Living with Joint Hypermobility
A lot of people will ask me why I got into physical therapy. For one, I always wanted to help people and was interested in healthcare, but I wanted to be on the wellness side. I liked that physical therapy allowed me to really get to know my patients, spend quality time with them, understand their bodies, and help them on their journey to wellness. Keyword, ‘journey’. There is not a health destination and unfortunately, there is no surgery or magic pill that will make all your pains and problems go away without effort on your part.
We have to be active participants in our health. Of course, it would be great if we could get better by just showing up for a couple physical therapy appointments or getting a monthly massage, but that is not reality. Unfortunately, I think people get a false sense of what it means to commit to themselves. Bottom line: if you are not willing to put in the work, you will not get the results you want.
Patients have said to me, “you don’t know what it is like to be in pain.” Unfortunately, that is the reason why I got into physical therapy; I KNOW pain! We all have what I call, medical baggage. Like many people, my life experiences brought me to my profession. At a young age, I had joint pain, clicking joints (due to my instability), felt the need to stretch, and could do things that I thought I were cool! (i.e. full back bends, bending my thumb back to my forearm, touching the floor with my hands, etc.). I considered myself accident prone and had poor proprioception (knowing where I was in space). Those darn doors and table edges! I have walked into inanimate objects more than I would like to admit. Little did I know that this all had to do with my joint hypermobility!
Our joints are supposed to be able to move, but some people’s joints move too much (hypermobility) and some people’s joints do not move enough (hypomobility). Being hypermobile requires a lot of neuromuscular re-education (muscular retraining) to help protect the joints, build strength, and decrease pain. It is not uncommon for hypermobile people to report that they are tight. So why do they feel tight?? Ligaments attach bone to bone; they help to give your joints support. With hypermobility comes ligamentous laxity; your bones can move more than others because your ligaments have more give. With less tension in your ligaments, there is less joint stability. Muscles are attached to bone by tendons. Muscles are what move our bones. If ligaments are lax, it is even more critical that your muscles are strong to support your joints. If your joints are not lined up properly, think of an elbow in a plank position with the elbow starting to bend backwards (i.e. hyperextending) the muscles are actively insufficient and cannot contract to their potential. This can result in injury, stress to joints, tendons, and ligaments and can perpetuate weakness.
The tightness sensation can also be a result of overstretching the joints and tissue. Our body sometimes picks strategies to protect us, but it’s not always optimal. For instance, if a spinal segment moves too much, muscles can lock down as a way to try and stabilize the joint, but that can result in tightness. Our muscles need to have resting tone, but going into complete lockdown is not ideal. Muscles need to be trained properly to get stronger so that they can control the axis of movement and allow freedom of movement without injury, especially in an unstable joint. I always tell people who are hypermobile, just because your body can go somewhere, does not mean it should!
People need to work on joint stabilization and strengthening. Hypermobile patients often state they do not feel any muscles working or do not feel what is supposed to be working (i.e. doing a bicep curl but only feeling fatigue from gripping a weight vs activation in their bicep). If this sounds like you, you would be surprised to see how much better you feel when your joints are in the right place at the right time. You can feel your muscles working the way they are supposed to be working!!!
It is also not uncommon to have joint pain throughout the body when you are hypermobile. If your joints are loose, where are you getting stability from? Even if you are generally hypermobile, you will have areas of hypomobility. Your body is the master of compensations! It will do what it can to function, so some areas lock down to go into protection mode. It can be overwhelming and stressful to experience multiple locations of pain at the same time, but as you start addressing the hyper/hypomobilities, restore mobility, and regain strength and stability, you will feel relief!
Treating hypermobility is challenging, but rewarding. The relief you feel when you actually stabilize your joints and use your muscles vs using your joints or ligaments as your primary support, the better and stronger you feel.
Living with joint hypermobility is a lot of work because you have to initially think A LOT about where your joints are so you can protect them, but like anything, practice and repetition brings about change. It is more brain fatiguing before physically fatiguing, but with time, your muscles will feel it! I am the strongest I have ever been and I can feel the right muscles firing when I am exercising. I am continuously working on my joint stability and strength because taking care of myself is a journey. It is rewarding to give my body the nourishment it needs not only through the food I eat, but through the exercises I do. Movement is healing! Moving provides joint nutrition, lubrication, increases blood flow, increases oxygen to your tissues, and improves joint flexibility, just to name a few.
If you have pain due to joint hypermobility, there is help for you! You just need to be guided properly and I am happy to help you on your journey to pain-free living!
