Coming apart at the...joints?
May 2, 2010 10:32 PM   Subscribe

YouAreNotMyDoctorFilter: Having issues with "benign hypermobility."

I am female and early twenties, and I've had a condition since childhood which I have recently learned from my doctor is called "benign hypermobility." It basically amounts to a weakness of the joints that can cause things to slip out of place in fairly painful ways, and while it hasn't been a huge problem in the past, I can tell it's starting to snowball. There was a question posted by a user named moira which I've already looked at, but my symptoms are not nearly as severe.

Some examples of what I'm talking about:

1) As long as I can remember, I've been able to take my shoulders out of my sockets without causing ligament or muscle tears. My lower back frequently slips out of alignment, and I have to lay on the floor to pop it back into place.

2) A few months ago, I blew my neck completely while lying in bed; I moved my neck, heard a *pop* and all of a sudden every muscle exploded in pain. Also, sleeping in general is hard--all positions seem to cause some muscle group to tense eventually.

3) I have already been diagnosed with TMJ by my dentist and physical therapist, and (possibly unrelated) I tore my ACL playing basketball at 15 and suffered a bone contusion in my knee playing ultimate frisbee last fall.

4) As a college student who spends a lot of time bending over books, my neck and shoulders frequently tense up or seize.

My doctor recommended strength training to help, and I'm wondering if there are MeFites who have this condition, and what you've done to deal. I'm looking for information, strength training regimens geared toward joint stability, specific solutions to my studying issue, and any other helpful information. If possible, I'd like solutions that don't involve daily pain medication...I really like my liver.
posted by hoperaiseshell to Health & Fitness (10 answers total) 9 users marked this as a favorite
I have this to a lesser extent and I have found strength training very helpful in keeping joints where they belong. It was worth it for me to get a physical therapist to recommend exercises to stabilize my problem joints. Another suggestion is to cross-train (for example, I run, bike, do yoga, and lift weights) and to sense when you're tired and to quit before your muscles give way and let
your joints get out of whack.
posted by *s at 10:43 PM on May 2, 2010

I also have this to a lesser extent. I found out about it through my oral surgeon, who, while first treating me for TMJ, grabbed my thumb and bent it to my wrist, thus proving my TMJ was caused by hypermobility. Weirdest medical appointment ever.

High-impact exercise is murder on my joints, particularly my knees, so I've been using a mini-trampoline to build up strength. I also use a memory foam pillow at night to stabilize my neck. As for the book situation, when I was in school, I found it most comfortable to sit on my bed with my back against the wall, and rest the books on my bent knees. This prevented me from hunching over books and getting the muscle strain you mentioned.
posted by Ruki at 10:54 PM on May 2, 2010

I have this to a much lesser extent (although the TMJ connection has rung a sudden bell for me). The biggest effect for me is upper back issues leading to migraine-grade headaches.

I'm trying pilates at the moment to build core strength as well as personal training to do some more active building of upper back muscles. The pilates is one on one with a physiotherapist and we use a reformer (I've injured myself in mat pilates classes before, don't recommend them). I also have massage on my lower back, glutes and legs to get rid of the muscle tension that builds up when I exercise (i.e. muscles overcompensating for my flaky joints!).

Like Ruki, I'm no good with high impact exercise -- I'm avoiding it at the moment until I build up my core strength some more.
posted by prettypretty at 11:10 PM on May 2, 2010

People are on a continuum from hypermobile (flexible) to hypomobile (tight.) The more hypermobile you are, the more important is to maintain strength so your muscles can support the joints that your ligaments are not stabilizing adequately. Start with your posture. If you are flat-footed, which most hypermobile people have a tendncy to be, get some good arch supports. Do not lock out or hyperextend your knees. Be sure top stand straight without arching your low back. Keep your shoulder blades down and back.
Avoid high impact activtivies like running, these put a lot of stress on your joints. Strengthen, strengthen, strengthen, but do so in the midrange, you don't want to put further stretch on those already loose ligaments. As a fellow hypermobile (although not to the same extent as you) and a physical therapist, I have been most impressed with Tai Chi as an exercise program. It's emphasis on alignment while strengthening is essential for someone like you. Pilates is also good, you are going to need that core strength to support your spine, especially as you age. Weight training is also good, but work up slowly, being careful not to stress or over stretch your joints.
Be sure to find a good instructor for any exercise program you undertake, who understands and respects you condition. Going to a physical therapist is probably the best pace to start. (S)he can recommend a good exercise program, make sure that you are performing it correctly and cue you into how to to evaluate any exercise you do to make sure you are receiving maxumum benefit without doing any damage.
posted by Lost at 11:34 PM on May 2, 2010

Not the first time I've mentioned this, but 25 years ago I used to have a problem with my jawbone popping out on a regular basis, sometimes extremely painfully, as well as an annoyingly weak ankle that would flop out from under me on the slightest misstep over broken pavement. A class I took in tai chi, solely for stress-managements, permanently and unexpectedly cured me of both maladies. It seems to me that strength training and tai chi have a lot in common.
posted by dhartung at 11:52 PM on May 2, 2010

Response by poster: I should also have mentioned that I can't kneel because of the ACL repair, so I'm not exactly sure if I could do yoga or pilates.
posted by hoperaiseshell at 12:18 AM on May 3, 2010

I can't kneel because of the ACL repair, so I'm not exactly sure if I could do yoga or pilates.

Plenty of poses that don't require you to kneel - find a good instructor who can guide you to these!
posted by koahiatamadl at 4:43 AM on May 3, 2010

I'm on the mild side of the spectrum, thumbs bending back, I can do the splits with very little warm up, and years ago a physiotherapist showed me some key posture issues and recommended a swiss-ball or stability ball for core training.

Good posture needs to be second nature so you don't slouch and get into trouble. Core strengthening excerices should help too. Don't knock pain relief if it becomes necessary. The liver is highly adaptable once you stick to recommeded limits. It sounds like you have quite a severe case so don't chuck anything out of your coping toolkit.

Best of luck with it
posted by Wilder at 5:07 AM on May 3, 2010

Yoga stress flexibility, which is not what you need. It is probably not a good way for you to go. You should be able to do Pilates without kneeling. Both Pilates and Tai chi will increase your hip strength, which will take some stress off your knee. Just be sure you get a good instructor, and listen to your body.
posted by Lost at 7:44 AM on May 3, 2010

I'm like this, only worse (pretty much every single joint slips out except my neck/spine, but, oddly, I can't do the splits), and I would not recommend yoga, unless you can find a class where the teacher is paying close attention to you. About a quarter of the classtime for me was frantically trying to put bones back where they were supposed to be while everyone else was moving on, since I didn't have the strength to back up the flexibility.

What I've found interesting (though I'm too lazy to actually do it), is the extreme strength training contortionists have to do both for their art and to keep from hurting themselves on a daily basis by doing stuff within the "normal" range of motion. Maybe look into that to see if a modified version would work?
posted by wending my way at 11:32 AM on May 3, 2010

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