What does it mean to be hypermobile? A gift & a curse wrapped into one


I grew up as a long and lanky kid playing every sport that was available to me.  I loved team sports and got deeply into soccer and rugby.  If I knew then, what I know now about my body, I would have stuck to volleyball and swimming.  Don’t get me wrong, I thoroughly enjoyed the sports I played, but I routinely felt like I had been hit by a truck afterwards and still have two wonky shoulders to show for it.

I am what you would call hypermobile.  That means that the soft tissues that help hold my skeleton and joints together are relatively looser and more flexible than the average person.  It is a genetic trait that a large number of people have, but most have no concept that the way they are put together is not “normal,” or the same way everyone else is put together.  It does go both ways, some people would be deemed hypomobile, implying that their spine and joints are relatively stiffer than the average population.

My estimation of the incidence of pain and injury as they correlate to genetic joint mobility:

Being loose jointed may sound like a positive genetic attribute, but let me assure you it can pose a lot of problems for people.  Gravity can become particularly annoying when you are hypermobile, especially if you have a job that requires you to sit or stand still for any length of time.  We are the only creatures on Earth that are built to stand and walk upright on two feet- that biomechanical feat requires a skeleton that provides both structural stability to vertically stack your body, and functional mobility so that you can move freely.  Hypermobile people are built to move and have to work a lot harder than everyone else to stack everything up and stay still.  We are also the only creatures on Earth that attempt to sit at desks or stand at counters for eight hours at a time.

When the passive support structures that hold you together are relatively loose, you become a lot more reliant on your muscular system, which can be a good and a bad thing.  Your body will be physically capable of many more movements and positions than your hypomobile counterpart, but you will fall into the paradox of choice.  If your body has twenty different postures to choose from, finding the right one can be really hard.  Control of your muscular system requires learned skill to use it and move it well and most hypermobile people never develop enough awareness to control their loosey-goosey bodies.  As a result, they tend develop strong muscle imbalances, postural issues and are susceptible to some very typically aches and pains if they attempt to function at a desk job or do a lot of physical labour.

Marble analogy:
Imagine the following scenarios represent your joint control and stability

#1 Normal/Average person
-I give you a marble and a small bowl and ask you to move the marble around the bowl and then try to balance it right in the middle
-You will have some room to play with it and then not much trouble keeping it in the middle

#2 Hypomobile/Stiff person
-I give you the same marble and a shot glass and ask you to move the marble around and then try to balance it right in the middle
-You won’t have much movement, but it’s really easy to keep it centered

#3 Hypermobile/Loosey-Goosey person
-I give you the same marble and a huge mixing bowl and ask you to move the marble around and then try to balance it right in the middle
-You will have lots of fun moving the marble all over the bowl, but you are going to have trouble finding the middle because you have so much room to play with.

Think about this analogy happening at every level of your spine, in your hips, in your knees, throughout your body.  Stiff people are good at standing still, carrying heavy loads and pushing big objects because their bodies give them a genetic mechanical advantage while loose jointed people are good movers but find the seemingly simple task of sitting still really hard.  Some people are built to be accountants while others are meant to be ballerinas.  You run into trouble when the ballerina wants to be an accountant, or the accountant want to become a ballerina.  Then there was me- the 6’5″ loose jointed rugby player who’s shoulder fell out every time he tackled someone.  I became a physio to figure out how to put my body back together and keep it that way.

Clinically, treating really hypermobile people is the most challenging because it is like trying to solve a 3-dimensional, moving puzzle; each time you see them, they may move a different way and you are forced to chase the problem around while teaching them how to create some control and awareness in their bodies.  As I mentioned, hypermobile people are much more dependent on their muscular system for stability, this makes them much more vulnerable to muscle imbalances creating problems with their alignment.  If they have a fall on one hip, or get whiplash in a car accident, the resulting muscle spasm will likely cause them way more trouble than your average person.  It can also be much harder to detect imbalances because the person may still have a lot of range of movement compared to the average person, but slight differences in muscle pulls can throw their stability system out of whack.

Stiff, hypomobile people generally gain a lot of benefit by just loosening them up and decompressing everything, but hypermobile people have to put in a lot more cognitive effort and practice to learn the skills of using their muscular system well.  It is the hypermobile people with poor body awareness that tend to have the most chronic pain issues and have the hardest time recovering from even minor car accidents.  (Videos: Why low backs hurt & Why necks hurt)

Understanding your body type is a crucial step to proper rehabilitation of an injury and the prevention of any future pain.  Just because you may feel stiff all the time does not mean you are hypomobile, in fact, hypermobile people tend to experience the most feelings of stiffness out of any group.  I recommend seeing a healthcare practitioner that is used to working with people’s bodies like a physiotherapist, Pilates instructor, massage therapist or chiropractor and ask for some feedback about your joints, muscles and fascia, then use the exercise progressions my video playlists to develop body awareness and control of your muscular system.  The average, ‘normal’ people will have the easiest time with them, but either ends of the spectrum may find some of the exercises really challenging.

