Tips on Training Clients with Hypermobility

During your time in the fitness industry, you’ll have helped a range of individuals achieve their fitness goals. Now, a new challenge has arisen; training clients with hypermobility.

In this article, we will provide you with guidance about hypermobility in these areas.

• What A Personal Trainer Needs To Know About Hypermobility
• 5 Tips A Person Trainer Needs To Know About Hypermobility
• 5 Key Exercises For Training Clients With Hypermobility

Are you interested in developing your personal trainer skills further? Our Level 4 Nutritionist qualification, we will help you get there. Download OriGym's course prospectus for more information about the courses we offer!

What A Personal Trainer Needs To Know About Hypermobility

Before training clients with hypermobility, you need to learn about hypermobility’s definition and its origins.

Let’s begin with its definition. The NHS defines hypermobility as follows:

Joint hypermobility means that some or all of a person's joints have an unusually large range of movement. People with hypermobility are particularly supple and able to move their limbs into positions others find impossible. Joint hypermobility is what some people refer to as having "loose joints" or being "double-jointed".

One of the reasons hypermobile people can move so freely is down to genetics, which can affect collagen’s functionality in their body. 

People with hypermobility have collagen that loses strength. This results in tissue becoming ‘fragile, which can make ligaments and joints loose and stretchy’ (NHS Inform). 

The NHS states that the condition can also be attributed to the shape of epiphysis bones, muscle tone, and joint movements.  

When it comes to sex, one study measured its prominence in different stages of puberty development. In post-pubescence, the condition was 4 times more likely to appear in women than men. 

If you are looking to specialise in this area, this should indicate the clientele you will end up working with.

The Initial Hypermobility Diagnosis

For a person to be diagnosed with hypermobility, their doctor will need to carry out tests. One of these tests is The Beighton Score. This NHS test monitors a person’s flexibility in the following areas, any score above 4, indicates hypermobility is likely in the individual

Hypermobility Joint Syndrome, And How It Should Factor Into Your Training

Hypermobility Joint Syndrome differs slightly from hypermobility, as the NHS states: 

Joint hypermobility syndrome is when you have very flexible joints and it causes you pain (you may think of yourself as being double-jointed). It usually affects children and young people and often gets better as you get older.

The syndrome can exhibit other physical traits. Clients with the condition can often feel tired, suffer injuries from strains, sprains and dislocations, lack coordination and experience tightness in their muscles and joints. They will also notice their skin’s elasticity and complications with their urinary system.     

Over time, the condition can worsen, and your client could develop arthritis as a result of cartilage deteriorating.

When creating a hypermobility exercise plan, you should consider the severity of the client’s condition. This will help you develop an appropriate exercise plan for them. 

You will know what exercises to avoid if the condition is localised to certain areas of the body. You will also know the level of intensity at which a session should be delivered.

For your client to fully benefit from your sessions, let's analyse some of these methods in detail.

If you are looking to expand your knowledge on treating conditions, you should read the following articles:

• 9 Tips For Personal Training Disabled Clients
• Expert Guidance on Personal Training Clients with Fibromyalgia
• Advice For Personal Training Clients With Diabetes

5 Tips On Being An Effective Personal Trainer For Clients With Hypermobility

#1 - Begin The Client's Session With Dynamic Stretches

When you are training clients with hypermobility, incorporating dynamic stretches into an exercise plan can help muscles achieve an unrestricted range of motion.

For these stretches to be effective, we encourage you to perform them with your client before their workout begins. By restricting dynamic stretches to five minutes, your client will have enough time to prepare for their intense workout. 

There are plenty of fantastic dynamic exercises that you can carry out with your client, including; wall push-ups, straight leg raises and bridging.

It is important to implement exercises that reflect your client’s condition and don’t put their health and well-being at risk. If you communicate with them, you will know when they are feeling discomfort and adapt their workout accordingly.

These steps will prevent injuries from occurring during the main workout.

#2 - Strengthen The Client's Stabilising Muscles Through Postural Exercises

Stabiliser muscles provide support all over the body. For example, around the shoulder blade, the teres minor and infraspinatus muscles help the shoulder move correctly. Your transverse abdominals contribute to spinal support and stability. 

As a personal trainer for a hypermobility client, it is important to strengthen their stabiliser muscles. This helps correct their posture and alignment, which in turn, will reduce pain and the chance of injury.

When stabiliser muscles are strengthened, your client’s fitness coordination and balance will also improve. Overall, this will help improve your client’s fitness. 

One exercise that can improve your client’s stabiliser muscles is the Lumbar spinal stabilisation exercise, which involves the client’s knees remaining bent as they rest their feet on the floor.

They should then raise their legs in the air, holding this position for a maximum of 30 seconds before returning to the starting position. 

If this exercise is new to your client, don’t be afraid to motivate your client with words of encouragement. Remember, it is equally important to listen to your client in case they expressed discomfort in their lower back, knees or feet.

If this happens, you should stop the exercise to prevent the risk of injury.

#3 - Get Your Client To Stick To Low-Impact Workouts

Low-impact exercises won’t exacerbate your client’s condition, as they are not pushing joints and muscles beyond their capability, which will help reduce the risk of injury. These types of exercises also build up fitness levels.

