The Role of Pilates in Enhancing Joint Hypermobility: Balancing Strength and Flexibility

Joint hypermobility, often referred to as hypermobility syndrome (HMS) or Ehlers-Danlos syndrome (EDS), is a condition where the joints have an excessive range of motion. While hypermobility can provide increased flexibility, it can also cause instability, pain, and an increased risk of injury. People with hypermobility often struggle with joint dislocations, sprains, and strains due to the lack of proper joint control and stabilisation.

Pilates, with its focus on controlled movement, muscle strengthening, and body awareness, offers an effective approach to managing hypermobility. Through targeted exercises, Pilates helps strengthen stabilising muscles around hypermobile joints, improving control and stability, while also promoting proper flexibility. This delicate balance between strength and flexibility is crucial for preventing injury and improving functional movement.

In this blog post, we will explore how Pilates supports individuals with joint hypermobility by targeting stabilising muscles, improving joint control, and enhancing overall mobility. We will also highlight specific Pilates exercises, for both the mat and reformer, that can be used to support those with hypermobility.

Understanding Joint Hypermobility and Its Impact

Joint hypermobility occurs when a person’s joints can move beyond the normal range of motion. In hypermobile individuals, the ligaments that support the joints are often more elastic and less able to provide the necessary stability. While hypermobility itself is not necessarily problematic, it can lead to issues such as:

• Joint instability: Due to the excessive range of motion, the joints can become unstable and prone to injury.

• Muscle weakness: The muscles around the joints may not be strong enough to support the joint effectively, leading to compensations and misalignments.

• Pain and inflammation: People with hypermobility are more likely to experience chronic pain due to excessive movement and joint strain.

• Difficulty with proprioception: Proprioception, or the awareness of where your body is in space, may be impaired in hypermobile individuals, making it harder to control joint movement and avoid injury.

While hypermobility may sound like a blessing in terms of flexibility, without the proper stabilisation, the joints are at risk of overstretching or being injured. Pilates helps individuals with hypermobility by focusing on the core, strengthening stabilising muscles, improving body awareness, and promoting controlled movement patterns.

The Role of Pilates in Joint Hypermobility

Pilates, developed by Joseph Pilates, is a method that focuses on controlled, precise movements that engage both strength and flexibility. Pilates exercises promote core activation, stability, and alignment, all of which are essential for managing hypermobility. Through mindful movements, Pilates helps individuals with hypermobility develop better joint control, muscle strength, and proprioception, thus reducing the risk of injury.

For individuals with hypermobility, Pilates targets the following key areas:

1. Strengthening Stabilising Muscles
   People with hypermobility often have weaker stabilising muscles, particularly those around the pelvis, shoulders, and spine. Pilates exercises engage deep stabilising muscles, such as the transverse abdominis and the pelvic floor, which are crucial for providing joint support. Strengthening these muscles helps to increase joint stability and prevent excessive movement.

2. Improving Proprioception and Control
   Pilates improves body awareness by encouraging controlled movements and focusing on the alignment of the body throughout each exercise. This helps people with hypermobility develop better proprioception, allowing them to understand and control joint movements more effectively. By improving control, hypermobile individuals can avoid excessive stretching and protect their joints from injury.

3. Balancing Flexibility and Strength
   While hypermobile individuals tend to have more flexibility, it’s important to balance this with strength to prevent injury. Pilates promotes flexibility through gentle, controlled stretching, but also incorporates strength training to stabilise the joints. This balance ensures that flexibility does not lead to instability, and that the muscles are strong enough to support the range of motion of the joints.

4. Reducing Pain and Preventing Injury
   Pilates can help to reduce the chronic pain often associated with hypermobility by improving the alignment of the joints and strengthening the muscles. The method also teaches clients to move with precision and control, reducing the risk of overextending the joints and causing strain.

Pilates Exercises for Hypermobility

Pilates exercises for individuals with hypermobility should focus on stabilising the joints while gently stretching and strengthening muscles. The following exercises can be adapted for both mat and reformer Pilates practices to promote joint stability, control, and flexibility.

1. Side Leg Series (Mat)

The Side Leg Series helps strengthen the hip stabilisers, particularly the gluteus medius and minimus, which are crucial for stabilising the pelvis and preventing overuse of the hip joint.

