Training the Hypermobile

Message from a trainer in Switzerland looking for some guidance in training this hypermobile young lady……..

This client is a female who is 29 years of age and has the connective tissue disorder Ehlers Danlos Syndrome. She has had several dislocations of the shoulder and knee but was referred to me by a sports doctor. She has issues with balance as well and gets extremely dizzy when she is in open spaces. Ideally she wants to improve her strength and improve her balance. Do you have any recommendations in terms of a training protocol? Should I focus on isometric exercises to start with?

For this individual, stay as far from stretching or any mobility drill as possible.

And for the stability drills, you may need to shorten the levers to allow for technical proficiency.
If it is in a corrective focus, get good at staying still under control before you get good at moving under control.  Static before Dynamic.

Start with bodyweight in the basic lifts and progress with load as tolerated. Don’t challenge her too fast.
Isometrics by definition are not a bad idea, but it’s not typically where my head is at for someone at this beginning level. I look for ISO holds with very advanced folks. I am not well schooled in the ISO holds, so I may be behind the curve on this, but someone with this medical condition is probably not going to tolerate such challenges at this time.
Use the Poop Test.  If it looks like Poop, you are probably in the wrong place with an ISO hold.

The dizziness will always take precedence, so try to pinpoint with the physician what does or can precipitate this.

To be flip, try to turn this young lady into a powerlifter. And using supporting gear like knee and elbow sleeves or briefs wouldn’t be the most idiotic think I’ve ever heard of. It may be the proprioception she needs to move with stability.

  • December 18, 2010

Leave a Reply 4 comments

Coach Len Kuhn Reply

Charlie; sorry I missed you yesterday, just got back from working out at Stonebay, where did you get the power box’s?

Charlie Reply

Len – Those I think are MCCS’s. These are the ones I ordered.
http://www.uesakabarbell.com/cgi/commerce.cgi?preadd=action&key=WG-360

No matter the brand, I think they are critical to get guys to stop trying to go off the floor.

Simon Reply

I’m probably on the spectrum of EDS, in the hypermobile form without significant vascular complications its basically synonymous with whats known as benign joint hypermobility syndrome. One patella dislocation but thats it. I have to say that while I do have to be cautious with mobility exercises, I don’t find it uncommon that I’ll get locked up in one place and steal the mobility easily from somewhere else without pain. For example, my R shoulder IR is crap, but I steal it all from scapular anterior tilt on any hand behind the back test. Its hard to see cause the scap moves so easily, but when you pin it in the sleeper stretch it comes out right at you. In addition, T Spine has gotten locked quite easily and resolving that has ended quite a few shoulder things. You might want to refer this individual to this book http://www.amazon.com/Hypermobility-Syndrome-Diagnosis-Management-Physiotherapists/dp/0750653906/ref=sr_1_1?ie=UTF8&qid=1292687508&sr=8-1. Its not great but its at least a start. Training DNF and cervical proprioception with a book on top of the head for balance is a biggie that I took away from it and has been quite helpful.

Simon Reply

Also, KB armbar has been a godsend, just my two cents. Charlie I get your DVD in the mail today can’t wait.

Leave a Reply: