20 Sep 2015 The Search for Stability – Is Flexibility Really a Bonus?
I found this photo of me in an old album dated circa 1978. Yes, we actually had albums where we had photos printed in a shop and then stuck them in a book! Luckily, no major seventies fashion or hair mishaps but I was immediately drawn to my hyperextended left knee. Blissfully unaware at this age, of course, of hypermobilty, I now recognise this as my body searching for stability. It found it by locking out my knees. This offers a false stability. It is not strong, it is vulnerable to injury and early onset joint wear and tear. It blocks communication through the tissue – almost cutting the body into individual parts. If I look at any photo through the years, I see the same – knees and elbows hyper extended, shoulders moving in various unusual directions!
I am hypermobile at just a few joints. I can be pretty stiff in other areas. Now as a Pilates and movement teacher, hypermobilty has become one of my specialities and an area in which I love to work with clients. At the studio I work with people like me with a few hypermobile joints through to those hypermobile in all joints and those diagnosed with Ehlers Danlos syndrome. This is a genetic connective tissue disorder leading to fragile and hyper-extensible tissues throughout the body.
All these clients have one thing in common – they get pretty annoyed with me when we first start working together. Why? Because I don’t allow them to do wide range, massive movement patterns. There is always a certain amount of questioning, resistance and frustration because they are easily able to move into these extended ranges. This is precisely why I restrict it. The last thing hypermobile people need is more flexibility, more range! They have it, in abundance and it is not always best for their bodies.
Hypermobile people have less proprioception – this means they can move easily and keep going, unaware of potential damage they could be doing. They simply do not feel it. They are easily injured so extra care must be taken. I have heard stories from clients where ribs have popped or a shoulder or a knee has dislocated when asked to ‘work harder’ or ‘stretch further’ by an over zealous trainer. Be aware too that these injuries can happen in routine tasks such as unloading a dishwasher. There is a certain vulnerability to this client group.
So I do the reverse: I focus on small-range motor control. Early sessions focus very much on building sensory awareness. I want to see how much joint control a person can have, rather than whether they can place their hands flat on the floor in a roll down. We gradually build control in all joint surfaces in all planes of movement. Once this is mastered, I reassess and we start to introduce bigger, open chain movements.
The initial frustration does pass as the clients start to feel in control of their bodies, they feel stronger and injuries can diminish. Control and body awareness allow normal participation in everyday life with confidence. We begin to uncover true stability rather than relying on false stability of locking joints.
Hypermobilty is a complex, fascinating issue. It can affect so much more than just the joints – it needs to be looked at globally in the body. Symptoms can be multi-systemic affecting more than one body system. Being flexible may look good but we need to look below the surface to appreciate what’s really going on. It’s not always a bonus!