In Part 1 we learned about the true meaning of Hypermobility, how poor posture can cause pain and how that before we can do anything, very much in the same way that you wouldn’t build a house on sand, we wouldn’t start to build our bodies without a solid foundation (your core posture). Now that we have spent some time laying our foundation, we need to start building..
Why your joints actually hurt
The pain in your joints; that dull, grinding ache that drives you insane, that one you’re pretty familiar with? Well one of the reasons it’s there is pretty simple.
It’s a mixture of the body trying to make life easier for itself and your body’s inability to use the surrounding muscles of a joint to stabilise and stop it at the end of its range of motion. Now when the muscles don’t engage properly, the body uses the next best thing available, which unluckily for you, means your ligaments.
The standard scenario for a lot of people is as follows;
You’re stood for lengthy periods of time, you zone out, your knees lock out, your hip shifts to one side to compensate the supporting load of your upper body and because of your inability, to stabilise the knee joints using muscles.
It means the ligaments act as the last fail safe to stop the force of the load. Over time, repetitive force applied to the ligaments only makes matters worse, as they are now effectively carrying loads that were meant for muscles.
The muscles get even worse at activating and eventually, muscle that should be stabilising the joints and controlling the slide across the joint surface in a very smooth and controlled manor, simply are just not doing it. Which in turn causes a shearing action of bone on bone, which very quickly becomes very painful. Something I’m sure you are all too familiar with.
Now unfortunately, because of the nature of Hypermobility, our journey ahead is definitely a long one, but don’t let that dishearten you. It doesn’t mean that we cant get there, it means it just takes a little longer and definitely needs my Three P Approach..Patience, Persistence and Positivity.
Where do we start ?
If you are reading this and you haven’t done part 1 of the guide, there is no point in reading on, as you need a strong foundation to start Part 2 as it will simply not work without it. Imagine building a house on sand; it wouldn’t matter how expensive the bricks were, how big and strong the house was, eventually that house is going to sink.
It has been a week or two since we read Part 1, which means you will have been setting a solid foundation for us to to build on.. So our first endeavour towards stable joints, is to increase muscle tone….Nope, not muscle strength. They’re two very different things.
Muscle strength is defined as the maximum amount of force that a muscle can exert against some form of resistance in a single effort.
Muscle tone however is the degree of muscle tension or resistance during rest or in response to passive stretching.
So let’s break that down. Muscle tone is pretty much the background tension within a muscle at rest, such as when you’re not paying attention, standing talking to someone or even doing the washing up.. Due to the random activation of a small amount of muscle motor units, even when you’re resting, you’re actually not really resting.
While your zone out, day dreaming or wherever you mind takes you, your body is autonomically holding everything together; stabilizing that hip, knee or ankle joint, while you’re walking about the kitchen on your cell phone not really paying attention; telling Lucy about how the neighbour has parked over your driveway yet again and it’s driving you insane!
So whilst you’re talking, your body is working very hard to help re-balance itself every time you shift your weight on to one leg or when you hold yourself in strange and awkward positions, just as most of us do whilst on the phone. The problem for those with Hypermobility however, is that the autonomic response described above, just doesn’t happen all of the time, so on occasions when you zone out, the muscles don’t engage, the force transfers and ultimately hangs off your ligaments, so to speak.
So the second part of our Hypermobility guide is simple. Now we have built our foundation In Part 1, we need to improve the stability of the muscles around the joint, reducing the shearing forces and aiming to reduce joint pain. How we do this is pretty simple and to be honest, is my favorite part of the programme. Most people see results pretty quick by using the following approach.
We are going to increase our muscle tone, this will help our muscles to stabilise the joints while we aren’t paying attention, because let’s be honest, how many times have you dislocated when not paying attention? It is a lot higher than when you where consciously focusing on a movement.
We are going to work to ensure that our tendons (attaches muscle to muscle and muscle to bone) can adequately stabilise our joints, reducing our pain and chance of dislocating. All whilst taking the load force off the ligaments and sending it back to the muscle where it belongs.
Now more than likely, there will be those who don’t agree with the methods I integrate into our hypermobility programme and that’s okay, you can’t please everyone. But every little thing we do within this programme, is for the bigger picture and based on the success of real people, former clients of mine and the following are carefully selected to compliment each other and get your body back to functioning how it should be. Using the knowledge I have gained over the years working with a huge spectrum of conditions and syndromes, through trial and error and an incredible amount of personal time, devoted to the pursuit of pain management.
