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Hypermobile Joints And Why Stretching Can Be Disastrous

Written by: Nick Jack
Category: 2014
on 23 November 2017
Hits: 20015

When we experience pain or tightness in an area of our body we have been told we must stretch, massage and loosen the affected area to regain the lost mobility of the joint or muscle. This is the typical approach of health therapists, corrective exercise and most rehabilitation programs. And in most cases it is the most logical place to start, and often pain will subside and things go back to normal quite quickly with this approach. However in some cases this can be the worst thing you can do! For the person who has TOO MUCH flexibility, otherwise known as hyper-mobile, will not respond well to this approach, as they lack stability and need to be tightened up, not loosened. For 15 years I have worked with over 1000 people with all types of injuries and when I first started I rarely came across this case. However, in the past few years I have seen a huge increase in these cases, and many times people come to see me after having tried several therapists, trainers and various health modalities that did not work, or even made the condition worse. I am not sure as to why this seems more common, and I see this problem mainly in females, but I believe one big factor is the rapid growth of Yoga and Pilates style training that emphasize more flexibility. And while both these are great forms of exercise, they have the potential to ruin the joints of a hyper mobile person if not used wisely, and especially if you do not move well standing up.

How Do You Know If You Are Hypermobile?

 

Make sure you watch the video above as this briefly sums up this article and helps to gives you some great visuals of what this article is all about. Sometimes you can easily tell by just looking at someone and how they move. Other times it is not so clear, for it may not even be their entire body but certain joints. If you are someone who is addicted to Yoga, stretching and trying to be as flexible as you can be, there is a good chance you are hyper mobile.

One simple test I use when I first meet clients that can give you a rough idea of a person's flexibility is using what is known as the 9-point test.

Here is how you do this.

  1. Pull your little finger back. If it makes a 90 degree angle with the top of your hand when pulled back, score one point for each little finger.
  2. Try to push your thumb towards your wrist. If you can touch your wrist with the thumb of the same side, score a point for each thumb.
  3. Straighten your arms as far as possible. If your arm hyper-extends ten degrees or more, you score a point for each arm.
  4. Straighten your legs as far as possible. If either leg goes past straight to hyper extension of ten degrees or more, give yourself a point for each leg.
  5. Finally while standing, if you can put your palms on the floor with your legs held straight, you score an additional point.

Score: 0-2

Stretching and yoga classes are recommended. Interestingly, many of the people rehabilitated from joint injuries are loose jointed and have been going to yoga regularly. Yoga is better suited for those that are tight jointed and show poor flexibility. People with this low score tend to tear muscles, and have sprains. Treatment using stretching and massage is highly effective for this person and should be consistently be used to prevent further injury.

Score: 3-4

This is someone with traits of hyper mobility at certain joints. Pay special attention to which joints were loose. Participating in resistance training may result in joint injury if you train that joint through excessive ranges of motion. Often people who have loose elbows have loose shoulders. If these people are not aware of how to create good movement and stability injury is very likely. This person may not always tear muscles but suffer from dislocations, broken bones and joint problems where excessive mobility is present. A program that combines stretching for tight areas only with stability and strength exercises for unstable joints is recommended.

Score: 5-9

This score confirms you are a hyper mobile person. All exercises and stretches encouraging excess mobility of the joints should be avoided. A carefully designed stability and strength program MUST be provided to teach the body how to correctly stabilize itself. This person will often break bones or suffer from dislocations, popping and clicking of joints. Stretching, massage and exercise modalities such as Yoga should be avoided.

Understand that there is nothing wrong with you if you are hyper mobile. This is just your genetic make up, and means your body has the capability to outstretch itself. It is more common in females as their anatomy is designed to be more flexible to allow for childbirth, but also due to lack of overall lean muscle and with wider angles at the pelvis creating weaker and longer muscles. This is not necessarily a bad thing as this allows for more mobility with movement, but it does expose joints to instability, which can lead to injury and pain.

I myself score 6 on the 9 point test and I am male. All of my 6 points come from the upper body, and it is no surprise that I have broken numerous bones in my wrist, fingers and suffered several shoulder injuries. Whereas my legs have suffered from several muscle tears, but no broken bones. Only an ACL tear from a sporting accident, but other than that my legs are much more stiff and more prone to tearing muscles than instability at joints.

