5 Signs You’re Hypermobile and How to Work Out Safely

Julia Malacoff
by Julia Malacoff
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5 Signs You’re Hypermobile and How to Work Out Safely

These days, you hear a lot about mobility in relation to recovery. Foam rolling, resistance band work and even self-massage with a lacrosse ball are all common components of many exercisers’ mobility routines. But there is such thing as being too mobile — and while it’s not necessarily a bad thing, it can affect your workout in some crucial ways.

“First, it is important to establish what mobility is,” notes Kari Woodall, owner of BLAZE. “Mobility refers to a range of motion of a joint. It is influenced by the relationship between your bony articulations (joint structures) and the soft tissue (muscle, fascia, tendons, ligaments), as well as your central nervous system.” On the flipside, flexibility refers only to the soft tissue. Each joint has an “optimal” range of motion, Woodall explains, and if you can exceed the ideal range of motion for a particular joint, it’s hypermobile.

A qualified trainer or physical therapist can help you figure out if you’re hypermobile, but it’s easy to test on your own, too. “The most common hypermobile indicator is the Beighton Score, which uses a simple nine-point testing system,” explains Tim Hartwig, a certified strength and conditioning specialist based in Los Angeles.

Generally, a score of four or higher indicates hypermobility. If you can’t quite tell whether your elbows or knees bend backwards, try drawing a visual line between three joints, Hartwig suggests. “For example, stand with your arm extended straight in front of you with your hand placed on a wall or object. Draw a straight 180-degree visual line between the shoulder, elbow, and wrist. If the elbow exceeds a 180-degree straight line, then it can be determined that the elbow is hypermobile.” You can also do this with your knee, standing with your leg extended in front of you and your foot flat against the wall.

It’s also worth noting that while there are definitely hypermobile men out there, it’s much more common in women. “Research suggests approximately 3x more women are hypermobile than men,” says Darin Hulslander, a certified strength and conditioning specialist, who runs This Is Performance, an online performance and nutrition program based in Chicago. “One explanation for this is that females undergo a lot of bone and muscular changes that create the joint laxity,” he says. Women are especially likely to be hypermobile in the upper body, according to a study in the Journal of Medicine and Science in Sports and Exercise.

So what does this all actually mean for your workouts? “Being hypermobile is an added obstacle to safe physical activity, but is by no means something that can keep one from being active,” says Shana Verstegen, fitness director at Supreme Health and Fitness in Wisconsin. “In fact, many elite athletes are hypermobile, but through physical therapy and strength training do not have any difference in injury rate than other elite athletes.” The extra work these athletes put in is well worth it, since those with hypermobility tend to lack proprioception or awareness of where their body and joints are in space, according to Verstegen. “This can lead to injury in and out of the gym.”


READ MORE > 3 STRENGTH AND MOBILITY WORKOUTS FOR RUNNERS


Most people don’t have major complications from hypermobility, but Joint Hypermobility Syndrome refers to when hypermobile joints cause chronic pain. This syndrome is relatively rare and is not the same thing as simply having hypermobile joints.

First and foremost, Verstegen believes that committing to physical therapy is the most helpful strategy for those who are hypermobile, because a physical therapist can best identify a person’s needs and teach them how to exercise safely for maximum joint strength and stability.

There are a few things you can incorporate on your own, though:

AVOID END RANGES

“People with hypermobility should avoid getting to the end range of an exercise,” Verstegen says. For example, maintaining a micro bend in the elbows at the top of a pushup rather than fully extending the elbows. This helps prevent joints from reaching that overextended position that makes you more vulnerable to injury.

SKIP STRETCHING

“When ligaments and tendons aren’t working properly, the surrounding muscles work doubletime to protect them,” Huislander explains. “In the training world we call this ‘protective tension,’ which is why a hypermobile person may feel tight.” That feeling of tightness may encourage you to stretch, but it can actually make things worse by overstressing the hypermobile joints causing the tension, he says. “Opt out of the stretching and opt in to a foam roller instead.”

UNDERSTAND THAT EVERYTHING IS CONNECTED

“If you have hypermobile joints, think of your body as one connected unit,” Woodall suggests. Avoid putting emphasis on joints you know are hypermobile and instead focus on strengthening your body as a whole. “For example, if you lack core strength, you may find your ability to reach overhead is limited. Lack of core strength may lead to poor posture, which would affect your shoulder mobility. It’s a complicated web! Think of the domino effect: If you can focus on strengthening your weak areas, it may help reduce stress on the joint/s.”

DON’T TRAIN TO FATIGUE

“The more fatigued the muscles get, the less they are able to stabilize at a particular joint,” Verstegen says. Instead of going all out and pushing past your limits, the focus should be on quality over quantity, she advises.

INCORPORATE ISOMETRICS

“In order to effectively train, we must seek to improve stability in the joints,” Huislander points out. “One of the most effective ways of doing this is through isometrics. This helps to both reprogram and rewire how our brain views our joints during exercise and helps create stability in the joints under tension.” An isometric exercise is one where you hold a particular movement for a specific amount of time. For example, holding halfway down in a push-up position for 10–15 seconds 1–3 times instead of performing a set of 10 regular pushups. “Doing this will make a big difference in how your body handles being hypermobile by creating strength and stability where it needs it most — near the joints.”

About the Author

Julia Malacoff
Julia Malacoff

Julia (@jmalacoff) is a seasoned writer and editor who focuses on fitness, nutrition, and health. She’s also a certified personal trainer and Precision Nutrition Level 1 coach. Based in Amsterdam, she bikes every day and travels around the world in search of tough sweat sessions and the best vegetarian fare.