One of the methods we will be using is Isometric exercise. This is where the joint angle and muscle length do not change during contraction, which means we are going to exercise our muscles without actually moving any joints and if no joints move, it’s going to be pretty hard to dislocate.
This is a huge advantage alone, but it will also enable the body to activate nearly all the available motor units, effectively reteaching the central nervous system and enforce positive neural adaptation. Isometric exercise gives us a huge range of benefits, from very little movement.
I have found over the years, another great benefit that Isometric exercise has to offer those with Hypermobility, is that the strength gained whilst a joint is set at a specific angle, also carries over to a greater range of motion. This means we get stronger throughout a bigger range of motion, even though we are not actually moving the through any at all.
We are going to still do our postural exercise as shown in Part 1, but now we are going to only do them on the days we follow the programme below. We are going to do these twice per week and move up to three sessions per week, once we feel able to. A large majority of our programme will involve big compound Isometric exercises. Exercises that require the use of multiple joints and muscle to be performed, thus gives us a multi attack approach, working deep stabilizers, prime and antagonist muscles.
The following exercises are to be done after one another with a short break in between. All whilst being consciously aware of where our limbs are in relation to the rest of the body, we need good concentration and a mind to muscle approach.
Remember you should always consult you doctor before undertaking any form of exercise. This should not cause any pain, but you will more than likely experience a small amount of discomfort and this is perfectly normal. But if you feel pain, please stop immediately.
Points to note ;
- You need at least 48hrs between sessions to properly recover. This type of training is incredibly tiring on the central nervous system, so we need to get as much benefit in the shortest amount of time.
- If it hurts; STOP immediately, a small amount of discomfort is normal, pain however is not part of my programme.
- Take as much time as you need between exercises and the sets of, as this type of exercise is very tiring on the CNS
- If you can’t get through all of the exercises, don’t worry. As long as every time you try these, you increase the time holding; even just by one second, you are still making progress!
- Drink water! There is literally tens of thousands of different chemical reactions going on everywhere in your body that need water to make it happen. Limited amounts of water make for a very un-efficient body.
- Eat! This is very important. If your muscles are to get better at stabilising joints, they need food to do so. Every time we do these exercises, we create tears in the muscles at a microscopic level. We need food and special protein to help rebuild the tissue stronger than it was previous to the exercise.
- After each session take it easy for the rest of the day and be aware of where your limbs are in correlation to the rest of your body. Your CNS will be tired making it harder to stabilise your joints more than normal. Once you have recovered, you will be much stronger. Think of it as 3 steps forward, then we exercise and go one back, but then we recover and go another 3 forward.
- If you can, have an Epsom salt bath. Epsom bath salts contains magnesium, which gets absorbed through the skin whilst you bathe. Magnesium is a key component that makes a muscle relax. It regulates biochemical reactions in the body and helps with muscle and nerve function and will be very beneficial for you. I would recommend however, that if you are diabetic, you don’t use this product. Excessive levels of magnesium in those with diabetes may cause blood sugar to drop, which can be life threatening. Also for those with Crohns disease, excess in magnesium may cause bowel spasms and diarrhea.
Isometric squat hold.
- Stand with your back against a wall, placing your feet about two feet out in front of you. Place your feet hip-width apart with your hands on your hips.
- Bending your knees, slide your back down the wall until your knees are at 90 degree angle. Both your knees should be directly over your ankles, your thighs should be parallel.
- Sit up tall (good posture), draw your belly button in towards your spine and engage your core. Pressing your bum into the wall and your heels into the floor.
- Hold for 15 seconds then slowly stand up, take a rest and repeat another 2 times. When you feel able to, work towards building up to 30 second holds. You may be able to go to 30 seconds the next time you try or it may take you 2 weeks. Ultimately though, as long as every session you manage to do a minimum of one extra second than you did the last time, then you are progressing.
Now your legs will more than likely shake when you do this, as you wont be used to engaging your muscle at this level. So I suggest that you have two dining room chairs either side of you to help you get back up, should you need the help.
If you feel this exercise may be too difficult, you suffer from regular knee dislocations or getting to 90 degrees is too hard, you can modify the exercise by ensuring that your knees are still above your ankles, but sit slightly higher up the wall. This makes it easier to perform and slowly over the course of a few sessions, you can work up towards sitting at a 90 degree angle.
