So you can touch your toes! But is there such a thing as being too flexible?
We all come to pilates and yoga classes for different reasons as far as our physical body is concerned. Some of us need more softness in our bodies and some of us more firmness. Our bodies are not all created equally and for many more flexible students some exercises or postures can feel relatively easy to get into because there is less resistance from opposing tight muscles.
These people often need to learn to become more active in their muscles and use their muscles to support their joints in each posture. For others on the opposite end of the spectrum, who naturally carry more tension in their muscles, they will tend to force their body into postures and need to learn to soften and let go. Each one of us will exist somewhere along this spectrum of ‘softness’ or ‘firmness’ in our natural bodies. This can also vary slightly from day to day or morning to evening, depending on the activities or stresses we experience that day.
Although this spectrum of soft-tissue flexibility is considered normal variation between individuals with females tending towards the more flexible and mobile end and males towards the more firm (less flexible) or rigid end, there does exist the situation where there can be an abnormal amount of flexibility in the soft-tissues. This condition is known as joint hypermobility syndrome and involves a disorder of the relative amounts of type 1 and type 2 collagen fibres in the connective tissues of the body. Connective tissue, such as ligaments, are what keep our joints held together or stable. Therefore if the connective tissue is too lax (loose or too flexible) the result is excessive mobility of the joints throughout the body, read: too flexible. While this is often seen as an advantage in activities like, yoga, pilates and dancing, if the secondary restraint to stability provided by the muscle system is inadequate, the joints can become overloaded and injury often results.
The Beighton score is a scale used to grade an individual’s amount of hypermobility from 0-9 with a score of > 4 representing a positive result. One point is given for left and right sides for each of the below joint positions able to be achieved.
Beighton score (Physiopedia)
It is not the only test used and a diagnosis is made clinically by a doctor or physiotherapist based on this test and several other criteria such as multiple joint pain, dislocated joints and morphology which form the Beighton Criteria.
The increased mobility in the joints caused by laxity in the connective tissue can also have an affect on a person’s proprioception (aka joint position sense) as the mechanoreceptors that send signals to the brain are less sensitive which can lead to clumsiness, leading to higher incidence of sprains and strains. The increased demands placed on the muscular system to stabilise and protect these ‘loose’ joints is also thought to be a contributing factor to fatigue and fibromyalgia in some of these people.
Over time muscles become overactive, loaded with trigger points and fatty infiltration occurs due to the poor blood circulation into the muscles. In fact many people with mild joint hypermobility syndrome don’t even know they have it and don’t experience any noticeable symptoms until they go through an extended period of inactivity causing them to become deconditioned or unfit. Things like increased workload or stress, caring for family or illness can all lead to a lack of time to exercise and eventually symptoms of joint overload and soft-tissue overuse injuries can start to develop seemingly for no apparent reason.
Although hyper mobility is a genetically acquired syndrome, the good news is that exercise, especially gentle low load strengthening exercise like pilates or a ‘yang’ yoga practice can help sufferers to markedly improve joint pain and symptoms by improving joint position awareness, lengthening and strengthening appropriate muscle groups and teaching optimal motor control patterns. Many hypermobile or “too flexible” clients report feeling constantly “tight” due to inappropriate muscle activation trying to hold their mobile joints in position, which can mislead an untrained eye to believe that what a certain client needs is more flexibility. This in turn can perpetuate a cycle of pain and instability for them.
It is important to note that the spectrum of flexibility variation between individuals is normal and not everyone who is ‘flexible’ has a joint hypermobility syndrome. If you are suffering from joint pain and other symptoms in various joints we urge you to consult a physiotherapist for an assessment and advice on whether you are “too flexible” or “not flexible enough”. Commencing Pilates alongside a physiotherapist, ensures that the appropriate diagnosis is made and hence, that the appropriate exercises are chosen for your condition.
Joint Hypermobility Syndrome Image References: