Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

Filtering by Tag: hypermobility

Hypermobility Resource Guide

Looking at elbow ROM.

Looking at elbow ROM.

I've been totally overwhelmed at the thousands of people who've read my last post, The Darker Side of Hypermobility, and I wanted to offer a part 2 of resources, suggestions, and other very well thought out blogs worth reading on the subject for a large range of movement professionals.  There is a ton of material on this subject, and I'm delighted to see so many people interested in supporting their clients through education, better assessments, and more. 

Some general suggestions for the hypermobile population, inspired by Katy Bowman, Brooke Thomas, Jill Miller, and many other folks here:

-Seek a movement professional who can help assess your ROM and identify where you need to stabilize your joints.  That may be an Alexander Technique teacher, Feldenkrais teacher, Yoga Tune Up® instructor, Restorative Exercise Specialist, strength and conditioning coach, Pilates teacher, physical therapist, Rolfer, or other professional. 

-Make your goal to increase proprioception (awareness of your body in space, awareness of your joints), through whatever means necessary.  This can be a movement class, a bodywork session, self-massage with Yoga Tune Up®/Melt Method®, etc. 

-Stop doing whatever is hurting you most, whether that be working with a coach/instructor who pushes you to your limits (or beyond) or a class that praises your "flexibility" as an end goal.

-Start addressing your muscle "tightness" (and weakness) issues, and stop using your ligaments to do the job. 

Self massage is an amazing way to increase proprioception and manage pain.

Self massage is an amazing way to increase proprioception and manage pain.

-Focus on quality of movement and motor control, rather than jumping headfirst into the heavy intensity/load arena.  (AKA. progress in a slow, thoughtful way in gathering strength)

-Seek a medical professional's advice, as to whether your hypermobility is part of a larger diagnosis, or correlates with other issues you may be having with your health.

Hypermobility and Athletes

Why You Must Not Stretch Hypermobile Clients, by Eric Cressey.  Great overview of ROM challenges in the strength and conditioning space for the hypermobile client.

Hypermobility and the Crossfit Athlete- survey of the challenges of being a hypermobile crossfit coach

Managing Laxity in Lifters and Athletes by Tony Gentilicore- this is probably one of my favorite blogs on the subject from the strength and conditioning vantage point.  Right away, he establishes a major priority (which I agree with) to be "increase proprioception and re-establish proper stabilization of major joints."

Hypermobility and Dance

Teaching the Hypermobile Dancer -this is more science oriented from the vantage point of a British PT, but definitely worth reading.

My Daughter is Hypermobile- a short read on what it means to be the parent of a hypermobile child dancer

Managing Joint Hypermobility, a Guide for Dance Teachers- terrific, detailed info sheet for dance and movement instructors on seeing hypermobility and assessing it

Hypermobility and Pilates

Pilates for Hypermobility- Much in line with the other articles here, this is a general blog on suggestions for pilates instructors.

Hypermobility- Keeping it In the Box: A short article on controlling ROM for pilates instructors.

Hypermobility and Yoga

Mobility's Dark Side, by Brooke Thomas - Brooke is a terrific writer, podcaster, and movement thinker, and her blog for Breaking Muscle is excellent. 

WAWADIA, curated by Matthew Remski.  This ongoing blog/project/future book is looking at the hard questions in the yoga community, and Matthew has talked about the praise of hypermobility many times.  This is just one interview with Diane Bruni in a series of many thought-provoking interviews.

Is too Much Stretching Bad for you? by Jill Miller- Jill (and many other YTU teachers, including Trina Altman) has been incredibly open about her experience with joint instability and pain as a result of too much yoga.  Jill (and the Yoga Tune Up®) challenges a dominant yoga paradigm of stretching and flexibility as the "goal" of yoga asana.

Hypermobility by Katy Bowman- As usual, KB schools the world on what hypermobility really means in general populations, and reminds us that "People with hypermobile joints actually have very (very, very!) tight muscles."