- Lay down on the floor with you knees bent and arms at the side
- Draw your belly button in towards your spine and engage your core.
- Squeeze your bum and raise your hips until your body is in a straight line from shoulders to knees.
- Hold for 15-30 seconds then relax, and repeat 3 times.
It’s very important to keep your bum squeezed and your core engaged. This will help keep your body straight and not allow you to arch your back. If you can’t get yoru hips up all the way, don’t worry about it. Take your time and build up to it in future sessions.
The bridge exercise will help retrain the body in stabilisation to prevent lower back injuries and pain. Working on core stabilisation, while the hips are extending, will help to stabilise the lumbar spine during lower body extension.
- Stand up tall and straight, engage your core and squeeze your bum.
- Straighten your arms at your sides with your palms facing toward you.
- Bend your elbows slightly as you move your elbows behind your back and pinch your shoulder blades together as if trying to hold a pencil.
- Hold for 15-30 seconds and repeat three times.
Most people shouldn’t have any problem with this exercise and it will go a long way to keeping good posture. Poor posture can stretch out and weaken the rhomboids, making them less effective at retracting the scapula. So strengthening the rhomboids will make it easier for the body when it comes to pulling it towards the vertebral column and therefore makes for good body alignment.
The Segmental Control of Early Movement Technique
Now the following exercise may seem somewhat strange and you definitely wont have seen it before because I created it for those who suffer with chronic pain. Many years agoI found it very hard to get chronic pain sufferers active enough to stimulate proper flow of Cerebrospinal Fluid (CSF) and without proper flow, the body becomes a toxic and painful place.
CSF maintains the electrolytic environment within the central nervous system by cleansing metabolic waste products from the brain and spinal cord.
This process plays a huge role in stabilising the Systemic acid-based balance of the Central Nervous System (CNS). CSF continually rinses the brain and spinal cord to cleanse and remove waste and toxins that would other wise negatively effect your health. In some individuals the flow of CSF can become sluggish, especially in those who suffer from chronic pain conditions. Generally sufferers have poor mobility and this sluggish flow has been implicated in the cause of many degenerative diseases.
When the spinal fluid becomes sluggish, it is known as Cerbrospinal Fluid Stasis (CSFS) and is commonly found in those with poor posture, but I’m sure you already saw that coming. The lifestyles of those with chronic pain, poor posture and low mobility caused from hypermobilty injury’s, can create an environment that easily causes CSFS. In recent years this has been associated with vertebral subluxation complex and causing restricted respiratory function.
Once we become more active we can move the way we were designed to and we can start to stimulate the flow of CSF, as well as the lymph system (that’s a whole other post in itself). Because when you break it right down, we are designed to move and the sad truth is, most of us either don’t or cant. Those who suffer from chronic pain generally cannot partake in movements that encourage proper flow of CSF because of limited mobility, fear of injury and the fact that most movements that promote healthy flow are high impact, such as running. The below exercise is a brilliant way to promote healthy flow (in a low impact movement), properly mobilise the hips and incredibly, calm the nervous system! This is very much in the same way modalities such as massage, Reiki and acupuncture help to calm the nervous system and ease pain. My clients over the years have found that my Segmental Control of Early Movement Technique, after spending a few minutes performing, brings a sense of well-being. This, I can only surmise, is because it mimics a movement most adults have not done since their early childhood years and causes a calm and soothing, regression like dampening effect on the CNS.
Points to note about this exercise;
- This exercise should be done at a very fluid and calm pace and should not be painful and will cause very minimal discomfort if any at all.
- Relax your head very much like an infant wriggling up and down a cot bed. Your head must be relaxed and you must use your hips, shoulders and core to move; not your limbs.
- Relax your arms, they are there to keep your legs from lowering. You don’t need to actively pull your legs back.
- Until you become stronger in this movement, use a little momentum to get moving.
- Spend anywhere from 1-5 minutes performing this exercise.
- Don’t worry about looking silly, its functional and has a purpose.
- I’m going to say it again because its important, relax your head!
Once we stabilise our joints and become slightly stronger we can move on to Part 3, which is going to focus on some things that I see a lot of in those with EDS and hypermobily…. Sacroiliac joint dysfunction as well as focusing on a few more things including strengthening the upper body joints such as the shoulders. But before we can do this we need to finish Part 2.
First Call Fitness
Personal Training newcastle