Coaching The Hypermobile Athlete
Too much of a good thing
We all know that a certain degree of flexibility is important for all runners, with many of us noticeably limited in our range of motion around certain key joints. In runners and triathletes I find that lack of flexibility particularly becomes a problem around the hips and ankles. I know this is something I personally need to work continuously on!
This lack of available motion can cause the body to compensate through other less desirable movements in order to find motion from elsewhere, enabling the body get through the running gait cycle. As an example of this, I’d suggest taking a look at this article on restricted hip extension, and it’s impact on calf loading. In so many runners, a big problem is a lack of available motion around the hips areas.
However, there is a significant population of athletes where the problem isn’t too little motion, but too much motion being available. Without the neuromuscular control and strength through range to control this increased available movement, the athlete is potentially at increased risk of injury. These hypermobile runners present their own set of challenges when it comes to coaching and injury prevention.
Flexibility vs Hypermobility
Some runners are more bendy than others, for sure. Just because you are more flexible than your training partners, this doesn’t necessarily suggest that you are clinically hypermobile. Somewhere in the region of 4-15% of the population are thought to suffer from the genetically inherited Hypermobility Syndrome (HMS).
The video below demonstrates the tests used to determine an athlete’s Beighton Score.
Adam describes Hypermobility Syndrome nicely in this blog post by stating:
It’s a syndrome that affects the connective tissue in our bodies, this is the stuff, the glue that holds our tissues and body’s together, it forms our ligaments, tendons, muscle, skin and most other things, there are different sub types and with hypermobility you have too much of a certain type and its disorganised in its structure, this is caused by a gene mutation and it is nothing that you can or could have prevented.
Due to this gene the connective tissue is very pliable or stretchy and so allows excessive movements of the body’s joints, this excessive movement and lack of control around a joint can then produce ‘arthralgia’ or joint pain believed to be from the shearing (side to side) forces that the joint experiences in day-to-day movements.
Challenges Faced By Hypermobile Athletes
I’m not going to get into the question of ‘What form of exercise is best for those with Hypermobility Syndrome?’. Needless to say, exercise is definitely the way forward compared to no-exercise. You will of course find that some forms of exercise are more or less stressful on the hypermobile body than others.
As this is a running blog, I’d like to focus more on what we as coaches and therapists can do to help hypermobile athletes become more resilient to the rigours of running. As 9 times out of 10, in my experience runners will run – hypermobile or otherwise.
‘Don’t run‘ is rarely an acceptable long-term solution!
Having coached a number of athletes diagnosed with various degrees of Hypermobility Syndrome, there are a number of common challenges I notice. The good news is that if their training is adapted to take into account their HMS, their ability to train and compete successfully is noticeably improved.
Take Home Messages
Athletes with Hypermobility Syndrome need to spend significant time training their body to control the extra motion they have available to them. With mobility must come strength through range, neuromuscular control and stability.
Often hypermobile athletes require increased input and feedback to establish good movement patterns and feel the correct firing patterns.
As I was putting this post together, these tweets came in…
Ellis and Jeff together sum it up nicely
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