Where To Look For Potential Problems

To know where to look for instability, first you must understand which joints need mobility and which joints need stability. The video above gives you a good explanation of this.

If you read Gray Cook's book titled Movement he discusses what he refers to as the joint by joint approach where each of the main joints in the body share different roles and affect the following or preceding joint. What you will see is that every second joint needs flexibility and mobility, and the other joints need the exact opposite being stability and strength.

Here is how it works.

  1. Feet - The feet have a tendency to being lazy, and easily losing strength and motor control. The feet need exercises to make them stronger and more stable.
  2. Ankle - The ankle tends to develop stiffness very easily and needs more focus on mobility in order to provide all the multi directional movements of the lower limb.
  3. Knee - The knee is basically a hinge joint and incapable of multi directional movement like the ankle. It needs Stability and strength work to ensure it does not get injured as in ACL tears.
  4. Hip - This joint is often the cause of many problems. Like the ankle it provides multi directional movements but for reasons we will look at shortly they have a tendency towards stiffness and as a result benefit from flexibility and mobility work.
  5. Lumbar Spine - The lumbar spine needs stability to prevent unwanted flexion or extension. A bit like the knee joint this is just a hinge and incapable of rotation.
  6. Thoracic Spine - Requires mobility and like the hips is pivotal in providing the athletic rotational movements in tennis, golf etc.
  7. Glenohumeral Joint - Requires a mixture of stability and mobility. This along with the scapula are a unique joint in that they require both. Another reason why they are often injured and difficult to treat.

The main areas of concern are obviously the knee, lumbar spine and shoulder/neck complex.

To see a detailed explanation of how to go about assessing your body correctly read this article - How to identify mobility restrictions affecting how you move

These 3 joints need a good amount of stability in order to protect the joint from dislocation or to keep it centred within the ball and socket. Without enough stability at these areas, there is a good chance of injury and if abused with excessive stretching and loosening exercises, osteoarthritis and chronic pain is guaranteed. The joint may even begin to lose it's mobility as it uses a protective mechanism of "stiffness" to protect the joint. I would say that the neck and lower back are almost guaranteed problems with hyper mobile people especially if they participate in regular Yoga classes, or activities promoting excessive mobility.

A quick word on Yoga and Pilates, I have nothing against either of these methods, I have many friends who run businesses in both of these models. I myself am qualified in Pilates with mat and reformer, and I really love Yoga. I do however appreciate that these methods are sometimes abused, or prescribed to people who should not be doing them. Just as Crossfit and body building is an obsession creating multiple problems with many young males, I see Yoga and Pilates creating problems with many females.

It is always amazing to hear hyper-mobile people tell me how stiff and tight they feel yet on assessment they are more mobile than anyone I have met for the entire week. They have become so adjusted to feeling loose that this is their normal. Also because they are good at stretching they tend to do more things like this because they feel good being great at it. This is very common in dancing, gymnastics and especially Yoga, and I have had to ban many clients like this from participating in Yoga classes or stretching. I actually want to stiffen them up! And in all these cases they improved significantly.

Below is a story of a client who came to see me for neck and low back problems who scored a 9 on the 9 point test!

“I’ve been coming to No Regrets for 10 months now and I honestly cannot believe the results I’ve gotten in this short amount of time! I came to No Regrets after to mainly to tone up my legs and arms and get a better bum! But I was never able to exercise much for I was constantly having neck and back problems. I had seen physios and chiropractors, and while I felt good afterwards it was short lived for none of these seemed to help long term. My exercise mainly consisted of pole dancing and yoga and surfing when I could. I had spent much of my youth dancing and I stretched everyday.

I had never tried weight training before and nobody had ever explained that my joints were too flexible. Nick explained to me that I needed to stop stretching for a while, give up the Yoga for a bit and concentrate on learning to move with stability and control loads.

At first it was hard but within a few months I noticed my neck and back stopped clicking so much, I no longer had headaches and I actually felt really strong! I now am a super keen gym junkie and I was super stoked to be getting compliments on my bikini bod and bum over summer with one of my mates even saying I was starting to get model abbs woooo! I really cannot thank Nick, Nathan and Mel and the rest of the team enough – their passion and commitment to the job is so inspiring and makes it so easy to get out of bed early!”- Emily Crosbie.

