Anatomy 101 - hypermobile joints

BALANCING FLEXIBILITY & STRENGTH
You see a lot of bendy elbows and knees in a typical yoga class. Flexible people tend to like yoga. We probably enjoy the fact that, in the beginning, we seem to be good at the physical aspect of it. There may be other factors to consider. Often, people who are less flexible think that they are at a disadvantage in a yoga class. How wrong they are!

Many people who seem to be very flexible (and plenty of people who don’t think of themselves as being flexible) have one or more hypermobile joint. A hypermobile joint moves beyond the normal range of motion. Knees turn inside out; elbows make strange angles when fully extended; thumbs bend to meet wrists; palms easily meet the floor in forward folds. For the majority of people, if you take care of your joints they won’t cause too many problems. Occasionally hypermobility can be more serious. Hypermobile joints are more susceptible to dislocate. Sometimes they can dislocate multiple times – then you really notice it.

POSES DON’T HAVE ALIGNMENT
Yoga is many things, one of which is a search for balance. In our asana practice, we balance right with left, effort with ease, and we aim to find a balance between strength and flexibility.

Recently, I read an article that quoted Leslie Kaminoff (Yoga Anatomy), as saying “poses don’t have alignment, people do”. Put simply, there is no perfect pose, there’s only the perfect pose for you. It follows that the alignment cues that are beneficial for one person may not be suitable for another. This is particularly relevant when it comes to yoga students who have one or more hypermobile joints.

HYPERMOBILITY IN YOUR PRACTICE
In the case of flexibility, you really can have too much of a good thing. Joints that are supported by strong muscles are less likely to be injured in sports and in yoga practice. Joints that move beyond the normal range of motion, and that aren’t supported by adequate muscle are much more likely to be injured.

In Tadasana/Mountain or Parsvottanasana/intense side stretch a micro bend at the knee can be helpful for lots of people, particularly those who have hypermobility in the knee joint. If your knee moves beyond the normal range of motion, a cue to straighten your leg might lead you to extend beyond straight. Instead, take a micro bend at the knee – a bend so slight that it is barely visible, but one that causes the muscles around your knee to engage and support the joint.

The same applies to the elbows in Vasisthasana/Side Plank. When weight is taken in the arms, a slight bend can help to activate the muscles that support the elbows so that the weight of the body isn’t “dumped” into the joints. In a pose like Vasisthasana/Side Plank, where you aim to balance on one hand, that tiny bend also makes it easier to soften the shoulder blade down the back into a safer position.  

In Adho Mukha Svanasana/Downward Facing Dog, we’re often instructed to melt the chest towards the thighs. If you have very mobile shoulders this cue might encourage you to drop low through your shoulders, putting an enormous amount of pressure into a joint, that is not terribly stable at the best of times. Instead, it can help to lift through the forearms as if pressing away through the front of the forearm, rotate the eyes of the elbows slightly towards each other and lift from the arm pits. With these slight adjustments, it becomes easier to support the shoulder joints with their muscles.

What is amazing is just how much difference these tiny bends and lifts make. Muscles that were rarely used are switched on and strength can be built. As a result, it often becomes easier to find a more comfortable and energised pose.

JOINT HYPERMOBILITY SYNDROME
Some of us bendy folk, myself included, have more than one hypermobile joint. In my case, after a period of ongoing pain and discomfort, I was diagnosed by a physiotherapist as having joint hypermobility syndrome. Several members of my family have it too.

In class I see a lot of people who have hypermobility in their joints, and some of them probably have joint hypermobility syndrome. Sometimes they don’t want to bend their knees or pull back from the full expression of the pose, to the gradual detriment of their joints.

I am particularly interested by the fact that many hypermobile people seem to find it difficult to stay still. There is a theory that we seek comfort from the feedback we get from a joint, and that people who have a hypermobility syndrome find it difficult to find that feedback – hence they want to stretch and lengthen their bodies, often moving more than other people do, in a search for comfort.

There are other symptoms associated with widespread joint hypermobility including – pain, anxiety, heart palpitations, an over active fight or flight response, feelings of faintness, sleeplessness and digestive problems similar to IBS. It’s a topic that has been widely studied within the medical community, and more is being learned all the time about hypermobility and conditions associated with it.

YOGA & HYPERMOBILITY
I've now come to believe that yoga classes see more than their fair share of flexible folk because yoga helps us to calm ourselves rather than because of any boost it might give to our egos. If we can resist using our practice to increase the flexibility in our bodies, and instead practice with care and kindness for our joints, with an awareness to muscle engagement, yoga can be the best medicine for the bendiest of bodies!

Click on this link if you’d like to learn more about hypermobility.


ANNA CLARKE
The majority of Anna’s weekly classes take place within the mental health departments of Dublin hospitals. In addition, Anna teaches pregnancy yoga and post-natal yoga (for mums with babies) at Init Yoga, Ringsend. She also regularly covers classes at The Yoga Room, Ballsbridge.

To contact Anna email annamclarke@gmail.com or find her on Facebook.