Many of our clients come Pilates to increase their flexibility. Some of them struggle to touch their toes with straight legs, while others work hard to stretch their shoulders. But how do you handle the ones who fight just to hold themselves in place? Can they also benefit from the wonders of this fantastic method? The answer is very simple and straight forward: Yes, yes and yes!
If a client is hypermobile, it means he or she has a range of movement beyond what would be considered normal. Unfortunately, it’s due to lax connective tissues and can lead to movement impairments and muscle imbalances that stress joints, muscles and soft tissues. In addition, it can make people’s bodies unstable, and also make them have less proprioception, which is an important part of the process of building awareness and embodiment.
Ironically, some hypermobile clients may not present as particularly flexible and may complain of stiffness and tightness. That’s because their muscles have to work overtime to stabilize and support their joints, and not in an efficient way. So they may go into a hypertonic state, which can lead to a wide variety of physical issues and injuries, from tendinitis to damaged ligaments.So, how can we handle all of this? First, we have to learn how to recognize this condition. Assessing a client’s posture and movement can offer telltale signs of hypermobility such as:
- Hyperextended knees and/or elbows (beyond 10 degrees extension);
- Extreme hip rotation;
- Extreme plantar flexion of the feet;
- Winged shoulder blades;
- Supinated or pronated feet;
- Hyperflexible lumbar spine, usually hyperextended;
- Fingers flex back beyond 90 degrees and thumb can be pulled back to the forearm;
- Laxity in joints, hypotonia (low tone in muscles), fatigues quickly and poor proprioception.
Once you’ve known you have a hypermobile person, here are some tips on training this client:
No more stretching: A hypermobile client may constantly feel the need to stretch. But years of overstretching already-lax ligaments may mean that the muscles are actually lengthened to the max, like a stretched rubber band. From a technical point of view, strengthening the joints is more important, so that we can make the joints more stable and they can move in coordination.
Choose closed-chain exercises: Because of the lack of proprioception, the body awareness is possibly deficient and they don’t know exactly how to brace their muscles to become stable. Therefore, the best option is stick with closed-chain exercises and use the cables and the spring-based resistance of the Reformer and the Cadillac to give them feedback, so they can feel the connection between their core and their extremities. It will help them to learn how to operate their body as a whole, rather than sinking into their flexibility in some joints and bracing too fiercely in others.
Connect to the breath. Hypermobile clients may generally have challenges with pelvic stabilization and deep core support. Both issues are greatly assisted by better breathing. A proper diaphragmatic breath will keep them from bearing down and helps the diaphragm, abdominals and pelvic floor to work together.
Some precautions: Although we often emphasize finding the fullest range of motion, hypermobile clients may have a tendency to over extend their joints. Our job is to watch for this and teach them how to stabilize their joints. Spine stretches, such as swan, or exercises that combine stability with functional strength, such as the saw, are opportunities to be mindful. Instead of going to the full range of motion, ask them to pay attention to the breath and to feel where their muscles — not their limber joints — can take them.
Heavy resistance can also be tough on their sensitive joints. Gradually work their way up to poses that ask them to bear much of their body weight, such as side lifts and push-ups.
The key is to release the muscles that are gripping, while training others to kick in for support!
One final thought: Help your clients to stay positive! Emotional frustration is very common with hypermobile clients, who may have a hard time staying stable or even feeling that muscle working. Finding exercises where they can really get connection and feedback is very important to give them the feel factor and it is what will make them learn how to move better!
Author: Barbara Lopes
Born in Brazil, Barbara is trained as a physiotherapist and Pilates teacher. She’s worked with a variety of athletes, pre- and post-surgical clients, rehabilitation, pre- and post-natal clients, and people of all fitness levels.
“When I’m working with a client, my focus is on contemporary, intelligent, biomechanically-efficient exercises that provide maximum results through precise alignment and controlled movements.”
I’m a teacher and my 12 year old is hyper mobile. He gets a lot of ankle injuries in soccer and also has problems with his hips which I think comes from his ankles. Any suggestions for how I can help him at home. I have all the equipment.
Thank you.
Hi Maria!
Thank you very much for your comment!
Pilates is a wonderful tool for helping a client who has persistent ankle and hip injuries, as weight and impact on the joints can be less during Pilates than during many other forms of exercise. Firstly, you have to consider the level of the injuries and whether it is an acute injury or a chronic injury. Considering this a chronic injury plus the hypermobility, your goal would be working on stability, strength and balance. Therefore, I would recommend you to start with calf raises, standing on balance props like the sit fit, yoga block or the bosu and lots of footwork on the Reformer (bilateral and unilateral). Once your client is pain free and shows good ankle alignment and stability with single leg, then do jump work. Begin with light resistance to decrease impact on foot and hip and progress endurance and balance by increasing resistance with jump work and going through jump series with no rest between sets. This challenges ankle and hip stability and endurance. Don’t forget to work the core and lower body muscles, always giving preference to closed chain exercises and staying away from the hole range of movement.
I hope it helps your 12 year old and also other clients with this mysterious condition!