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What is Too Much Exercise with Hypermobility Syndrome? The Art of Finding Balance
James Rind MSc
15th Feb 2025 - 4 Min Read
Hypermobility syndrome is a condition characterised by excessive joint flexibility, which can lead to pain, instability, and a higher risk of injury. Many individuals with hypermobility struggle to find the right balance between staying active and overexerting themselves. Exercise is crucial for maintaining strength and joint stability, but too much can cause pain, fatigue, and setbacks. So, how do you determine what is "too much" exercise when you have hypermobility syndrome? Let’s explore this delicate balance.
Understanding Hypermobility Syndrome and Its Challenges
Hypermobility syndrome occurs when connective tissues, particularly collagen, are more elastic than normal. This increased laxity allows joints to move beyond their typical range, making them more prone to dislocations, sprains, and chronic pain. Common symptoms include:
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Joint pain and stiffness
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Frequent injuries (e.g., sprains and strains)
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Fatigue and muscle weakness
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Poor proprioception (awareness of body position)
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Digestive issues and autonomic dysfunction in some cases
Because hypermobility affects multiple body systems, managing physical activity requires a nuanced approach. Too little exercise can lead to deconditioning, while too much can exacerbate symptoms.
Joint over-flexibility characterises conditions such as
Hypermobility Syndrome and Ehlers-Danlos Syndrome
Recognising the Signs of Overexertion
People with hypermobility must be vigilant about listening to their bodies. Overtraining can lead to increased pain, fatigue, and even long-term damage. Signs that you may be overdoing it include:
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Increased pain lasting more than 24-48 hours: Some muscle soreness is normal, but persistent pain suggests excessive strain.
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Joint instability or frequent subluxations/dislocations: If your joints feel more unstable after exercising, you may be pushing too hard.
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Extreme fatigue or post-exertional malaise: Feeling exhausted for days after a workout can be a red flag.
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Swelling and inflammation: Swollen joints after activity may indicate too much stress on connective tissues.
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Increased heart rate or dizziness: Some individuals with hypermobility experience dysautonomia, meaning excessive exertion can cause dizziness, palpitations, or fainting.
If you notice these symptoms, it’s crucial to reassess your exercise routine and make adjustments.
Finding the Right Type and Intensity of Exercise
1. Prioritize Low-Impact, Joint-Friendly Activities
High-impact activities such as running, jumping, and heavy weightlifting can place excessive strain on hypermobile joints. Instead, consider:
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Swimming: Reduces joint stress while providing resistance for muscle strengthening.
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Pilates (with modifications): Focus on controlled movements, stability, and core strength.
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Resistance Training with Light Weights or Bands: Helps build muscle strength without excessive joint strain.
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Cycling or Walking on Even Surfaces: Low-impact cardiovascular exercise that supports joint health.
2. Control Range of Motion
One common mistake among hypermobile individuals is overextending joints during exercise. It’s essential to control movements and avoid pushing joints beyond their normal range, even if flexibility allows it. Engaging stabilizing muscles and practicing controlled, slow movements can help reduce injury risk.
3. Strengthen Key Muscle Groups
Strengthening muscles around hypermobile joints is vital for stability. Focus on:
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Core and Pelvic Stability: Strong core muscles help reduce stress on the spine and hips.
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Glute and Hip Strength: Supports knee alignment and reduces joint strain.
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Shoulder and Upper Back Muscles: Helps with posture and reduces the risk of shoulder instability.
4. Balance Activity and Recovery
Recovery is just as important as exercise itself. Allow for rest days between workouts, incorporate stretching and mobility exercises, and listen to your body’s cues. If you feel excessive fatigue or pain, scale back your activity level.
Developing an Individualised Exercise Plan
Each person with hypermobility has unique needs, so a one-size-fits-all approach doesn’t work. Here are some key considerations when creating a balanced routine:
1. Set Realistic Goals
Instead of aiming for high-intensity workouts, focus on small, consistent improvements. Goals could include increasing strength in stabilizing muscles, improving endurance gradually, or reducing post-exercise pain levels.
2. Follow the “Goldilocks” Principle
Exercise should be not too much, not too little, but just right. If you’re sore for more than 48 hours or experience increased instability, adjust your intensity. On the other hand, if you feel no exertion, you might need to increase activity levels slightly.
3. Use the 10% Rule
To avoid overloading joints, increase exercise intensity or duration by no more than 10% per week. This gradual approach helps prevent injuries and allows time for the body to adapt.
4. Incorporate Proprioception Training
Poor proprioception (body awareness) is common in hypermobility syndrome, leading to balance issues and misalignment. Exercises such as:
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Standing on one leg (with support if needed)
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Using balance boards or stability balls
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Practicing mindful movement (e.g., Tai Chi, controlled resistance exercises) can improve coordination and joint stability.
When to Seek Professional Guidance
Because hypermobility varies widely in severity, working with a physiotherapist about hypermobility can be invaluable. A hypermobility physiotherapist can:
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Design a personalised, joint-friendly exercise plan
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Provide techniques to improve proprioception
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Offer taping or bracing solutions if needed
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Guide safe strength-building strategies
Conclusion: The Art of Balance...next steps
Finding the right balance of exercise with hypermobility syndrome is both a science and an art. The key is to move consistently without overloading fragile joints. By choosing low-impact exercises, strengthening key muscle groups, controlling range of motion, and allowing for recovery, individuals with hypermobility can enjoy the benefits of movement while minimising pain and injury risk.
Doing this all alone without professional guidance isn't impossible, but it can be exhausting and difficult. If you would like a complimentary 30 minute call with James to meet and discuss your symptoms...book it up now.
