Today we're discussing flexibility, mobility, and hypermobility. The great news is, whether you're looking to become more flexible or find more stability in hypermobile joints, Pilates can help. Tune in to hear some tips to help you meet your goals in your Pilates classes!
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Mary Thorton is a British physiotherapist and founder of The Clinical Pilates Studio in England. You can learn more about her and her studio here: *https://clinicalpilatesstudio.squarespace.com/our-team*
The article I mentioned came out in 2017, so it was a big deal when I heard about it in 2018. It's still very new. You can check it out here: *https://onlinelibrary.wiley.com/doi/full/10.1002/ajmg.c.31552*
The Beighton Test is super not useful to measure hypermobility because those 9 points I talk about don't get into the hypermobility that could happen in one's heart, intestines, bladder, blood vessels, eyes, etc. It's a very limited and outdated test that doesn't cover much of the spectrum of Hypermobility Spectrum Disorder.
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[00:00:00] Hello and welcome to Pilates Students' Manual, a podcast helping you get the most out of your Pilates classes. I'm Olivia and I'll be your host. Join the conversation and share your thoughts on Instagram at @pilatesstudentsmanual. You can support the podcast by visiting buymeacoffee.com/OliviaPodcasts. Let's learn something new.
Hello, hello everybody. Welcome back to the podcast. We're talking about three really interrelated topics this week, and they are flexibility, mobility, and [00:01:00] hypermobility. So I attended a workshop with Mary Thorton, who is a British physiotherapist, which physiotherapists or physios are what you call physical therapists in the UK. And I think that that's really cool and we should call all of our PT friends "physios." just sounds like more fun.
And I've also, in addition to attending this workshop, worked with a variety of bodies, with a variety of flexibility, mobilities, and some hypermobility as well. And today I'm going to be talking about how Pilates fits into that conversation, as well as giving you some tips if you are either not flexible, mobile, or hyper mobile and what you can do, how Pilates can help. And also if you are very mobile, very flexible, things that you can do in class to kind of look out for yourself as well.
So first, I just want to define these terms so we have a nice [00:02:00] dictionary going forward and we're all on the same page about what these things are.
Flexibility is also known as limberness and that is the range of movement in a joint, often passive range of movement. It's like if you were to grab a hold of your big toe and then lift your leg, how high can you lift your leg? Like with the assistance of your arm, or someone else's arm lifting your leg. That's flexibility.
Range of movement, just so that you have that term defined as well, are the direction and distance that a joint can move. That's your range of movement. So you might have a really big range of movement at a joint, like your hip or your shoulder. Some joints have smaller ranges of movement, like your knee. And then given muscle tightness or tension or trauma, your range of movement may be even smaller or larger as a result of that.
Mobility is [00:03:00] strength in your range of movement, where just the muscle is doing the work. So if we look at that first example of you grabbing ahold of your big toe and then lifting your leg, how high you lift your leg is dependent on the strength of your arm, as well as the flexibility at the joint. Mobility would be how high can you lift your straight leg when just leg muscles are lifting your leg and you're not being assisted in any way by a prop or a body part.
Then lastly, defining the hyper mobile joint. And that is a joint that can move passively or actively beyond the normal limits of that joint. It's often characterized by joint laxity or sort of looseness, even hyperlaxity. Often called double jointed as well.
Hypermobility is often genetic and it's usually [00:04:00] in that case, a symptom of like a greater issue. And when I attended Mary Thorton's lecture in 2018 up this article came out in a journal of medical genetics, and it really defined a lot of what we now know about hypermobility. So you really do see that this is kind of cutting edge in a lot of ways. Like this is very new information. And like, what we knew about hypermobility was like old and dated. And so now we have a little bit better picture of it.
So Ehlers Danlos syndrome is the most common genetic connective tissue disorder and when we're talking about hypermobility, the different manifestations of disorders often have to deal with collagen fibers and which collagen fibers are being affected. So you might think about collagen as, for me, the first thing that usually comes to mind is like skin [00:05:00] elasticity. And, you know, you think about collagen in skincare, like keeping your skin firm and tight and not having wrinkles.
That might be a collagen you think about, but collagen is just a connective tissue fiber. And we also have it in our muscles and in our organs and just in our connective tissue at large kind of holding us together in a lot of ways. So when we're looking at hypermobility as a connective tissue disorder, I really just want to differentiate from the fact that hypermobility is not the same as being really flexible.
