Wednesday 30 November 2016

Hyper mobile?

Hyper mobile?

I maintain that a sign of a good training course is that it stimulates a change in thought patterns. Last week I was blown away by Yin Yoga, I still am. However there are other aspects of the training provided by The Yoga People which have really impressed me, and if I ever design a training programme, I will ‘borrow’ this practical session.
The area of study is functional anatomy, and we spent a considerable amount of time comparing the differences as well as the similarities in the shape and construction of the pelvis, using the 30 people in the room as a study population.
This little bit of research revealed an interesting and blindingly obvious result,

EVERYONE IS DIFFERENT.

The purpose of this study is to bring home the importance that, as everyone is unique in pelvic shape and form, and unique in movement history and use, and individual in every other way, it is impossible that one pose, movement or asana (it is yoga) can be achieved in the same way for everyone- obvious isn’t it. So why do trainings and teachers, even with huge amounts of experience insist that a pose is only correct (I hate that term) if it looks perfect? Why do teachers force legs wider, turn hips square, push bodies down, make forceful adjustments to achieve the perfect (who defines perfect?) shape, and why is achieving that perfect shape so important. I suspect it’s aesthetics, it looks beautiful, and ease and grace are often used to describe someone who has a perfect practice, all very judgmental and not very yogic!!
I’m not really knocking yoga, but I am critisising teaching that places clients, who are ‘naturally’ bendy ahead of the ones who struggle to long sit or drop into splits. How many clients have tried yoga only to be disillusioned because they are not ‘doing it right’ can’t bind or do inversions or have to use a block! It seems to me that some yoga classes are full of people who do not need more flexibility, how many participants know the original reason why yoga asana were performed? Great for the Pilates teachers out there, our classes are full of failed yoga participants who think yoga is not for them, but I think it is sad that many miss out on other aspects of yoga, in it’s widest definition.

Why this little rant? Well the functional anatomy observation session made it easy to see that huge ranges of movement of the femur in the hip socket is only available to some, the rest are not hindered by short muscles but by the shape of their bones. Some cannot go further into a wide legged position, internal or externally rotated because of compression, literally the bone of the pelvis hitting the bone of the femur. No amount of stretching can change this situation. No amount of manual adjustment can make it better unless breaking a bone is thought appropriate.
In the arts, where range of movement is important, such as ballet, Xray’s of the pelvis are used to check out the shape and depth of the hip sockets, no amount of stretching can significantly change basic bone structure without injury and the dancers with inadequate pelvis shapes are not offered places at ballet school, ballet however is all about aesthetics.

This is important to know in all movement disciplines, a simple change in angle can facilitate a huge difference in Range of Movement, being pedantic about foot position or pelvis direction is not serving the client and may create unnecessary pain or injury both physically and mentally.

The question is; when is a huge range of movement due to a lack of compression (the skeleton restricting the movement) and when is it due to joint hyper mobility syndrome. I often hear people describe themselves as hyper mobile because they have a huge range of movement, is this really the case?
Joint Hyper mobility syndrome is not to be admired or wished for, it is caused by genetic defects affecting the encoding of collagen( Beighton et al.1999, Bird.2005, Grahame.2009) anyone who has this syndrome is susceptible to trauma/overuse injuries. It is a complex condition, with a wide range of clinical features:
  • ·      Neurophysiological
  • ·      Musculaoskeletal
  • ·      Skin
  • ·      Cardiopulmonary (asthma)
  • ·      Chronic pain
  • ·      Gastro- intestinal dysmotility
  • ·      Postural orthostatic tachycardia syndrome.
  • ·      Etc…..

Hyper mobility can be inherited, easily tested for, using the Beighton Scale and currently there is no cure, so management of the syndrome is the only option. The spectrum of the disease is from being bendy with generalised joint hyper mobility to not being able to walk because the joints are too floppy to stand up.
It is a connective tissue issue, Collagen is one of the components of Fascia or connective tissue, and Fascia is ubiquitous in the human body, if there is an issue with this tissue it will affect the whole fascial network, hence the huge range of possible clinical features. For many hyper mobility can be an asset but it comes with risk of injury.

I think that we all have areas of our body which exhibit an ease or flexibility in the joint, often they are the site of chronic injury, this can be caused by so many factors, I see very few truly hyper mobile people, Pilates being one of the management options available to this population. 

Fascia is plastic in nature, think about pushing your finger into a plastic bag, the resulting blister will not return back to the original shape, if too much pressure is applied the plastic will break. If ligaments are forcefully stretched they will break, or the resultant stretch ‘blister’ will not return to its original length. Fascia can survive the melting stretch as the tissue creeps back to it’s original length, however whilst it is creeping back it is vulnerable to injury.

So next time someone tells you they are hyper mobile, check if it is caused by lack of compression or by a connective tissue issue. It may be that the lack of compression creating a huge range of movement (a cause of pride in many) is masking an imbalance. Simply by adding variations in movement vectors/angles or bending a limb will provide more space for movement or elicit a stretch where it was not felt before.

November 2016


Thanks to The yoga People and Dr Jane Simmonds.

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