You can read over 100 more stories like Emily's by going to our testimonials page.

Stop Trying To Become Too Flexible!

Now don't get me wrong their is people who do need to stretch all the time, and should be trying to improve flexibility. But these people you will almost have to bribe them to do it, for they HATE stretching. The people who really need it, avoid it as much as they can because they suck at it, do not enjoy it at all and show very small improvement for a lot of work. These people will get a zero on the 9 point test and fail every stretch test we throw at them. If Pilates and Yoga classes were full of these people it would be a great thing, unfortunately these people will rarely be seen in a Yoga or Pilates studio. But you will find them at the gym doing exercises to make them even tighter.

The people I am more concerned with are the ones who love stretching, spend a lot of time with stretching, and always looking to become more flexible. These people have no method for selecting stretches, they believe everything should be more flexible, but like I already discussed some joints need to be kept quite stiff. When you loosen a joint that needs stiffness, you now open the floodgates for potential injuries and pain.

A great article to read about this is Mobility & Flexibility What You Must Know. Always, always remember this important point.

**** ONLY STRETCH MUSCLES THAT ARE TIGHT! ****

Watch the videos below that explains the concept of how mobility and stability are intimately linked to each other. You cannot have one without the other.

  

I have found in recent years more and more females using Pilates and Yoga as their only form of exercise has in turn created more hyper mobile people who in turn develop some chronic injuries from their lack of stability. People who have used strength training in combination with Yoga and Pilates tend to keep their stability much better, as their body learns to keep it's stability with load, although they may not be the most flexible in the Yoga class. But who cares if you are not the best at touching your toes and you have no pain.

Stretches like the ones pictured below will result in poor stability, and poor motor control. The two pictures to the right in particular are great ways to ruin your lower back, with either facet joint or SIJ problems, and secondly herniated discs.

Now I understand that some sports and hobbies require this flexibility like gymnastics, dancing, maybe even Yoga is your professional job. Even weight lifters require their elbows to hyper-extend when lifting weights overhead. 

Just also understand that if you expose joints like the knees, the lumbar spine, the neck and the shoulder to excessive mobility you must also train these joints to keep their stability and what we call "good stiffness". Without this training there is a good chance you will end up in pain, it is just a matter of time. Many gymnasts and dancers when they are in the 40's often experience many problems in their spine from excessive extension that they got away with in their youth but now their body feels the affects of this instability in later years.

Stiffness Versus Stability

This is also when I see people who are super stretchy lying on the floor, but move exactly the opposite. They move with a lot of stiffness.

For example, I see people all the time with incredible ankle, hip, quad, hamstring flexibility with our lying on the floor stretches, but when I ask them to squat they can barely reach 90 degrees of hip flexion!

They are so flexible on the floor but extremely tight when they try to squat! It looks as though they need to stretch to get deeper but this only makes matters worse. This was a paradox I faced for many years and could not get my head around. What is happening is that they lack stability, and also strength. Not flexibility. Because they are so overstretched the muscles cannot protect the joint from damage so the body creates it's own version of stability, a plan B if you like, and that is called STIFFNESS!

But you will only see this when they stand up and move. Lying on the ground there is no need to stabilize so the muscles let go and relax.

When you stand up you now need stability, and because your muscles are not able to do this, your body creates the stiffness instead. Stiffness is the body’s attempt to restore stability using prime mover muscles instead of stabilizer muscle and restricts movement in order to protect joints. True stability is being able to react with perfect reflexes to be able to maintain joint alignment ready for efficient and smooth movement. As soon as we stand or need to move stability must be present but the stiffness will disappear as soon as we lie down or relax. The only way to get rid of the stiffness is to learn stability and strength drills, and how to move correctly.

A great article to read more about this concept is - Why the body chooses stiffness over stability

Also here is a quote that sums this up by John Gibbons in the book The Vital Glutes - "Tight muscles reveal themselves lying down, weak muscles reveal themselves standing up".

As I have said many times in this article I see this more and more in the last few years. Maybe I am looking for it, or maybe it was always there and I was not good enough to see it. But one thing is clear we must treat stretching with more caution. This is where the current model of health practitioners also must look at treating pain and injury in the same way. Our instincts tell us when a joint is sore it gets tight and stiff, and that we must restore it's full range of movement with stretching and massage. But sometimes this is like throwing kerosene on a fire. The joint could be creating the stiffness for it does not know how to move.