When you go back to that definition and we're talking about laxity in the joints, or like really loose joints. And one of the things we were able to do as part of the workshop is there were some attendees who were hypermobile. And if you were to do something like hold onto a person who's hypermobile, like hold onto their index finger and give it a little bit of a wiggle so that you could feel what was holding the bones [00:06:00] together. Really the ligaments, supporting the joint, the tendons, supporting the joint. And when you wiggle the finger of someone who is hyper mobile, it feels loose.
Like if you were to hold on to one of your index fingers with your other hand and give it a little bit of a wiggle, there's some movement that happens, but for a hypermobile person, it might be a really drastic and sort of uncontrolled range of movement, you know, to the point that fingers could be dislocated. Like joints can be dislocated because the ligaments are not holding them in place. And that's what leads to this excessive range of movement that's really unsupported.
And you might think in terms of, you know, joints like knees and hips, you're just like, Oh, well that, person's just really flexible. But in hypermobility spectrum disorder, the symptoms can be a lot greater and actually a lot more serious than that. It can be things like, you know, your heart muscle is too flexible. Like we don't want our [00:07:00] heart muscle to be flexible. We want it to have the valves close entirely and pump blood through our heart. But if you have an expression of hypermobility in that muscle, like it can be really dangerous.
Same thing with hypermobility in your bladder or in your intestines, it could be in your circulatory system. You could bruise really easily and have a difficult time healing. It could result in spinal curvature. If the muscles that are holding your spine in place are too mobile, then you can be curved by, you know, either other muscles or by gravity. If your eye is too flexible, you could have, you know, detached retina, or easily detach your retina.
So it's quite a serious issue, or it can be a serious issue. So even if you're looking at, you know, Oh, I can lock my knees or, Oh, you know, my elbows can go beyond 180 degrees. You might be very mobile [00:08:00] at those joints, whether or not it's hyper mobility, it just depends.
There isn't really a test for hypermobility and this isn't a concern you or anything. I just want to give you like lots of information about hypermobility so we can talk about what you can do in class, in the second part. But there is this test. That's like really old. I don't know exactly when it came out, but I want to say it was like the fifties and it's called the Beighton test. It's a nine point test.
And it's supposed to determine whether or not you are a hyper mobile individual. One part of the test is can you do a forward fold with straight legs and place your palms flat on the ground? You get one point, if you can. If your knees can extend beyond 180 degrees. So when you straighten your legs, your knees kind of bow backwards towards the back of your body. You get one point for each knee if you can do that.
Can you extend your [00:09:00] elbows beyond 180 degrees? You get one point for each elbow. Can you bend your wrist back? So the back of your hand touches your forearm, and then can you bend your fingers back or your index finger perhaps back so that it touches the back of your hands. You get one point for wrists and one point for fingers, each hand each arm.
According to this test if you get more than five points, you're considered a hypermobile individual. And if you're, you know, over the age of whatever and you get three points, you're considered a hyper mobile individual. But I think because in some of those things, it can be flexible, like maybe for fingers and wrists, that's going to be hypermobile. But some of it's also flexibility because if you are very flexible, you might be able to put your palms flat on the ground and not be locking out any joints.
I think the really important thing when we're thinking about hypermobility is this looseness in the joint and kind of lack [00:10:00] of control in that excessive range of movement. And, you know, that can be really tricky and that can be really difficult to deal with.
So coming up after the break, whether you are someone who has hypermobility spectrum disorder, or you are just a really flexible person, or maybe you're on the other side of the spectrum and you're not a flexible person, but you would like to be, I'm going to share with you some things to keep in mind as you're going to your Pilates classes.
Things that can both help you and things that can protect you as you're doing your Pilates. That's coming up next.
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If flexibility and mobility are your goals, Pilates can definitely be something that helps you reach them. You can do that by paying attention in your Pilates classes, to your range of movement. Especially, whether it's passive range of movement or is this active. [00:12:00] Then it would become, you know, mobility versus flexibility.
And you'll see that you will progress as you come to class, especially if you work consistently and frequently. To really build your flexibility, you want to be holding those stretches for a longer amount of time, 30 seconds to I've even heard, like as long as two minutes, Which seems like a lot, but you're asking your tissues to like reorganize themselves in a way that allows you to do something that they don't currently do. Like they need some time to adjust to that.
