Bohan PT & Training, PLLC

One of the biggest misconceptions about hypermobility is that people feel really loose and flexible.
However, many of us with hypermobility actually feel constant tightness in some areas, along with the looseness in others.

This is because your muscles are trying to create stability that your connective issue like ligaments don’t fully provide.
So your nervous system keeps muscles switched “on” all day long, resulting in feeling tightness in places like
* hip flexors
* neck
* jaw
* glutes
* low back
And that tension is usually protective.

This is why aggressive stretching often makes hypermobile people WORSE. We get temporary relief with the stretching by calming down nervous system firing to those tight muscles…
but then the instability kicks in and when the body recognizes this, it rebounds with tightness.

So the long term way to improve feelings of tightness and improving the stability is through strength and coordination training, so the nervous system doesn’t have to stay in “guard mode”. We want to create stability and safety for the system.

Here are some exercises I like to start with my clients:
1. Squat to elevated surface (progress to without the surface)
2. Banded overhead press with a wall (progress to weights; many of my hypermobile clients like to keep the wall for feedback!)
3. Deadbug
4. Open book (keep the elbow bent and squeeze your knees together. Take a breath or two at the end to gently work on ribcage and thoracic mobility)
5. Theraband row (progress to a row with weight)

Like and follow for more advice on exercising with hypermobility.

Does your SI joint constantly feel “out” or unstable after workouts?

It’s a debate in research on how much the SIJ actually moves - but we do know it’s a key piece in force transfer between our legs and our trunk. I often find in my patients who get this sensation we need to work on our:

- core stability and motor control,
- breathing patterns,
- and a left-to-right hip discrepancy in strength and tightness creating this feeling. By working on these things, we can get your SIJ to feel more stable with force transfer and not “out of place”.

With hypermobility, a lot of us tend of hang out at end range joint positions such as in a big anterior pelvic tilt and ribcage flare. This makes it much harder for the trunk and hip muscles to fire correctly, to create stability for that force transfer across the SIJ.

Also, coordination of smaller stabilizer muscles can be impaired, making it even harder to use muscular control to support the SIJ.

This combo makes it so:
* glutes don’t fully engage
* core pressure shifts poorly
* pelvis feels unstable
* We get movement in our pelvis in places we shouldn’t under load
And then the SI joint gets overloaded.

So here’s what we want to do to improve it:
* Set up your system for success with good ribcage + pelvis positioning
* single-leg stability work
* glute exercises (this can include anything from a bridge up to deadlift variations, depending on your symptom severity and current exercise control)
* foot stability
* breathing exercises to improve core pressure management (ex: Childs pose belly breathing with a pillow, modified open book)
* controlled strength training
* better load management

I had issues with SIJ for YEARS before I figured this out. Let me know what questions you have regarding exercising with SIJ pain!

If you want personalized help getting rid of your SIJ pain, comment “SIJ PAIN” and I’ll see how I can help.

Is lifting weights bad for your pelvic floor?

Like any other muscle group, we need the right amount of training for those muscles to be developed and strong. We want exercise to improve pelvic floor health, even during pregnancy.

However, very heavy loads and high volume can lead to dysfunction if we’re not mindful.

Here are tips to make sure pelvic floor stays happy and strong with exercise:
- NO breathholding!
- constantly clenching pelvic floor during exercise = less stability and support. Let your pelvic floor lengthen during certain parts of exercises!
- Perform stability exercises during your warm up such as bird dogs and plank variations to coordinate pelvic floor with the other core muscles
- Include Hip mobility drills. Strong and mobile hips mean a stable pelvis, so pelvic floor isn’t compensating for weakness or tightness in the hips.

I offer in person and remote coaching for pelvic health! Link in bio.

Here’s why people with hypermobility can struggle with balance.

We have 3 different ways we keep our balance -
through our eyesight,
our inner ear equilibrium,
and proprioception.
Strength also plays a key role in maintaining our balance when challenged.

Hypermobility can affect proprioception, and so your brain gets less accurate joint feedback -> can affect coordination.
THIS is why balance can be tricky - a lot of us with hyper mobile bodies over-rely on vision to compensate for poor proprioception.

Some other signs of reduced proprioception can look like:
* clumsiness
* ankle rolling
* bumping into things
* poor coordination
* feeling unstable during workouts

However, we can train proprioception to improve our balance and coordination. Balance can improve quickly with practice if we are consistent! It’s not just about training your muscles, but your brain too.

Here are some exercises to start with:
1. Tandem balance
2. Single leg stance
- Both of these can be performed on an unstable surface and/or with eyes closed to make it more challenging. You should be shaking and fighting a little to maintain it! Just make sure you’re practicing balance exercises in a safe way such as with a partner or a sturdy surface nearby if you need help.
3. Single leg deadlift
4. Backwards walking
5. Reverse lunge

Want individualized help exercising with hypermobility? I offer both in-person and remote PT options, link in bio.

Here are 3 Things people with hypermobility do that makes their pain worse!

1. Hanging out on locked out joints. A common posture position I often see with clients:
- locked out knees, anterior pelvic tilt and slouched upper body.
- Hanging out on end range joint positions can stress out connective tissue and put our muscles in a difficult place to help create support.
- Instead, do a soft knee bend and line up your pelvis and ribcage.
- So stack your ribcage over your pelvis, so your muscles are in a more optimal position to create stability.

2. Stretching every time something feels tight.
- A tight muscle is often a weak one! Full range of motion strengthening will lead to more long term relief than passive stretching.

3. “All or nothing” training.
- Many of my clients do too much, too soon.
- This is why you hurt every time you try to get back into exercise. Our goal is to do the minimal effective dose of exercise - so work smarter not harder. 

Do you catch yourself doing any of these? Fix these and your joints will thank you!
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Want more personalized help? Reach out for coaching, link in my bio ➡️

Do your knees cave in during squats despite having strong legs?
Your feet might be the problem. 

A lot of us with hypermobility have arches that love to collapse inwards. If you’re collapsing through your arches, it changes your lower leg and femur mechanics operate.
So thinking ‘knees out’ won’t fix it.

Try this instead:
1. Create a tripod foot—big toe, little toe, heel.
2. screw your foot into the ground slightly.
3. Now squat—without losing that pressure.
You should feel your glutes turn on automatically.

If you can’t keep your foot arch and tripod position, doing foot intrinsic exercises (ex: foot and toe yoga) and single leg balance work can help build up the strength of your feet.

Quality movement starts with our contact with the ground - so next time you exercise, pay attention to what your feet and toes are doing!

Like and follow for more advice on training with hypermobility.