Ever wonder how contortionists manage those impossible-looking poses?

  • Fitness
  • Friday, 03 Jul 2020

Most acrobats and gymnasts have some degree of hypermobility, especially contortionists. — Photos: Filepic

Can your thumb bend backwards to touch your forearm?

Can you do a perfect side split effortlessly? Do your joints click every time you walk?

If you answer is yes, then you could have hypermobile joints.

This is a common condition in children and young adults, who will eventually grow out of it.

The older you get, the less likely you are to be hypermobile.

Hypermobility, or double-jointedness, is a term referring to individuals who have a wider-than-normal range of movement in their joints.

This is due to extremely lax ligaments, allowing the joint to stretch farther than usually possible.

As such, the surrounding muscles have to work extra hard to compensate for the laxity in the ligament.

People with hypermobility are particularly supple and able to move their limbs into positions others find impossible.

Certain sports such as gymnastics, acrobatics and dance view hypermobility as aesthetically appealing.

As a former dancer with some amount of hypermobility, I can tell you (I’m biased!) that when your elbows and knees are hyperextended, it makes your movements flow better.

You also seem taller on stage than you actually are.

Possible problems

Dancers are required to be flexible and being hypermobile is an added bonus. — AFPDancers are required to be flexible and being hypermobile is an added bonus. — AFP

Generally, some people are naturally more flexible than others.

To a certain extent, it is hereditary and runs in families.

According to the UK National Health Service, one of the main causes is thought to be genetically-determined changes to a type of protein called collagen.

Collagen is found throughout the body, e.g. in skin and ligaments (the tough bands of connective tissue that link two bones together at a joint).

If collagen is weaker than it should be, tissues in the body will be fragile, which can make ligaments and joints loose and stretchy.

As a result, the joints can extend further than usual.

People who are double-jointed are more prone to dislocations, subluxations (partial dislocation), muscle sprains and aches.

Most people don’t experience any problems, but when your hypermobility causes pain, you could have Hypermobility Joint Syndrome (HJS).

HJS is widely thought to be a feature of an underlying condition affecting connective tissue called Ehlers-Danlos syndrome.

Although the condition is not often recognised or is misdiagnosed, it’s believed to occur more in females than males.

One explanation for this is that females undergo a lot of hormonal, bone and muscular changes that create the joint laxity.

You can test this yourself by stretching while you’re having your period.

During menstruation, the drop of oestrogen (which gives strength to muscles and ligaments) makes you feel weaker, and levels of relaxin (a hormone that causes the cervix to open) start to rise, causing the ligaments to soften.

When the ligaments soften, it’s easy to overstretch them.

Sometimes, despite having a hypermobile joint, you might also get joint stiffness.

If a joint feels stiff or tense, it may be caused by fluid collecting inside the joint.

This is probably because your body is trying to repair the small amounts of damage that have been caused by overstretching the ligament.

Your pain will often feel worse as the day goes on and improve at night with rest.

Assessing hypermobility

A simple way to test if you’re hypermobile is to use the Beighton score, a series of five tests that have a total of nine points.

The score is worked out as follows:

  • One point if you can place both your palms on the ground while standing with your legs straight.
  • One point for each elbow that bends backwards or hyperextends.
  • One point for each knee that bends backwards.
  • One point for each thumb that touches the forearm when bent backwards.
  • One point for each little finger that bends backwards beyond 90°.

If your Beighton score is four or more, it is likely that you have joint hypermobility.

However, while a high rating on the Beighton score may indicate hypermobility, it doesn’t mean that you have HJS.

Additional symptoms to look out for in HJS include frequent dislocation of joints such as the jaw, shoulder or knee cap; chronic fatigue; chronic muscle and bone pain; some heart conditions; elastic skin; bruising easily; and repeated sprains or rolling of the ankles.

My score came up to five, and yes, I have experienced some of the symptoms above, especially frequent bruises and countless ankle sprains over the years, but the doctors have ruled HJS out.

Preventing injury

For people like me, we have to learn to control our movements while doing exercises, ensuring that we do not extend to the furthest possible point of our hypermobile joint.The writer’s hyperextended elbows may seem as if they’re ready to snap, but this is a normal range of movement for her.The writer’s hyperextended elbows may seem as if they’re ready to snap, but this is a normal range of movement for her.

It’ll save us a lot of injuries and pain.

For example, when I’m performing a bicep curl, I have to be cautious not to straighten my elbow completely once my arm is down because I always hear a little “pop” at the end.

There’s no pain, but I feel like the joint can come out of the socket.

I’m aware that every time it pops, there is a risk of elbow dislocation.

My shoulder joints were also pretty hypermobile once and I could show off contortionist manoeuvres until a difficult trapeze trick I was practising (never do this in your advancing years) ended up with me tearing multiple shoulder ligaments.

It took years to recover, but my shoulder is now no longer hypermobile.

However, my right shoulder now hurts whenever I attempt certain arm balances.

To protect the joint, I’ve to constantly resort to strengthening the muscles around it.

Here are a few tips for my fellow hypermobile readers:

Always warm-up and cool down

Before you embark on your workout routine, make sure you actively warm-up by jogging on the spot or brisk walking.

Limit dynamic stretches before the workout.

After completion, cool down by walking around to bring down your heart rate.

Limit stretching

When the ligaments are lax, the surrounding muscles have to work doubly hard to protect the joints.

A hypermobile person often feels that their muscles are tight, making them want to stretch, but this actually worsens the problem and causes joint tension.

Some experts advise you to opt out of stretching and use a foam roller instead.

If you really want to stretch post-workout, try to limit stretching the hypermobile joint.

Stop before hitting the end range.

The problem is that we always prefer to work on what comes easily and minimise the time spent on difficult things.

Perform strengthening exercises

An overly flexible body is often a weak one, so you must incorporate strength or resistance-training exercises to build the muscles surrounding your hypermobile joints, as this can help stabilise your body and prevent injuries.

Use your own body weight, resistance bands or dumbbells.

However, you need to take proper precautions when exercising.

In a 2018 quantitative study on hypermobility and sports injury published in the British Medical Journal Open Sport & Exercise Medicine, researchers surveyed 114 individuals, of whom 26% were hypermobile.

They found joint dislocation to be exclusive to hypermobile individuals, as well as a longer duration of sports injury, compared to the non-hypermobile group.

Try isometrics

Isometric exercises are contractions of a particular muscle or group of muscles.

During isometric exercises, the muscle doesn’t noticeably change length and the affected joint doesn’t move.

By using this technique, not only do your joints stay still, but you can also prevent your muscles from getting fatigued.

The more fatigued the muscles get, the less they are able to stabilise a particular joint.

Remember, you can never be too flexible and you should never feel the stretch in your joints.

Revathi Murugappan is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. For more information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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