Is Pilates Good for Hypermobility?
Hypermobility, while often thought of as being super flexible, is actually much more than that. It is a spectrum disorder that can affect all of the connective tissue in the body. People with hypermobility can experience anything from minor niggles to debilitating signs and symptoms.
Pilates is a form of exercise that is low impact and therefore gentle on the joints and tissues. It can be done on the mat with no equipment or using Pilates equipment such as the reformer, Wunda chair and trapeze table.
While Joseph Pilates originally designed the equipment as a bridge to his more challenging mat exercises, these days it is often perceived to be the other way around.
With the principles of Pilates being breath, concentration, centring, control, precision and flow, Pilates can be a suitable form of exercise for people with hypermobility. The focus on both strength, stability, precision and control of both the core and joints can be very beneficial for joint laxity and other signs and symptoms of hypermobility.
In this blog post I’ll cover:
What is Hypermobility?
Hypermobility spectrum disorders (HSD) are connective tissue disorders where there is an increase in laxity, or stretchiness of the connective tissues. This can cause joint hypermobility, instability, injury, and pain.
Because connective tissues are not just found in and around joints such as tendons and ligaments, but are also throughout the body. Fascia is a network of connective tissue that is interwoven in all body systems from our muscles to our internal organs and even the linings of our blood vessels, airways and colon contain connective tissue.
This explains why other problems such as fatigue, headaches, GI problems, and autonomic dysfunction, pelvic floor dysfunction and hernias are often seen as part of HSD.
Hypermobility is often diagnosed using the Beighton’s score which assesses joint mobility at the little fingers, thumbs, elbows, knees and spine, however this does not account for all presentations of hypermobility. As mentioned above, it is a spectrum disorder and can present in many different ways.
Hypermobility is actually quite common and in my experience in clinical exercise physiology practice, people are often unaware they have it and how their symptoms correlate.
For example, a recent client presented to my clinic with chronic low back pain and also displayed hypermobile shoulders, a history of ‘palms to floor’ when bending over (unable to do now with his back pain), pelvic instability, varicose veins in his late 20’s and diverticulitis. He did not meet any of the Beighton’s score criteria except for his spinal mobility, however he displayed many characteristics of hypermobility.
How Pilates Helps Manage Hypermobility
One of the main focuses of Pilates is to stabilise one body part while moving another in a controlled fashion. This can include stabilising the torso and moving the limbs for core and trunk stability, or stabilising the limbs and moving the body (or another limb) for either localised joint stability or a full body approach.
A good balance of the above can be very beneficial in improving strength and stability in hypermobile joints including the spine and can increase proprioception and awareness of body in space, through the focus on stability and precision of movement.
This focus on precision and control in Pilates is also beneficial in fostering balanced flexibility and strength and avoiding overstretching.
Benefits of Pilates for Hypermobility
When performed with the Pilates principles in mind, Pilates has many benefits for people with hypermobility including:
Increased joint stability and support.
Improved posture and alignment.
Improved pelvic floor function
Improved core strength and stability
Pain management and reduced risk of injury.
Improved overall strength
Prevention of hypermobility-related injuries by improving muscle control.
Reduction in fatigue
What Type of Pilates Is Best for Hypermobility?
Nowadays there are many different types of Pilates. While all forms can theoretically be beneficial for hypermobility, in my experience, some are better than others.
Clinical Pilates will always be my go-to recommendation here because the program is likely to be individualised and either delivered as a one to one or small group session of four or less participants.
Studio Pilates is next in line as it also encompasses a variety of Pilates equipment and is more likely to be small groups or on-one with individual circumstances taken into consideration. The instructor is likely to be well qualified with a diploma in Pilates or several certifications in the varying equipment pieces.
Mat Pilates is third on the list as the classes are often quite gentle in nature and the risk of injury is less than when using equipment improperly.
Lastly in my opinion is group reformer Pilates classes. The groups are often large, the classes fast paced and the instructors not qualified to manage clinical conditions or equipped to cope with individual circumstances in this setting.
It is also super important to ensure your instructor is suitably qualified and has a thorough knowledge of the hypermobility spectrum. A clinical exercise physiologist with Pilates qualifications (like me) is a great example. Other options include:
Physiotherapist
Diploma qualified Pilates instructor
Personal trainer with Pilates qualifications and thorough knowledge of hypermobility.
These people will know how to select and modify Pilates exercises to suit your circumstances.
If in doubt, ensure your Pilates journey begins with a thorough initial assessment and a familiarisation of the Pilates equipment before joining a group. Also ask the instructor what their experience is in working with hypermobility.
Precautions When Practicing Pilates with Hypermobility
When practicing Pilates with hypermobility it is important to avoid taking movements to the ‘end of range’ even though it might feel amazing! This can perpetuate lengthened and unstable tissues.
You may also have areas that feel super stiff and tight. These feelings are not a reliable indication that you need to stretch. You most likely need more strength in the area, or even in joints above or below. The muscles or connective tissues may be short and tight or long and tensioned.
While listening to your body and how it responds can be great, with hypermobility the messages are not always that accurate. This is why it’s important to have a good initial assessment and a qualified set of eyes on you while practicing Pilates.
Is Pilates good for hypermobility?
In conclusion, Pilates can be an amazing form of exercise for people with hypermobility when practised in an appropriate setting with a suitably qualified instructor.
And when the Pilates session is actually delivering PIlates- not just a fast paced, high intensity form of exercise done on Pilates equipment.
It is important to find an instructor who is both suitably qualified and understands the diversity and challenges of hypermobility. If you live in the Toowoomba, Queensland area, I offer Clinical Pilates for hypermobility at my clinic Ebb & Flow Exercise Physiology.
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Disclaimer: The information provided in this blog is intended for educational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare professional before starting any exercise or health program. By using this content, you agree that EBB & FLOW EXERCISE PHYSIOLOGY is not responsible for any injuries or health issues that may arise from your use of the exercises or advice provided.