I've also loved exercise, even training as a fitness instructor when I was in my early twenties while on summer break at university. But then all my medical conditions entered my life, or became recognised, including hypermobility. So I was super nervous about exercising, or didn't have the energy to do so. I wasn't sure whether certain exercises were OK to do as a person with hypermobility, or whether they could be making the situation worse. It seems my fears were largely unfounded.
It was fantastic to attend the talk by a physiotherapist who specialises in hypermoblity, and hear a professional giving his expert views on how to exercise with hypermobility.
So here are my notes from a really interesting talk given by Jason Parry, a specialist physiotherapist in hypermobility, that was given as part of the London EDS UK events series. It is rather 'bullet-point' in its tone, but I wanted to make sure that I conveyed as much of the talk as possible so that it was a useful resource.
I hope you find it useful and informative. The notes below relate to aerobic / cardio exercise and strength. There is also a post on flexibility and proprioception / balance from the same talk, that I hope you find informative and helpful.
Exercise and Hypermobility
Jason Parry
Clinical Specialist Physiotherapist in Hypermobility
2 September 2018
Event held by Ehlers-Danlos Support UK.
GENERAL BACKGROUND
Exercise is a cornerstone of treatment for hypermobility patients.
Exercise can . . .
- Help with pain from stiffness and deconditioning
- Give you more energy to help with fatigue
- Help improve your overall stability
- Reduce the risk of injury
- Reduce the risk of dislocations
- Help reduce the symptoms of dysautonomia (such as POTS)
- Helps release endorphins aiding mood management
- Mindful movement can help take the fear out of moving and using our bodies
- Enhance general health and wellbeing
There are four types of exercise:
- Aerobic
- Strength
- Flexibility
- Proprioception / balance
It is important to incorporate all these forms of exercise into your routine, whether you have hypermobility or not.
AEROBIC EXERCISE
Includes swimming / walking in water, walking, going up and down stairs, using ‘pedals’, rowing machine and cycling, amongst other forms.
Pacing is important.
- Find a baseline of exercise that doesn’t cause you intense symptoms afterwards, then ‘grow’ your exercise from there. If you increase exercise (time or intensity) then get symptoms, decrease it again. But don’t stop altogether!
- It can be counter-productive to push through to finish an activity – don’t overdo it on a good day!
- You need discipline and self-control to know your limits and when to stop the exercise.
- Stop BEFORE symptoms arise, not BECAUSE they arise.
Benefits of aerobic exercise:
- Higher levels of fitness can reduce symptoms of fatigue and provide more efficient energy expenditure.
- The more you exercise the more you build fitness and reduce fatigue.
Cardio Exercise and Dysautonomia
POTS patients typically have a reduced circulating blood volume. Exercise training can increase blood volume.
Exercise may need to begin in a recumbent position (such as on a recumbent bike or swimming), then change to an upright position. (personally I found that using a pedal exerciser at home to be really helpful)
It can take two months or more before you are able to exercise in an upright position.
STRENGTH TRAINING
Benefits of strength / resistance training:
- Strength training reduces the risk of injuries and supports joints.
- Makes your body more robust for ‘real life’ activities.
- Provides additional support to painful and flexible joints.
- Reduces the risk of dislocation and subluxation.
- Increases resting metabolic rate.
Starting a strength training programme
- Work out the baseline of reps of an exercise that are suitable for you.
- Use a paced approach, as per the cardio approach.
- Movements should be done with control – slow and careful.
- Reflect on post-exercise ache – a degree of aching is normal but there shouldn’t be strong pain
** REMEMBER – it can take hypermobile patients twice (or even three or four times) longer to gain strength than non-hypermobile persons **
Hypermobility exercise is a long game – you need patience!
Exercises
- Strength training means using some form of load – gravity / bands / dumbbells / body weight / bottles filled with water or sand.
Pilates is also helpful – increases cores strength – super important for hypermobile patients.
If you are interested then also have a look at my post on exercise and hypermobility: flexibility and balance/ proprioception.
Please follow the advice of your doctor as to all medical treatments, supplements, and dietary choices, as set out in my disclaimer. I am not a medical professional, and this is simply my story and the resources that are helpful to me.
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