Hypermobility, and 12 steps to Stronger Shoulders - Here, Katy Bowman looks at things you can do right now to improve your proprioception, plank position, hanging position, and other hypermobile woes.

This is just the tip of the iceberg, and I welcome any additional resources you may have.  To learn more about Ehler-Danlos Syndrome, and the stories of people living with that diagnosis, read:

Living with EDS, which has a series of short blogs from people of all ages and types of EDS

So You Think You Might have EDS, which depicts the various symptoms of the different types/classes of EDS, and is extremely detailed.

Living Bendy: Life with Ehlers Danlos Syndrome, which is a very realistic, honest blog about some of the immense frustrations and challenges of EDS.

Paganini was Probably Very Hypermobile (Amongst other things)

In discussing hypermobility, one must also mention that many musicians are hypermobile, for better or for worse.  In looking at Niccolo Paganini, 1782-1840, many historians have concluded that he had extremely flexible joints and may have had a genetic tissue disorder known as Ehlers-Danlos syndrome.  Let's backtrack for a moment- Paganini was an epic violin virtuoso doing things that people never thought possible.  His caprices were written in the first 20 years of the 19th century, and pushed violin playing to a limit that was unimaginable then and still challenging now.  (Left hand pizzicato 16th notes in succession?  Huge extensions?)  Nowadays, Paganini caprices are an expectation of elite violinists, at least in music school and training.  While they are still virtuosic masterpieces, they are seen as a requirement for studying violinists.  Basically, we have taken a man's unique hypermobile superpowers and expected that the rest of the violin population will gain those skills, irregardless of frame, hand size, or dexterity.  Let's backtrack and look at Ehlers-Danlos for a moment.

Manuscript copy of the first Paganini caprice.

Manuscript copy of the first Paganini caprice.

Hypermobility throughout the body can also be a symptom of different connective tissue issues, including Ehler-Danlos, Marfan Syndrome, and Loeys-Dietz.  (Some people also believe that Rachmaninoff had Marfan Syndrome, given his hands, huge span, and appearance.)  On the flip side, a small proportion of the population has hypermobile joints and no other issues.  Ehler-Danlos is sometimes seen as a collagen issue, and hypermobility is only one of a few different classifications of the disease, including vascular issues, skin elasticity, and many other different variations of hypermobility, including joint deformation, tendon and ligament damage, and whatnot. 

In regards to Paganini, people at the time described his ability to span multiple positions without shifting, an ability to contort his hand to extreme positions, and how as he aged, he practiced less, possibly because of pain (osteoarthritis).  Will we ever know if he really had these connective tissue diseases?  Not really, unless someone exhumes him and does some genetic testing.  But the next time you're practicing something made for a body much different from yours, it might be worth asking the question of whether it's worth it and what the real payoff is if it's painful...

Tag Cloud Block
This is an example. Double-click here and select a page to create a cloud of its tags or categories. Learn more



Tag Cloud Block
This is an example. Double-click here and select a page to create a cloud of its tags or categories. Learn more
Tag Cloud Block
This is an example. Double-click here and select a page to create a cloud of its tags or categories. Learn more
Tag Cloud Block
This is an example. Double-click here and select a page to create a cloud of its tags or categories. Learn more

One Last Hypermobility Chat: The Knees

Picture is referenced in KatySays.com, amongst many other blogs as well.  Can you see the woman's knee position on the right?

Picture is referenced in KatySays.com, amongst many other blogs as well.  Can you see the woman's knee position on the right?

In my first post, I talked about what hypermobility is, and in my second post, how it relates to music, fingers, etc.  However, your mobile knees (or your student's) also affect your posture, your standing, and your spine.  If you're a regular reader, you may remember a series of posts about standing, stance, high heels, etc., and hypermobile knees are a part of that equation. 

