Hypermobility Syndrome
Hypermobility of joints is really quite common and, in my opinion, is vastly under-diagnosed. It is believed to be present in up to 30% of the population, according to a rheumatology colleague of mine, and people can vary from being slightly hypermobile to being a super-bendy contortionist – it’s a sliding scale. In recent years, things have got much more interesting and it is coming to light that it is part of a bigger syndrome that contains many other possible symptoms or conditions. (More on that below).
I first started getting really interested in hypermobility when I was training to be a yoga teacher. At least half of the teacher trainees were hypermobile. Then I noticed that all of the fabulous online yogis were hypermobile too, so yoga was obviously a ‘thing’ that hypermobile people were attracted to. Little wonder really, when you realise that a lot of the very fancy yoga poses you see on Instagram can ONLY be done by hypermobile people and that super-bendy person next to you in the class was probably born that way. As a yogi, I was jealous of them and a bit bitter that it took me a year to achieve a pose that someone else could just do automatically ( I’m definitely not hypermobile!). But the physio part of me knew a bit more and tapered my bitterness a bit ….
You see, hypermobility is both a blessing and a curse. It’s a total blessing if you want to be a ballet dancer (check out those backward-bending knees and elbows!), a gymnast, a circus performer, a dancer or a yogi. In these pursuits, the inherent bendiness of your joints is a natural advantage. However, in my experience as a physio, it’s also a massive cause of joint and spinal pain unless you know what to do with it. I can safely say that anyone I’ve seen who has required a back operation without any known cause ( e.g. a previous bad accident) is hypermobile, most people with really flat feet are hypermobile and those who are prone to dislocating kneecaps or shoulders for no reason are always hypermobile.
So it’s a double-edged sword, but if you look after your spine and joints right, then a lot of the problems can be prevented. I wrote about hypermobility and how it affects your joints in a previous blog but here’s the bottom line:
When you are hypermobile, your ligaments are bendier and this means that your joints are more mobile and less stable.
As physios, we don’t get hypermobile people to work on their flexibility, but instead strengthening is the name of the game. As a yoga teacher, I make sure that my hypermobile students are doing their poses in a way that increases the strength and muscle activity and doesn’t push into their natural bendiness. See my previous blog post about this here.
It's part of a syndrome
Finally, hypermobility is about to reach the spotlight because increasingly it is being recognised as just one symptom in a wider collection of symptoms (also known as a syndrome) with one underlying cause: the structure of your soft tissues is different to others. Please remember, before you go any further, that if you have this syndrome, you will rarely tick all the boxes and have all of the possible symptoms. You may just have one or two or you might have many. And remember, up to a third of the population have this too.
So, buckle up and let’s go. Here are just some of the things that are associated with hypermobility to date:
- Digestive problems. Hypermobile folk are more likely to have irritable bowel syndrome and sensitive digestive systems in general and may struggle a lot with their body weight.
- Anxiety. Hypermobile people have a bigger amygdala in their brain, the part of our brain that responds to the environment, so many struggle with anxiety and being a ‘sensitive’ person or an empath.
- Polycystic Ovary Syndrome and fertility issues in women – check out the next person who talks about having PCOS and see if have they knees that bend backwards (I’m not kidding!).
- More likely to be neurodiverse – a lot of very hypermobile people are dyspraxic, dyslexic or on the autism spectrum.
- Mast cell activation syndrome: you know those people who are sensitive to just about everything: face creams, food, smells. Google it, it’s fascinating.
- Skin is more stretchy and more prone to scarring. I see this a lot in my work with breast cancer patients – a lot of the gnarly post-surgical scars are seen in hypermobile patients.
- Fatigue: hypermobile people are more likely to have chronic fatigue and overwhelm. Post-Covid syndrome was more common in hypermobile people than not. By the way, check out my excellent blog on fatigue here:
- In my opinion, a lot of people with primary lymphoedema are also hypermobile, so I wouldn’t be surprised if this association is made soon.
The good news is that these associations have been made or are suspected.
The bad news is that so far, there is not a cure but with one third of the population being affected in some way, I’m pretty sure the drugs companies will be interested in investing in the research required to further this field along.
If you are seeking a diagnosis, you will require a referral to a rheumatologist. It is often called Ehrlos Danos Syndrome and the pragmatic advice will be to strengthen up: Pilates, weights training, core stability exercises. Strengthening will make your body feel like it is being ‘held’ together more.
Some people advise against using yoga, but I totally disagree IF IT IS USED CORRECTLY. I actually use yoga poses to strengthen my hypermobile patients and it also has a soothing effect on anyone with anxiety : a win-win. Check out my old but good series here on how to adjust poses for hypermobility (excuse the noise quality, it was before I got a good mike!).
And of course, if you want a 1:1 consultation, just have a look here at how to get my individual advice.
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