Exercising Yoga

We’re often told that flexibility is good for cyclists – tight muscles can pull on weaker muscles and create discomfort. However, flexibility and mobility are two different things, and riders struggling with hypermobility will quickly tell you that it’s not so beneficial.

We asked Osteopath Jill Shooter to explain the difference between flexibility, and hyper-mobility – and how the latter can affect cyclists….

What is hypermobility?

As an osteopath working with athletes I often hear: "oh, I have been told I am hyper-mobile!" This is useful as I can then target my treatment. However I find there is some confusion as to what being hyper-mobile actually means.

Simply put, Hyper, means over, above, excessive. Mobility, means movement. Add them together and you get excessive movement.

Hyper-mobility and hyper-flexibility are often mixed up. An individual you can be very flexible without being hyper-mobile.

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Flexibility is the ability to bend, as seen in many yoga poses, ballet dancers and gymnasts. This is usually through the pliability of muscles and their ability to stretch. Some people find it easy to reach to the floor with the knee in a normal straight position, others not so.

Mobility relates more to the joints of the body and specifically the ligaments which surround them and support them.

Ligaments can be described as the joint's seat belt or guide ropes. They work to restrain the joint and keep it aligned within range of movement, allowing the joint to function and the body to move safely and without pain.

beighton

Hyper-mobility occurs when there is gene alteration before birth which gives the connective tissue which forms ligaments, tendons, and skin, a slightly looser make-up.

Hyper-mobility syndrome (HMS) is a graded condition, with varying levels. It is usually obvious with the ability to move your joints beyond the usual limits.

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HMS is often evident from a young age, via the reduced ability of ligaments to restrain the joint within its normal range. It often results in joint pain and even repeated joint dislocations at the extreme end of the spectrum. It is reasonably rare, affecting between 4 – 15% of the population.

Single Joint Hyper-mobility

A single joint can become hyper-mobile. This is usually following a trauma such as a fall onto the shoulder or elbow or knee dislocation where the ligaments have been stretched. The collagen make-up of the connective tissue will not repair and ‘un-stretch’.

Dependent on the severity, surgical repair may be suggested, or the patient may need a series of exercises to strengthen the area before returning to activity.

bike fit

You can be hyper-mobile, strong, fit and active but it takes work! Exercise is good. Guidelines suggest gentle, non-impact exercise such as swimming or cycling and pilates.

Cycling is brilliant if you have this condition, low impact and aerobic as well. It may be best to avoid extreme mountain biking as a novice and stick to the roads or light trails!

Make sure you have a good set up on your bike to avoid extra strain on your knees if. For example, if your seat is set too high it will put your knee into extension when the knee is straight. A professional bike fit might be something you want to look into.

It is suggested that high impact activities such as running, rugby or skiing are avoided. However I have patients with HMS who are successful in all of these sports. What you should do is very dependent on each individual, the level of laxity.

The main aim for anyone with HMS is to increase the control and stability of the muscles surrounding the joints allowing them to act as a natural brace.

Strength training, using weights and resistance, are recommended but start slowly and work up. I would suggest you seek advice from a specialist physiotherapist, osteopath or strength and conditioning coach. They will look at your ability, levels of laxity and fitness and devise a program.

Jill enjoys cycling, swimming and running, and has taken part in several triathlons - check out her site here.