Hypermobile elbows (& other joints of the body) are sometimes really visible in a Pilates class. I wanted to look into the topic in more depth than we can easily cover in a group setting, as information for those affected.
The human body is an incredible thing but sometimes we need to take back a little bit of control for ourselves. Just because we can ‘stretch’ (ie. over-extend) at a certain (or all) joints of the body, doesn’t mean it is helpful to do so.
The most common examples of hypermobility I see in class are:
- locked-out knees in a standing position – where the back of the knee is pushed as far backwards as possible – and
- locked-out elbows in a quadruped (all-fours) position – where the upper arm becomes rotated and the inside of the elbow joint turns forward
Of course, if you are hypermobile (or tend towards it) you will often be hyper-mobile at many joints in the body, but these are the two that are most visible in class.
What is joint hypermobility?
Joint hypermobility is often hereditary and cannot be prevented, but it can definitely be managed. It is caused by a weakness in the soft tissues that support the joint, and specifically a difference in the collagen. If you are hypermobile, it may not cause you any problems or it may cause pain in the joint itself or in surrounding areas of the body.
What happens when we hyper-extend?
When we go to the end-range of movement in a joint, it gives us a feeling of stability, which is great. However, when the joint hyper-extends, it means that the stability isn’t coming from the supporting muscles but from the joint itself. Over time that is likely to create wear & tear on that structure and other compensations in surrounding areas of the body – eg. if you lock out your elbows, you are very likely to experience associated neck and shoulder pain issues; if you lock out your knees, you are very likely to experience hip and back pain issues.
Just because you can hyper-extend, doesn’t mean you should!
What can we do about it?
The ideal is to learn to stop short of your end-range point (keeping the affected joint ‘soft’) so that the supporting muscles surrounding the joint can get stronger. To start with it will feel unstable, but your body will gradually adapt and build stability in the muscles, so keep giving it the opportunity to do so.
I will keep reminding you about this in class because even if you feel like I’m nagging, I believe that I would be negligent if I didn’t bring your attention to it. You might not be ready to hear the message yet, and that’s ok because it is your body, but I’m going to keep on mentioning it when I’m teaching, and hopefully that’s ok too.
In the case of hypermobility in your knees, ankles or hips you may also be better avoiding fast-paced or high-impact exercises where the joints will hyper-extend without you having the chance to control the range of movement, and where the added impact will place extra load through the (already compromised) joint structure.
Although you can’t change your physiology, you can work on creating a stronger support system to protect your joints if hypermobility affects you. It may seem frustrating & like a backward step to begin with, but further down the line you will be so glad you made some changes and created a stronger body, especially if it avoids/delays your need for invasive surgery.
If you’d like to know more on this topic, Jeannie di Bon is a Movement Therapist who works extensively in this area. She directed me towards a blog post she wrote a few years ago:
I think this is a really useful starting point, but Jeannie has plenty more great content on her blog which you can find via her website and she also covers the topic in her latest book.