity, and the thoracic diaphragm forms the top. Together these muscles modulate the IAP. This then reacts automatically to changes during physiological actions like breathing, speaking, movement, and strenuous activities.

These muscles continuously go through periods of contraction and relaxation or lengthening – which is what we call concentric or eccentric actions. Breathing involves a constant alteration between relaxation and contraction of muscles in the thorax.

The PFM muscles need to work in synergy with the thoracic diaphragm to maintain healthy IAP.

If, through core stability training, we are trained to hold in those PFM and abdominal muscles, there will be a direct impact on the movement of the diaphragm and increased IAP. It is very difficult to move with fluidity if you are holding these bracing patterns.

When we hold our breath as we do exercises, this can stress the pelvic floor by creating higher IAP, which doesn’t allow the pelvic floor to relax. If we use this altered breathing pattern regularly and repeatedly, it could lead to pelvic floor dysfunction (3).

We know that many of us with hypermobility suffer from PF issues – either weak or hypertonic. When we participate in movement programs, we want to make sure they are contributing to healthy breathing and movement patterns and don’t lead to or make PF issues worse.

The functional way of strengthening the core

My Integral Movement Method teaches stabilization in a gentle, functional way. It is specifically adapted for people with hypermobility and chronic pain. Instead of rigid bracing or extreme hollowing, I encourage stability through breath and movement integration.

• Breath first: never hold your breath through movement. I teach my clients and Zebra Club members how the PFM and abs work with the diaphragm as a team.
• A Soft belly that responds to load: I discourage gripping and bracing. We learn to softly connect with those muscles appropriately without creating unnecessary tension.
• Whole-body integration: I take a whole-body approach – from the feet up. A body that is well organized will have a strong ‘core’.  I used to refer to this as an Apple Core that starts from the arches of the feet and runs up to the roof of the mouth. To focus on a few muscles in the pelvis would be a disservice to the amazing integration of the whole body. 
• Avoiding the overuse of the superficial muscles is key: Many people with hypermobility will compensate with their rectus abdomis (the 6-pack) or hip flexors. I retrain the whole system to work efficiently together without gripping. When I first started out, my upper abs would always be very painful because I would use those to stabilize my trunk.
• Building strength from the inside out: Foundational movements and patterns that are performed small and very slowly, with awareness of the breath and potential breath-holding patterns, bring stability naturally.

This was the basis for my program, Strengthen Your Hypermobile Core, which was used in a recently published qualitative study. We found participants “Reported benefits include improved body awareness, self-efficacy, and relaxation, as well as strength and stability.” Our quantitative study on this project is coming soon!

Exercises for core stability

I find it funny that exercises are classified into ‘core exercises when, in fact, any exercise is going to work the ‘core.’  Walking is working it, sitting in a well-aligned position is working it.

If you’ve ever watched any of my YouTube videos or Zebra Club classes, you may have noticed I never cue ‘the core’.  Over my 16 years of clinical experience, I have had so many patients come to me in pain.

They have been taught to ‘engage’ their core, and when they try to exercise, it is painful, and breathing is difficult.  When I teach them to move and stabilize without this artificial bracing patterning, their pain goes away, and they can enjoy improved mobility.

For all of these exercises, we want to promote whole-body breath and integration.

1. Breathwork with a ball between the knees: Not to squeeze hard but to bring proprioception and awareness that the inner thighs are connected to the PFM and the PFM are connected to the lower abs. We notice the rise and fall of the belly with the inhale and exhale and visualize the movement of the PFM and diaphragm together.
2. Pelvic Rolls or Tilts: Allow the breath to move the pelvis. Inhale tilts the pelvis forward, exhale (and the change in IAP) draws the pelvis back and flattens the back. No need to engage the abs – they know what to do.
3. Knee Rolls: A great foundational stability exercise. Lying supine feel the weight of the pelvis. That’s your stability.  Allow one leg to slowly float up, keeping the knee bent. Notice how the abs naturally contract as you do this.
4. Four-point kneeling: If you are able to – organization the trunk and limbs in a four-point kneeling position, you can start to build real stability. Can you let the belly relax and drop on the inhale and naturally draw up on the exhale as the IAP changes and the muscles naturally contract?
5. Dead Bug: I always start with a hypermobile-friendly foundational version of this traditional exercise. I keep one leg on the ground and move the opposite limbs.
6. Bridge: If you’ve ever tried a bridge when ‘engaging your core’ in the traditional way, I would love to hear your experience. In a bridge, the abs need to lengthen eccentrically whilst the posterior chain provides support. This cannot happen if the abs are held in a contraction. I always start Bridges from the feet to get whole-body expansion.
7. Plank: This is often given out as a core strengthener. I always say when you are in a plank you should be able to hold a conversation with the person next to you.  Plank is a dynamic breathing exercise.  The whole body is working, not just the core.
8. Bird Dog/Superman: Almost always prescribed for core work. I think it is a great exercise but for people with hypermobility, I consider this pretty advanced. We need to have whole body organization in four-point kneeling before we contemplate moving the limbs away from the centre. I did a video on how to build up to doing a safe Bird Dog.

FAQ

How to strengthen the core with hypermobility?

⁠To strengthen the core with hypermobility, it needs to be a whole-body approach. Having tight abs and pelvis floor are not going to fix neck pain for example. The whole ‘core’ of the body needs to work together.

Can you be strong with EDS?

Yes, you can get strong with EDS. However, the approach must be set on strong foundations to learn effective movement patterns. Build that first through following a program like the IMM. Discover effective core stability techniques specifically designed for hypermobility with Jeannie’s expert approach.

Are Kegels bad for you if you have hypermobility?

No, not necessarily – for some people, Kegel exercises are very beneficial, especially pre and post-pregnancy or if you have a prolapse. Kegels are a separate exercise often prescribed by a pelvic floor physio. This blog refers to the artificial engagement of the pelvic core muscles to build stability.

Originally published August 20, 2020 and updated March 31, 2025.

Jeannie Di Bon

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.