Your WTH Dashboard will allow you take notes as you learn about your body and the video library will help you figure out what body type you are, why things hurt and what exercises you should work on to keep your body in working order.

Related videos (search on video library page):

Please leave a comment below if you have any questions.

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17 Comments ↓
  • April Kite

    Hi Brent,

    I couldn’t find a direct email link…

    I found this info really helpful. I’m looking forward to getting a peak at the videos.

    Thanks!

  • mimi

    Everything you have said about hypermobility has resonated with me. I have had PTs, Yoga Instructors, Acupuncturists, Rolfers tell me that I am hypermobile and that I need to just strengthen my core. Well, I’m not even 30,have had chronic low back pain for 5 years now, and strenghtening my core always makes it worse and my knots get tighter and will not release, just like you say. So after receiving IMS, what should you look for in a PT/physiotherapist-are there certain kinds of trainings that some PT have that know they need know how to teach you to stabilize your core and train your muscles to trigger correctly before they go onto strengthening exercises. I live in upstate New York so its not as simple as going to your practice, but I have found IMS practicioners outside of Ottawa.

    • Brent

      good question Mimi. You may consider looking for a physio that does Feldenkrais work or some experienced clinical Pilates instructors to try some one on one work.. To my experience hypermobile people have trouble with the traditional model of "strengthen you core" that most physios and trainers will take so you have to find someone that is more focused on movement, alignment and posture than strengthening. Your core workout should be trying to hold your spine in a neutral position during day to day tasks like sitting, standing, bending, walking. If you try to add strengthening exercises before you understand your fundamental postural imbalances you will likely get worse instead of better. Unfortunately I don’t have a specific person or qualification for you to look for, but I would start by reading/watching on this site:
      Read: Everything your mother taught you about posture is WRONG
      Read: Why Hips Hurt
      Watch: 4 Point neutral spine and How to Sit
      Read: Core Training: when less is more
      Then look at some of the progressions linked from the WTH Instruction Manuals on the right side of the blog

      I hope that helps….good luck

    • karl

      hey (Mimi), from my point of view in any case over training a muscle won’t fixed anything, if your back hurt, its probably because your back as some kind of weakness or imbalance, try to work every part of your back. i also suggest you to train your entire body.
      keep in mind that your body is a whole line of muscle attach by joint. if any muscle is compromise another muscle will pick up the slack witch most of the time translate to pain. For your (Hyper mobile)… witch affect your ligaments, the best thing to is reinforcing both end muscle around them while limiting SHEAR FORCE. google it :) if ever a exercise hurt, take a step back, regress with less weight or a difference variation of it, until no pain result.

  • Kate

    Hello Brent!

    What a great website you have here :) I was actually reading your post on hypermobile feet, currently in the market for shoes for my tricky feet. I myself have hypermobility syndrome and have been formally diagnosed with Ehler’s Danlos, although I didn’t have the specific genetic markers to 100% place me under this branch of the hypermobility umbrella. Like you, I played lots of team sports as a kid and teen and was constantly injured. I then lost a large amount of weight very rapidly when I was about 19 and thereafter immediately and quickly began to experience widespread chronic pain, inflammation manifesting physically as tendonitis, which travelled progressively from feet upwards. I’ve come a long way since this time, approx. 6 years ago, but I still have many tendonitis-like symptoms, muscle imbalances, trouble walking (I have really well-made flexible orthotics, but they still throw me off), lots of neck/jaw/head, hand/arm pain (student-computers!) and am just wondering if you might know anybody who is experienced with hypermobility issues in Hamilton, ON (I noticed you went to school at Mac! My current Uni too ;). My hypermobility very much effects my productivity in certain areas- like you mentioned, I need to move all the time but don’t have great endurance. Studying is difficult because of this, as would be/are any jobs in my potential field (language, linguistics). I try to infuse as much movement into my work as possible (dynamic, interpersonal and experiential learning) but I’m often exhausted just trying to accommodate myself. I know a major part of my issue is my feet – I have very high arches which actually flatten as I walk (I’ve been told this is super rare), which makes me question barefoot shoes for myself…..I guess this novel of a post is simply me inquiring as to whether you have any advice/contacts that you might be willing to share? The fact that you yourself are hypermobile in itself is amazing because I’ve yet to meet a practitioner who could really empathize with my situation. Anyway, sorry for taking up so much of your time! Thank you again for such a great site :)
    Kate

    • Brent

      Hi Kate

      I did go to Mac, but haven’t been out there since 2003 and although I do have classmates still there I can’t say I know enough about them now and what they do to confidently refer you to someone….sorry….that is partly why I have been working on this website because hypermobile people are hard to work with. The exercises you need to work on are subtle and require mental awareness and a basic understanding of the biomechanics of your body and how they apply in different movements. Consider finding someone that does IMS (istop.org) and some one-on-one Pilates. Read my article on Why Hips Hurt, watch the video on How to sit and work your way through some of the other videos on this site. There is an exercise regime called Foundation that I like most of too. Hope that helps.

