Flexibility is often glamourised in fitness, but as with most things, too much of a good thing can become a bad thing.
Hypermobility can be practically defined as an unusually large or excessive range of motion. This can occur globally or locally: in the whole body or in a specific joint, muscle, tendon or ligament. Some degree of hypermobility is very common, but not acknowledging it, and not knowing how to train a body with it, can leave a lot of gains on the table and expose the body to greater injury risk.
Hypermobility injury mechanisms
The standard fitness industry assumption is: the more flexible you are, the less injured you'll be. This oversimplification is just not true. Flexibility is a red herring when it comes to injury incidence. We should be focusing on tissue tolerance, strength and control, and robustness to the specific demands placed on the body.
Being more flexible just means we might typically experience different kinds of injuries: usually more joint injuries rather than muscular strains and tears. Despite feeling tight in certain muscles, hypermobile athletes typically get more issues like joint pinches, tendinitis and ligament problems. Why?
We often think of muscles' job as creating movement, but often more important is their ability to decelerate or control movement. In a squat, muscles work hard as we descend, lengthening under load and contracting eccentrically. That's the brakes. In a hypermobile person or body part, because there is so much available length, the brakes may not kick in early enough or with enough force to control the eccentric phase, so the athlete crashes into end range. If the muscles can't provide enough tension, the tendons and ligaments pick up the slack, which can lead to tendinitis or ligament injuries.
The same mechanism applies across most movements, and helps explain why certain populations experience more ligament injuries. Female footballers experience a greater incidence of ACL injuries than males: not only a greater average Q angle, but typically less muscular tension created to decelerate movement into the injurious positions.
Global hypermobility can also lead to local hypomobility, where looseness in one part of the body leads to tightness in another. Hypermobile, loose hips often lead to tightness in the lower back or hamstrings, neighbouring areas doing a similar job. We see the same in the spine: pivot points of excessive movement compensating for stiff neighbouring segments, which can lead to overuse and eventually disc issues. It's also heavily linked to shoulder problems, since shoulder function depends so much on a well-moving thoracic spine.
Performance considerations
If you or your athlete tends towards hypermobility, the training approach should differ from a stiffer athlete's. Hypermobile athletes typically struggle to get out of ranges of motion; hypomobile athletes struggle to get into them. Failing squats unable to stand up out of the bottom, versus failing squats because you can't reach the position in the first place.
Hypermobile athletes also typically struggle to generate explosive power and absolute strength. It's why yogis tend to have awful vertical jumps.
The overarching question to ask: do I have enough range of motion and tension to do what I want to do? If you can reach the positions easily but can't get out of them with control, you're at the hypermobile end of the spectrum. If you struggle to get into positions but have good tension from partial ranges, you're at the hypomobile end. Context matters: an individual may be hypermobile for powerlifting but hypomobile for dancing.
How to train hypermobile individuals
Broken down, hypermobile people and areas lack tension, stability and motor control. Training should emphasise building those qualities.
- Tension. Like a longer, thinner rubber band, a hypermobile muscle needs more length to hold tension. Use movements demanding greater ranges of motion: deficit RDLs, sumo squats.
- Stability. Demand more stability with single-limb variations (split squat instead of squat, dumbbell press instead of barbell press), unstable loading tools (kettlebell over dumbbell), and longer-lever loading (overhead rather than back rack).
- Motor control. Tempo, pauses and partials teach the body to contract from shorter muscle lengths rather than defaulting to maximum length.
What we don't want is to create more laxity through further flexibility work, which trains relaxation and loses the tension we need to stabilise joints and create force. Generally, training and loading hypermobile tissues helps; stretching and resting can exacerbate the issues.
Some form of hypermobility is common. By accurately identifying it, we get better results and avoid the typical issues it causes. Always consider function over feelings: objectively assess whether you need range of motion, or whether tension, stability and motor control would serve you better. Then apply the correct training stimulus.