Often it is a joint above or below the one in pain that is the real source of the problem.

For example, knee pain is often a result of the ankle and hip not providing the correct alignment and throwing the knee into a bad position for patella tracking, ITB friction to ACL tears. The knee itself has little influence over the alignment as this job is done by the other joints.

Read our article Why The Knee Has Nothing To Do With Knee Pain for more information on this.

How Do You Keep Good Flexibility Without Risking Stability?

Simple. Learn how to move correctly.

When you know how to move well you never need to spend too much time stretching, for you will do this within the movements themselves. You know exactly how to achieve great range of movement with squats, lunges, bending and even pushing and pulling with the upper body, by perfectly timing mobility with stability. This is how the joints remain free from stiffness and able to do amazing movements without fear of injury. Every now and then you may need to address tight areas specific to you, but if your workouts are well balanced and designed specific to your weaknesses then this will not be a problem.

I myself had a really sore shoulder for the first 6 months of this year caused by a moment of stupidity last year. I had terrible stiff shoulder and could hardly put my shirt on in the morning. I was able to improve my flexibility in my shoulder without doing even one stretch! All of my improvement came from improving scapula stability. My shoulder was reacting to pain by creating a more stable shoulder using stiffness that caused a chain reaction of other symptoms.

How do you do this then? Well I cannot give you a one sized fits all approach to this for I do not know anything about you, previous injury, current injury, how you move etc etc. I would cover all this in a 60 minute assessment if you came to see me and even then I am still not 100% certain of what your body does. It takes a detailed assessment to determine where to start and careful analysis to narrow down the right exercises choices.

Now my point is you have to assess your body, find your weakness and learn how to improve them. The videos shown below give you some ideas on how you can go about this.

 

I highly suggest to read the article "Functional Movement Is Everything & This Is Why" for a detailed description of all of the fundamental movement patterns.

There Free Report below is an excellent resource to help you put all this together. You can get this by clicking on the image below.

 

Summary

I hope this article gives you some insights into flexibility and mobility, and in particular what it means to be hyper mobile. Remember you may not be hyper mobile at every joint, it could be just your elbows, or your knees or even your lumbar spine. Just recognize that where you have excessive flexibility you will create stiffness to counter this. If you don't create stiffness joint injuries will occur, osteoarthritis is also not far away as you continue to wear out the cartilage and wear and tear at ligaments and tendons. Learning how to stabilize, create strength in weak areas and most importantly how to move STANDING UP, is where you will become bullet proof and remain flexible with strength.

Too much flexibility is just as bad as not enough. You must strive to achieve a perfect balance between strength and flexibility. If you get this right you can do anything and live life full of fun and enjoyment.

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 300 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily.

If you live in Melbourne and would like to know more about our programs click the image below to request a free consultation and I will be in touch within 24 hours to book a time.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

  • Functional Anatomy of the Pelvis and the Sacroiliac Joint - By John Gibbons
  • The Vital Glutes - By John Gibbons
  • Movement - By Gray Cook
  • Corrective Exercise Solutions - by Evan Osar
  • Back Pain Mechanic - by Dr Stuart McGill
  • Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
  • Low Back Disorders - by Dr Stuart McGill
  • Ultimate Back Fitness & Performance - by Dr Stuart McGill
  • Core Stability - by Peak Performance
  • Athletic Body in Balance - by Gray Cook
  • Anatomy Trains - by Thomas Meyers
  • Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
  • Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
  • How To Eat, Move & Be Healthy by Paul Chek
  • Scientific Core Conditioning Correspondence Course - By Paul Chek
  • Advanced Program Design - By Paul Chek
  • Twist Conditioning Sports Strength - By Peter Twist
  • Twist Conditioning Sports Movement - By Peter Twist
  • Functional Training For Sports - By Mike Boyle
  • Athletes Acceleration Speed Training & Game Like Speed - by Lee Taft
  • Knee Injuries In Athletes - by Sports Injury Bulletin
  • The ACL Solution - by Robert G Marx
  • Understanding & Preventing Non-Contact ACL Injuries - American Orthopaedic Society For Sports Medicine