    • kd

      Hi…years later….there are not 2 different hypermobilities…they are all EDS hypermobility the genetics testing isn’t accurate in diagnosing. There are so many different shades of grey with this. Not enough is known about this syndrome and we need to have different approaches with physio. It all depends on the extent of your symptoms and which joints are involved. The last 3yrs I’ve had issues and had no explanation till the arthritic physio withing 5 minutes of meeting me ealized I’m EDS hypermobility.
      That was a year ago,I’m now 57.

  • Kate w

    Hi, I have found this in absolute despair on google over my hypermobile injuries. I am 38 and now it is kicking off oin the worst way with a new injury for any activity. I have always swum, but now even swimming is a problems after 2k my inner elbow bones get so sore they burn all day and m wrists hurt a lot too. I have have prolapse disc at L4/5 and cervical kyphosis with prolapse at C5/6, now swimming is out not sure what else is left. Have Ben doing physio and Pilates for 5 months, had my blood tested for inflation, that is ok but all my hand joints are sore too and that was after a ton of essay writing! Seriously, am I deficient in some nutrients or eating something wrong? I eat a plant based whole food diet, I supplements B12. I have young children so always fitting, cooking cleaning etc. could swimming of injured my elbows and wrists? I swimm a high mileage of about 16 to 20 k a week but technique is good.

  • Cheryl G

    Hi Brent,

    I have a 7 year old son just diagnosed with hypermobility. The Dr. told us to have him stop gymnastics, which, aside from jumping on the trampoline in the back yard, is one of the only physical things he really enjoys. I was wondering if you have any suggestions for us as to what activities are good for hypermobility (in addition to swimming) that might be engaging enough for a 7 year old. Thanks!

    • Brent

      Hi Cheryl

      The best thing you could probably do is see if you can find a pediatric physio in your area. My friend runs a few in Vancouver http://www.kidsphysio.ca but not every city will have this service. They have combined physio with jump gymnastics. Gymnastics can be helpful or harmful for a young hypermobile kid. It is really important to have a trained professional try to work on developing body awareness, good movement patterns and posture in a fun environment. Gymnastics in a non-competitive environment can be that place. Practicing catching, throwing and jumping with someone helping drawing attention to how they are doing it is important. Work on movement and form not stretching and strengthening activities. Start by looking for a Pedeatric physio.

      hope that helps

      • Cheryl G

        Thanks so much!

  • SHELLEY HOLDERNESS

    Hello Brent!

    I was so thrilled to find your website, and specifically your article about hypermobility. I had no idea that this was my body type until I suffered whiplash about three months ago and began seeing a very knowledgeable physiotherapist. I have always known that I have very flexible joints, but was not aware of how this can affect your recovery rate or how much more you rely on your muscles to stabilize your body. I am somewhat shocked to see how few medical professionals seem to be aware of this difference. My GP and his various colleagues and locums thought that because my mobility seemed good then my injury can’t have been that bad. It’s been just over three months and my pain ebbs and flows still. I’ve had a whole host of interesting symptoms, which I have noted seem pretty standard (by what I’ve read online), but it’s surprising how many GPs don’t seem to be fully aware of this injury and its various symptoms. The only person who has really understood my injury, and how my body type is responding to it, is my physiotherapist. Otherwise, I would be feeling perpetually frustrated about my slow recovery time and wonder what was wrong with me! (Prior to my accident I had a pretty active lifestyle, had decent core strength, and went to the gym at least 4 times a week.)

  • Jac

    I have loved everything on your site so far and this article really resonated with me. Like most on here, have struggled finding health practitioners who get it. I am located in St. John’s Newfoundland – wondering if you know of any physios or trainers you could recommend out here that would practice similar to you? Also – I don’t believe there is anyone who does IMF in this area – is there another treatment you could recommend for pain management?

    • Brent

      I do know two physios in St Johns but they don’t work in the same type of practice unfortunately. If you can’t find anyone to do IMS, I would try acupuncture, or a good osteopath for some manual therapy or potentially a chiro for A.R.T. (active release technique).

      Best of luck

  • Veronica nowakowski

    Thank you so much for explaining some things. My parents refuse to explain my HMS to me and won’t take me to the doctor to find out what I should do. Both my parents have HMS so they say they can help me them selfs. But they just tell me to put a brace on before every game(I’m in volleyball,basketball,martial arts, weightlifting, badminton, tennis, and fencing.) but recently that isn’t "keeping me together". I was wondering what should I do to get out on the court again?

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