You can look at all of our Pilates exercises as having a stretching component in them, especially in our classical exercises. There is a great deal of strength and a great deal of you being responsible for that. But you will improve your mobility as you get stronger and you will get more flexible as you [00:13:00] incorporate more of the stretching aspects of Pilates. And those are really side effects. You may not even need to focus on them. You just need to keep showing up and keep doing the work. And it will happen for sure, if that's the side of the flexibility mobility spectrum that you're on.
If you are very flexible or even hypermobile, the focus for you is going to be on stability, right? You already have a really big range of movement and perhaps a lot of mobility, even hypermobility. So what we really want to focus on is staying stable.
Personally, I have hypermobile- I don't even know if I want to say hypermobile because I don't have that joint laxity, but I do have very mobile knees and elbows.
And for me, and what I see most often in classes is this ability to sort of lock out the joint, [00:14:00] or sometimes I call it camping out in the joint. What I mean is you've gone to a range of movement and your muscles are no longer supporting the action. You've just gone to your end range and then you can hang out there.
I'm not going to ask you- definitely, in my class and if you're taking class with another teacher and without me- I not going to say, Oh, you need a soft bend in your knee or a soft bend in your elbows. That's not the goal because you're not going to walk around with soft knees. And you're not going to be like baby bending your elbow.
I think that when you hear, you know, soften the knees or soften the elbows, the idea is, I'm assuming that teacher's trying to get at, for you is some muscular engagement around the joint so that you aren't locked in your end range of movement.
So if you're thinking about elbows extending beyond 180 degrees, I don't need you to bend your elbow, but I do need [00:15:00] you to activate your bicep. What that's going to do is support you at the range of movement that you're in. It might look like you bent the elbow slightly, but you know, we're talking about this difference between flexibility and mobility, where flexibility as you passively going somewhere and mobility is you actively going there.
When you activate the muscles around that joint, you may have a smaller mobility than you have flexibility. And that's important because when we're doing things like, for example, down stretch where you've got all of the weight and the palms of your hands. I know for me personally, I can lock my elbows when I do down stretch if the resistance is too high and I'm not paying attention. If I'm focusing on other things, it's easy for me to lock my elbows and then do down stretch because I get a little bit more [00:16:00] support.
What I would challenge you to do in your classes is to find that support muscularly by activating the muscles around your joints so that you're just supported. You're not out there in an unsupported way. As I said, your mobility might be less than your flexibility. Your range of movement may get smaller when you are muscularly responsible for it. And that's okay, because maybe we start with a really small range of movement that's in your mobility, where your muscles are able to support you and then we can build on that. But the important thing is that we're coming from a really centered place. We're coming from a really grounded place. And we're coming from a supported place.
A mirror might be really helpful in this regard because when you are paying attention to things in your body that you may not have had to pay attention before, or you'd been focusing on other things, having the ability to see where [00:17:00] your body is in space can really help you.
I know in my past experience, more so in yoga than in Pilates, but I've fallen into the trap of what I call a sensation junkie, where you're constantly looking to like feel something and like go deeper. And there is the possibility that you go beyond what is necessary. The goal isn't necessarily to keep going and push yourself further.
So when you're able to see what's going on in a mirror, when you're able to look at your body and kind of see, like what's working, what isn't working, what's kind of camping out, what's hanging out at the end range of movement where I don't have to support it muscularly. That can give you some good feedback as well.
If you do have a severe hypermobility spectrum disorder, if there's anything going on, you know that I love to recommend privates because when you work one-on-one with a [00:18:00] teacher, they'll be able to make a plan with you that really focuses on that stability. What I said before, you can definitely incorporate into your group classes and your private classes as well.
You can do both. You can do just one, but in a one-on-one session, you might be able to focus a little bit more on breathing a little bit more on centering. And if you are interested in it, rebuilding and recreating movement patterns, that might feel strange at first, but really do give you more support at those hypermobile joints.
Pilates is a great fit for both building flexibility and mobility, and containing flexibility, mobility and hypermobility. You can do that in your group classes. And you can do that with a teacher one on one. Pilates itself is an exercise system that really lends to body awareness, to paying attention to your [00:19:00] body in space and that can really help you regardless of what your goals are.
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I hope you all have a fabulous week and I'll talk to you again soon.
Thank you for tuning into this week's episode of Pilates Students' Manual, a podcast helping you get the most out of your Pilates classes. Be sure to check out the podcast Instagram at @pilatesstudentsmanual and subscribe wherever you're listening. Interested in teaching Pilates too? Check out Pilates Teachers' Manual, available everywhere you listen to podcasts.
I hope to see you next episode. [00:20:00] Until next time.