In the first part of our series on ‘Hypermobility,’ we explored the concept of Hypermobility Syndrome and methods to identify potential hypermobility issues. Now, let’s delve deeper into the management strategies for Hypermobility Syndrome, which encompass a range of modalities aimed at improving joint stability, muscle balance, and overall quality of life.

Effective management of Hypermobility Syndrome involves a multifaceted approach, incorporating various modalities to address symptoms and improve overall function. Here are key strategies for managing this condition:

Primary Training

1. Cognitive

During the cognitive stage of training, individuals focus on gaining awareness of lumbar spine neutral and training deep postural muscles. Start supine to train independence of the pelvis/lower spine from the thoracic spine without global muscle substitution. As soon as possible move to crawling, sitting, standing and locomotion/movement.

2. Breathing

The focus will be on the development of lateral costal and diaphragmatic breathing while being able to maintain lumbar spine neutral.

3. Core Training

Here the focus will be on strengthening the transversus abdominis (TVA) and the pelvic floor. As soon as possible train in weight-bearing and functional postures. Next task will be to activate the bilateral lumbar multifidus with co-contraction of the TVA while maintaining lumbar neutral and controlling lateral costal diaphragmatic breathing. Eg. Move to quadruped kneeling with a strong emphasis on technique.

Secondary Training

Secondary training involves stability exercises for the entire body, focusing on areas such as the cervical spine, thoracic spine, shoulders, hips, knees, and ankles. Proprioception is enhanced through the use of wobble boards and Swiss balls, progressing to functional movement patterns such as squats/deadlifts/pulling/pushing/pressing. Cardiovascular exercise may be integrated only once stability has been addressed. As soon as strength improves, normal sporting activities can be included, providing they are built up slowly and non contact is preferable for those suffering from Hypermobilty Syndrome. Walking, cycling, deep water running, swimming are good low-impact choices. Vary mode of exercise to reduce the chance of overstraining a joint or tissue involved.

Lifestyle Modifications

Review and re-educate sitting and standing habits. Harmful postures often adopted in an attempt to improve stability include hip slumping, hyperextending hips/knees, sway back, buttressing the knees when standing or when moving from sitting to standing, sitting with outstretched knees unsupported, sitting with legs in W position, sitting with legs tucked under buttock or in meditation style crossed legged (potential to stretch the collateral ligaments of the knee).

Stretching (Only Where Needed)

Stretching can be performed in a controlled manner with proprioceptive awareness to maintain muscle length and increase circulation, rather than with the aim of improving range of motion. Careful, controlled, supported stretching for tight tissues only, and held for no longer than 15 seconds. Short stiff muscles can result from misalignments and altered recruitment patterns so may need to be identified and addressed.

Relaxation and Breathing Techniques

Relaxation, rest, and proper breathing techniques are essential components of managing Hypermobility Syndrome. Adequate sleep is crucial for muscle relaxation and recovery, while controlled breathing exercises can help alleviate tension and promote relaxation.

Empowerment and Responsibility

The body in which we live influences our understanding of who we are and where we fit in society. Successful management of the Hypermobile individual requires they have an internal sense of control, to feel they can change their life by changing their behaviour and feel responsible for their health.

In conclusion, effective management of Hypermobility Syndrome involves a comprehensive approach that addresses both physical and psychological aspects of the condition. By incorporating these strategies into daily life, individuals with Hypermobility Syndrome can minimize symptoms, improve joint stability, and enhance overall well-being.

Please feel free to contact me if you would like an in-person assessment and program.