Let's take a look at this picture, which is from a few months back when I initially wrote about heels and standing.  Can you see how the woman on the right has hyperextended her knees and thus forced her spine into an excessive curvature?  She's basically exaggerating the curves of her spine and forcing her head forward.  You don't have to be wearing heels to have this phenomena though, take a look here.

So this gender neutral character has slightly hyperextended knees, which then forces an exaggerated curve of the spine, and the belly is forward.  This can be in combination with soft tissue issues as we see on the right, but hyperextending the knees is definitely part of the problem here.

So this gender neutral character has slightly hyperextended knees, which then forces an exaggerated curve of the spine, and the belly is forward.  This can be in combination with soft tissue issues as we see on the right, but hyperextending the knees is definitely part of the problem here.

So what's the solution?  For me, (I have one hypermobile knee) it comes down to a few steps.

1.  Bring the feet parallel (or very close to parallel) when standing, walking, etc.  When the feet turn out a lot, it makes it easier to tuck the pelvis and hyperextend the knees.

2. Slightly bend the knees to try to find a non-hyperextended position.

3.  Bring the pelvis to neutral, either un-tucking your pelvis or the opposite, lengthening your tailbone down if you have an anterior tilt.  The second image is of someone with an over-tucked pelvis or posterior tilt.

4.  When standing, try to externally rotate your thighs (but don't actually move your legs at all) and feel your glutes turn on.  This basically means that your right thigh wants to rotate clockwise and your left thigh wants to rotate counterclockwise, but you don't move your legs at all. 

If you teach children (who often hyperextend their knees unknowingly), suggest that they slightly bend their knees and bring their feet to parallel.  The more subtle cues may not work for them right away, but helping their lower body find neutral is definitely a start.

***A Cautionary note:  If you regularly practice yoga or any form of stretching, please DON'T hyperextend your knees in that practice.  Watch out in forward folds, triangle, warrior II, etc.  It's not great for your knees and not great for your spine.***



Hand Hypermobility Helpers- Part 2

To get started, take a look at this gallery of images related to setup, bowhold, and simple solutions for teachers and students.

So here's the deal- when students have hypermobility, it means their joints are unstable because they don't have a normal end range.  When you then ask unstable joints to support weight or articulate, you are putting undue stress and strain on the joint and just continuing to ask the ligaments to do the work, rather than strengthening the muscles to support the joint.  What we want to do is strengthen the muscles as much as possible, and then add load.  The easiest way to do this is take the instrument away and isolate specific joint issues.  Many PT's use theraputty as a great way to get specific finger strength (it's basically a denser version of silly putty with different resistance levels).  This would be great to have on hand in studio (no pun intended) and add to your weekly lessons, especially with growing kids.  The most important moves to focus on would be the finger pinch, keeping the fingers curved.  For string teachers working with wayward pinkies, I like this video about using a clothespin for resistance- also a great idea.  (Also, take a look at how to teacher kids to hold pencils- great if you're a parent!)

 

I'm also a huge fan of bow hold buddies, especially for young children.  This creates a pinky nest to help curve the pink, as well as provide a nook for the right thumb, especially if it locks out usually.  They also make something called the "cello-phant" which looks interesting. 

For flute, clarinet, etc., I've also seen finger slings/rings/ etc, that can help to train the joints to stay bent and start to strengthen the muscles.  Also ask the student to look at how they type, text, hold a pencil, etc.  If you can cultivate even a smidge of awareness in daily life, there can be huge transfers in a musical setting.

The bottom line, is that continually locking out the joint puts strain on the joint, can lead to osteoarthritis, pain, and other issues, and that the surrounding muscles are usually weak and can't support the movement being asked.  Some people live a full pain free life with hypermobile joints, others deal with osteoarthritis early in life, or are diagnosed with Hypermobility syndrome.  Helping students (or yourself) can improve your performance and prevent future pain.

Powered by Squarespace. Home background image by kayleigh miller.