What is "Hypermobility" & How Can Pilates Help?

Hypermobility Syndrome (HMS) is not completely understood yet, but is grossly defined as a connective tissue abnormality which causes excessive mobility of joint or soft tissues of the musculoskeletal system. It also impacts cardiac tissue, smooth muscle of the genital system, and the gastrointestinal system. Often HMS is misdiagnosed or overlooked because of the myriad of symptoms that can present with it.  

Common complaints & injuries for HMS patients
​include, but are not limited to:

• Acute or traumatic sprains: - recurrent ankle sprains
• Acute or recurrent dislocations or subluxations of joints
• Unspecified arthralgia or effusion of affected joint(s) - (foot, ankle, knee, hip, back, neck, shoulder, elbow, wrist, finger)
• Nerve compression disorders such as carpal tunnel syndrome & thoracic outlet syndrome
• Chronic pain or Fibromyalgia
• Chronic fatigue syndrome
• Chronic headaches
• Osteoarthritis
• Pelvic floor dysfunction​

​ Common conditions that can cause hypermobility:

• Ehlers-Danlos Syndrome
• Marfan syndrome
• Rheumatoid arthritis
• Systemic lupus erythematosus ​​​

​How is HMS currently diagnosed by physicians & other health practitioners?
Often by use of the Beighton test or score Beighton Score of ≥ 4/9  & Arthralgia (joint pain) for > 3 months in > 4 joints.
 The Beighton Test:

1. ​ A passive dorsiflexion of the little finger above 90 degrees, (1 point for each hand).
2. Bringing the thumb passive against the ventral side of the forearm, (1 point for each thumb).
3. Hyperextension of the elbow above 10 degrees, ( 1 point for each elbow).
4. Hyperextension of the knee above 10 degrees, (1 point for each knee).
5. Flexion of the trunk, whit knees straight &  palms flat on the ground (1 point).

Other diagnostic factors can include:

• Fatigue: Fatigue Severity Scale (FSS) is a scale that quantifies the fatigue intensity. This scale has a high internal consistency and validity. FSS exist out 9 items with a 7-point response format that indicates the degree of agreement with each item.
• Pain: Numeric Rating Scale (NRS) is an 11-point numeric scale to roughly measure any kind of pain.
• Quality of Life: The Medical Outcome Study 36-item Short Form Health Survey (SF-36) is a survey to evaluate aspects of health that are most closely related to quality of life. It consists of 36 questions that measure 8 domains: body pain, physical functioning, physical limitations, general health, vitality, social functioning, emotional limitations and mental health.

Treatment often consists of pain management &  therapeutic exercises which include: proprioceptive & motor control, stabilization & strengthening of affected joints & tissues.
So... How can Pilates exercises help?
The Pilates method of exercise is based on quality of movement, control and body awareness teaching clients with HMS how to move more safely.  Exercises on equipment such as the reformer & cadillac can use resistance springs in an anti-gravity position to safely stabilize & strengthen the hypermobile areas of these clients.   
At Pilates Sante, a large majority of our clients have HMS, (often not medically diagnosed), who benefit greatly from a regular and safe Pilates-based home exercise program, in addition to private sessions administered by a physical therapist or highly trained pilates instructor.   

For more information about HMS, see resources below.

• Information on Hypermobility 
• Types of Hypermobility