When Being Flexible Isn’t Always Better: Hypermobility & Pelvic Health
Hypermobility is a condition that affects the connective tissues in our body, making them more flexible. This results in joints with greater-than-normal range of motion, requiring the muscles nearby to work harder to keep the joint stable. Hypermobility can also affect other parts of the body, like the digestive tract and cardiovascular system, since connective tissue exists all throughout our bodies.
For some people, this extra joint mobility does not cause pain. However, for others, the altered structure of the connective tissue means it cannot properly stabilize joints and support surrounding structures: This can cause a range of symptoms, including:
Aching or persistent joint pain
Muscle soreness, fatigue, or sensations of stiffness
Recurrent sprains and strains
A sensation that a joint is loose or unstable
Joint subluxations or dislocations
Difficulty with balance or coordination
Excessive fatigue after physical activity
Difficulty tolerating prolonged standing
Did you know? A very common symptom of hypermobility is feeling like your muscles are really tight, no matter how much you stretch. Muscles may hold tension in order to help provide stability to the joints, so although it may sound counterintuitive, gradual strengthening can be more effective than stretching to relieve muscle stiffness.
How does this affect my pelvic floor?
When people hear the word hypermobility, we often think about flexible shoulders, knees, hips, etc. However, the pelvic floor is another area where connective tissue, muscle strength, coordination, and stability all work together. For some people, hypermobility can result in pelvic floor tension, because the muscles are working overtime to provide stability and support to the pelvis and pelvic organs.
During pregnancy and postpartum, people with hypermobility may be more prone to experiencing pelvic floor symptoms like pelvic pain, diastasis recti abdominis (spreading of the abdominal muscles) and pelvic organ prolapse. This doesn’t mean everyone who is hypermobile will experience these, but preventative strategies like strengthening, using support garments, and avoiding straining can be important.
How can physical therapy help?
The goal of physical therapy isn't to make a hypermobile person less flexible. Instead, treatment aims to help the body better control and support the range of motion that is already present. Your physical therapist can help you build body awareness and get started with gradual, progressive strengthening and neuromuscular control exercises that are appropriate for your body. If you are experiencing pelvic floor symptoms, addressing the pelvis as part of a larger movement system including your core, hips, breathing, and movement patterns can provide better relief than treating the pelvic floor in isolation.
Written by: Mary Panushka, PT, DPT, OCS