• How to do it: Lie on your side with your legs stacked and slightly forward. Rest your head on your arm and keep your torso aligned. Lift your top leg to hip height, keeping the knee straight. Hold the leg at the top for a few seconds, then lower it back down slowly. Repeat 10-15 times on each side.

• Benefits for hypermobility: This exercise strengthens the muscles around the hip joint, helping to stabilise the pelvis and reduce the risk of hip dislocations or strains, common in individuals with hypermobility.

2. Bridging with Footwork (Mat)

Bridging with Footwork targets the glutes, hamstrings, and core muscles, promoting stability in the pelvis and lower back. This exercise encourages a controlled movement of the spine while strengthening stabilising muscles.

• How to do it: Lie on your back with your feet flat on the mat, hip-width apart, and knees bent. Inhale to prepare, then exhale as you lift your hips towards the ceiling, creating a straight line from the shoulders to the knees. Inhale at the top, and exhale as you slowly lower the spine back down, one vertebra at a time. Repeat 10-12 times.

• Benefits for hypermobility: This exercise strengthens the glutes, hamstrings, and lower back muscles, which are essential for stabilising the pelvis and lower back, areas that often experience strain in hypermobile individuals.

3. Reformer Footwork (Reformer)

The Reformer Footwork is a key exercise to strengthen the legs and improve stability. It targets the quadriceps, hamstrings, glutes, and calves, improving muscle control and supporting joint stability.

• How to do it: Lie on the reformer with your feet on the footbar, hip-width apart. Push the carriage out by extending your legs, then slowly bend your knees to return to the starting position. Vary foot placements to target different muscles (parallel, heels together, toes apart). Repeat for 10-15 repetitions.

• Benefits for hypermobility: The Footwork series strengthens the lower body muscles, particularly the hip and knee stabilisers, reducing strain on the joints and enhancing control during movement.

4. The Roll-Down (Reformer)

The Roll-Down on the reformer helps improve spinal mobility and encourages the engagement of the deep stabilising muscles of the abdomen and lower back. It also promotes alignment and control through the spine.

• How to do it: Sit on the reformer with your feet on the footbar, knees bent. Hold the straps with your arms extended in front of you. Inhale to prepare, then exhale as you slowly roll your spine down towards the mat, one vertebra at a time. Inhale at the bottom, then exhale as you roll back up. Repeat 5-8 times.

• Benefits for hypermobility: This exercise strengthens the core and encourages proper spinal alignment, helping to stabilise the lower back and prevent overextension of the spine, which is common in hypermobile individuals.

5. Scapula Push-Ups (Mat or Reformer)

The Scapula Push-Up is excellent for stabilising the shoulder girdle and improving control in the upper body. It targets the muscles around the scapula, particularly the serratus anterior, which helps maintain shoulder stability.

• How to do it: Begin in a plank position, either on your knees or toes. Keep your arms straight and your body in a straight line. Inhale as you lower your chest towards the floor by retracting your shoulder blades, and exhale as you push the shoulder blades apart to return to the starting position. Repeat 10-12 times.

• Benefits for hypermobility: Strengthening the stabilising muscles around the shoulder joint improves control and reduces the risk of dislocations or other injuries in the shoulder area.

6. Leg Circles (Mat)

Leg Circles help improve control and stability in the hips and pelvis, enhancing joint awareness and flexibility without overstraining the muscles or ligaments.

• How to do it: Lie on your back with one leg extended towards the ceiling and the other leg flat on the mat. Keeping your core engaged, draw small circles with your elevated leg, first in one direction, then the other. Perform 8-10 circles in each direction, then switch legs.

• Benefits for hypermobility: Leg Circles promote hip stability and control, crucial for individuals with hypermobility in the lower extremities. It also helps improve proprioception, reducing the risk of joint instability.

Conclusion

Pilates offers an effective, low-impact approach to managing joint hypermobility by strengthening stabilising muscles, improving control, and balancing flexibility with strength. By targeting key areas of the body, such as the core, hips, shoulders, and spine, Pilates helps individuals with hypermobility build joint stability and improve functional movement patterns. Through carefully chosen exercises, both on the mat and the reformer, Pilates offers a safe and efficient way to prevent injury, reduce pain, and enhance overall mobility for those with hypermobile joints.