Hypermobile joints have a larger range of movement than usual and, as a result, can be less stable. Some people with hypermobility may need to avoid certain exercises, such as stretching or high impact activities, that stress the joints.
In contrast, exercises that build strength, enhance joint stability, and support bone health can benefit people with hypermobility.
However, this condition affects each person differently, and they may have different needs regarding movement. People with mild hypermobility and otherwise stable joints may not need to limit their activities.
This article looks at which exercises are suitable for hypermobility, which exercises to avoid, and how to prevent injury.
Exercise can benefit people with hypermobility, including those with connective tissue disorders. However, it can also present some challenges.
Hypermobility means a person has joints that extend beyond the typical range of motion. It is relatively common and not always harmful. Some people have mild symptoms that do not affect their ability to exercise.
However, people who have hypermobile joints due to medical conditions, such as Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorder (HSD), can be more prone to overextending their joints and potentially dislocating them.
Hypermobility disorders can also cause other symptoms that can interfere with exercise, such as:
- muscle pain
- joint stiffness
- extreme tiredness, or fatigue
- impaired proprioception, or awareness of the body’s position in space
However, exercise can also help those with hypermobile joints. For example, exercise may improve:
- Joint stability: Strengthening the muscles around the joints helps improve joint stability and may reduce the risk of dislocations.
- Bone strength: People with EDS may be more likely to develop osteoporosis, although this is more common in rarer types of EDS, according to a 2020 review. Weight-bearing exercises may help preserve bone density for longer.
- Overall health: Regular exercise supports cardiovascular health and mental health, can reduce muscle tension, and may help improve stamina.
Because hypermobility varies so much, there are no types of exercise that all people with this condition must avoid. The suitability of an exercise can depend on the extent of the person’s hypermobility and which joints it affects.
That said, some types of exercise may exert more strength on the joints than others. These include:
- high impact activities such as running and jumping, particularly on hard surfaces
- sports that involve physical contact and sudden movements, such as football or basketball
- heavy weightlifting, especially without proper form
- excessive stretching
Some people may be able to do these types of exercise safely and without pain, while others may not. A doctor or physical therapist can give advice tailored to each individual’s situation.
Exercises that build strength, enhance joint stability, and support bone health can benefit those with hypermobile joints.
For strength, exercises include:
- Resistance training: Light to moderate resistance training helps build muscle strength. Using resistance bands or light weights can provide the necessary resistance without overloading the joints.
- Low impact exercises: Exercises such as cycling, swimming, and rowing are low impact activities that are gentler on the joints. However, individuals with hypermobility should be careful not to overextend the joints during these activities.
- Pilates: This low impact exercise focuses on core strength, stability, and flexibility. However, people may need to avoid more advanced movements.
Exercises that may improve bone strength
- Weight-bearing exercises: Activities such as walking, dancing, and light hiking help maintain bone density. These exercises are less intense than running but still provide bone-strengthening benefits.
- Balance training: Exercises such as walking backward, step-ups, and lunges can improve balance and help prevent falls. Tai chi and qigong are helpful in building stability and balance.
- Elliptical training: Using an elliptical machine offers a weight-bearing workout without the impact stress associated with running or jumping.
Some people with hypermobility have additional symptoms, such as postural tachycardia syndrome or chronic fatigue, that can make it more challenging to exercise.
Some people with these conditions may adapt their movements to make them safer, more accessible, or less likely to induce fatigue.
Here are some tips to make movements more hypermobility-friendly:
- Begin gradually: If a person is not used to exercising or is trying a movement for the first time, they should begin slowly and focus on getting the right form before proceeding. If they are not quite ready for that movement, they may need to strengthen other muscles first. For example, a person may need stronger knee joints before they can squat or lunge.
- Modify movements: In many forms of exercise, there are often ways of modifying movements to make them easier or to accommodate different abilities. This could mean doing fewer repetitions, using lighter weights, or reducing the load in other ways. For example, doing push-ups against a wall is easier than doing them on the floor.
- Use supportive equipment: To prevent overextension, people may find it helpful to wear supportive braces or use equipment such as gym balls, yoga blocks, or foam rollers to support the body.
- Exercise sitting down: Sitting down allows a person to exercise their upper body rather than their whole body, which may be more accessible for some. Examples include chair dancing and wheelchair-based activities.
- Do smaller workouts: While the recommendation for aerobic exercise for adults is
150 minutes per week , people do not have to do this in large chunks. The nonprofit Ehlers-Danlos Support UK suggests breaking it down into smaller sessions. For example, a person could do three 10-minute workouts daily for 5 days every week. - Include rest periods: Allow sufficient time for rest and recovery between sessions to avoid overloading the muscles and joints.
To exercise safely with hypermobility, it is important to:
- Focus on form: Proper technique and posture are important for avoiding injury. Exercising in front of a mirror, using video tutorials, or working with a physical therapist can help ensure correct form.
- Warmup and cooldown: Always begin with a gentle warmup to prepare the muscles and joints. Ending with a cooldown may relax the body and reduce muscle soreness.
- Listen to the body: Slogans such as “no pain, no gain” can encourage people to exercise beyond their limits. If there is any pain or discomfort, it is time to stop.
- Avoid overtraining: Gradually increase the intensity and duration of exercises to avoid overloading the joints.
- Seek professional guidance: Regular check-ins with a physical therapist can provide personalized advice and adjustments to an exercise routine.
If an individual experiences persistent joint pain, frequent dislocations, or other concerning symptoms, it is important to seek help from a healthcare professional.
A doctor or physical therapist specializing in hypermobility can provide tailored advice, recommend specific exercises, and suggest modifications to an exercise routine.
Exercising with conditions that cause hypermobility, such as hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorder (HSD), can require a careful balance between activity and safety.
Some people may need to avoid high impact, contact sports, and stretching too much. Activities such as resistance training, swimming, pilates, and tai chi offer safer ways to build strength, stability, and bone health.
Adapting exercises to individual needs and following injury prevention strategies can significantly improve hypermobility management. Healthcare professionals can help create a personalized exercise plan that takes a person’s unique circumstances into account.