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11 responses to “5 Signs You’re Hypermobile and How to Work Out Safely”

  1. Avatar Hui Yin says:

    great article! As someone who has HSD I want to set the record straight and say that the term Joint Hypermobility Syndrome in the article is actually an outdated term since March 2017. Now it is called Hypermobility Spectrum Disorder (or HSD, which I was officially diagnosed last month). It is not rare. It is only rare because many medical professionals haven’t heard about it and if they did, they don’t know a whole lot about it. The top physicians around the world all agree that as many as 20% of population has either HSD or Ehler-Danlos Syndrome (they both fall on the same spectrum). Treatment is same for both conditions.

  2. Avatar Stacia Barrett says:

    I have hypermobile Ehlers Danlos Syndrome and the scale mentioned here is a test for that or HSD as mentioned below. My issues are much more than just having extra range of motion as my joints sublux (partially dislocate) so it definitely impacts you more than just mentioned here. I would recommend that those that attempt to do this scale at home talk to a Rheumatologist or a Geneticist IF they score high AND have pain. It is possible to be hypermobile without pain, but since this article uses a scale used to identify medical conditions I wanted to chime in.

  3. Avatar arboreal says:

    Excessive mobilty CAN indeed keep one from being active. If it isn’t recognized until AFTER injury has occurred, the damage done combined with the psychological impact can be a serious deterrent to future attempts at fitness.

  4. Avatar N says:

    As someone with true hypermobility- Ehlers Danlos this article is misleading and contains dangerous information. Such as stretching. We are NEVER told not to stretch! We see actual doctors to show us how to stretch correctly.

    • Avatar Darin Hulslander says:

      As someone that contributed to the stretching part, it is highly contraindicated to stretch for a multitude of reasons that go beyond what this article says. Stretching other joints that contribute to instability is one thing, but true stretching really shouldn’t be done to a hypernobile joint. And this comes from some of the world’s leading researchers in the field.

  5. Avatar Robin says:

    Apparently questioning hypermobilty and it’s validity is worthy of your post being removed. You should take this as a sign that rhetoric only is allowed for this particular blog

  6. Avatar Kay Lynne says:

    I’m greatful to see this topic discussed in a mainstream forum. The people who are mildly hypermobile and/or in early stages of sever disease need this information. All hypermobile ability levels can benefit from adapting these tips to their needs. Love It!

  7. Avatar Christina Seery says:

    I also have hEDS and exercising is very difficult for me to do even after years of physio therapy, my joints just do not want to stay in place. hEDS Also means that I have chronic pain and chronic fatigue which on top of joints not staying in place can at times make exercising near impossible!
    The best exercise I have found is doing a circuit in a hydrotherapy pool, still liable to hyper extend but once you do it for a while you start to learn where to stop. The author of this article is also correct, isometric exercises are fantastic and they have been the main staple of most of my physio sessions. Great to see hypermobilty being discussed here. hEDS is a very complicated hyper mobility condition and just because you are hypermobile doesn’t necessarily mean you have a chronic condition.

  8. Avatar Terri Burks says:

    Thank you my fellow zebra!

  9. Avatar Terri Burks says:

    Thank you for addressing hypermobility as, like with most every condition, there is a very wide spectrum! Ehlers Danlos Syndrome (EDS) places a serious exertion on your body, as when the tendons and ligaments do not keep our joints in, it is imperative to make sure your muscles are strengthened enough to assist in this feat. This must be done with great care and caution as dislocating your shoulder is quite possible just opening the refrigerator door. Body awareness, proprioception, is something we must ALWAYS be aware of. Imagine having to make sure to stop and consciously think and assess each time you open a door, reach for an item, pick up an item, etc. It is physically and mentally exhausting. Those that are hypermobile, need to know the variations in this spectrum, with some that literally dislocate numerous joints every day, have cervical and or spinal instability that literally cannot support the weight of their head needing a full spinal fusion, to those that have minimal pain, lead normal lives but just note that they need to use extra caution in daily activities and may need braces for certain times or activities. Because this syndrome affects the integrity of tissue that makes up every system in the body, it can also mean weakened organs, veins, arteries, etc that can rupture or prolapse. So those who might just think of it in terms of being really flexible, and ability to do cool “party tricks” by their contortionist abilities, remember, it can also be the cause of digestive issues, dizzy spells (weakened vessels are slow at getting blood to extremities and the brain), and unfortunately can have fatal consequences . Education is the best defense in trying to avoid serious injury or other catastrophic consequences.

  10. Avatar Deborah says:

    Keep in mind that someone that has been hypermobile their whole life has torn in a majority of the joints & spine at an early age. So by their early 30’s they can have osteoarthritis & HYPOmobility, even though they are hypermobile. You can strengthen all you want but when your ligaments are like overstretched rubber bands, you’re still going to get injured & the muscles can’t do the job of the ligaments. I was a bodybuilding champ at 15yo & a personal trainer in my 20’s. I couldn’t have been any stronger. I still ended up with so many injuries, failed surgeries, failed Physical Therapy treatment protocols, that by 27yo I was destroyed by joint injuries that wouldn’t heal. We don’t heal correctly with Ehlers Danlos Syndrome. I’ve been struggling to stay active & exercise for 25 years. Deep water running, shallow water exercise, weights, stability yoga- no fast flow classes… But it’s been a nightmare. There’s no way to stay active when you’re constantly in recovery.
    Massage is better than the foam roller any day, especially when used with heat.
    Prolotherapy treatments have been the most helpful for repairing joint stability over the last decade.
    It’s impossible for healthy people to even begin to wrap their brains around what having a completely hypermobile body is like to function in. Just accessing muscle contractions in a muscle between two unstable joints can be incredibly hard to do, especially after both joints have been injured countless times.

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