Stationary bike and swimming sessions are great low-impact exercises for a hypermobility client, as they don’t put too much pressure on the client’s joints and bones.

If swimming is carried out with your client, it is advisable to avoid certain strokes that could hurt their muscles and joints. Breaststroke, for example, can aggravate a client’s knees and hips.

Whilst carrying out exercises with your client, you can track their progress in the pool. You can use their wearable device to monitor their heart rate, active minutes and distance travelled in the pool. Over several weeks, you can inform the client of their progress from swimming.

If you are carrying out a stationary bike session, make sure your client is doing timed sessions and moving at a steady pace. 

If you are using free weights, make sure you are using weights that reflect the client’s condition, strength and body size.

Whilst these exercises are carried out, it is important to monitor your client’s progress and make sure they are not being pushed beyond their limits.

#4 - Improve Your Client's Proprioception With Simple Movements

A hypermobility exercise plan that incorporates proprioception training can benefit your client, improving their balance and reducing the chances of injury.

This is because hypermobility affects their ligaments' range of motion. They can lose their balance if their knees weaken. 

You see the benefits of this proprioception training when your client stands on one leg. This balancing exercise builds better links between the vestibular system, joints and muscles.

Another beneficial proprioception exercise is the toe tap exercise. It works several muscles, including the gluteal muscles, hip flexors, hamstrings, and quadriceps. These muscles can help contribute to improving your client’s balance.

Whilst your client is carrying out this exercise, it is important to remain by their side, should they lose balance. 

This will give them the confidence and motivation to complete the exercise correctly.

#5 - Start The Client Off With Isometric Exercises

Isometric exercises are beneficial when training clients with hypermobility. They tighten your client’s muscles without moving their joints.

These exercises also help build stronger muscles, minimise pain, and promote better posture and coordination.

Isometric exercises will be incredibly useful if your client suffers from pain as a result of Joint Hypermobility Syndrome.

For your client to complete these exercises, they will need to hold a position during the exercise and not use any muscles. All exercises should require the client to hold the position for up to 10 seconds. 

Some of the isometric exercises that can be carried out are hamstring curls, wall sit and plank. You should factor in your client’s physical health to determine the length of each exercise.

This will allow you to build a tailored program to reflect their current health, physical capability and personal goals.

Whilst these exercise types are being performed, you need to make sure your client is performing them correctly. 

If performed badly, isometric exercises run the risk of injury. This can happen during a plank exercise and the spine is not correctly aligned.

If the client expresses they are in pain, we would advise you to stop any isometric exercise immediately.

5 Key Exercises For Training Clients With Hypermobility

#1 - Try The Wall Press-Up As A Great Modified Exercise For Hypermobility

Ability: Beginner

Energy: Low Impact

The wall press-up utilises a wide range of muscles in your client’s upper body. These include your deltoids, triceps and pectorals.

Wall press-ups are a great way for your client to gain confidence if they are hypermobile or suffer from hypermobility syndrome and exercise causes them concern.

This is because the exercise is simple to carry out and the wall they use can provide them with balance.

This exercise can be completed in three simple, this requires your client to 

• Face a wall and place their hands at shoulder height.
• Bring their shoulder blades back and bend their elbows as they lean against the wall.   
• Then return the body to its original position.

For a person to benefit from this exercise, they should carry out 2 to 3 sets of this exercise. There should be no more than 15 reps for each set and should include a 1-minute rest in between.

If required, you can adapt this exercise to match your client’s condition, adjusting the number of reps, sets and rest times to meet capability.

The benefit of this exercise is that your client will be able to build up their upper body strength and at the same time, improve stability. 

This is because your client will be using their abdominal muscles and lower back muscles during this exercise.

#2 - Incorporate Wheelbarrow Exercises Using A Gym Ball In Your Sessions

Ability: Intermediate 

Energy: Low Impact 

A gym ball is a great piece of equipment to carry out exercises for hypermobility. Your client can improve their abdominals and shoulders when performing the Wheel Barrow exercise on the gym ball.

This exercise can be carried out by your client by completing the following steps:

• Lie with their stomach on a large gym ball 
• Walk their hands forward with their legs remaining on the ball
• Then they should move back to starting on the ball
• They can stand upright by removing their arms from the ball first, followed by their legs. This should be completed slowly and steadily.  

We recommend you factor in your client’s capability and condition when carrying out this exercise. 

Make sure they are moving at a steady pace when completing this exercise. This will reduce the chance of them feeling fatigued, and sustaining a strain or sprain.

#3 - Calf Stretch Exercises Have A Huge Impact On Hypermobile Clients

Ability: Beginner

Energy: Low Impact

Calf exercises can help reduce the risk of injury and dislocation. These exercises help the muscle to stretch properly

When you are a pt for a hypermobile client, make sure you complete the following steps to complete the stretch properly.

• Make sure the client’s right leg is in front 
• The client should move their body weight onto this leg
• The client’s right leg should remain bent, with their left leg straight
• They should then lean forward and feel a stretch in their lower leg
• Once completed, the client should switch legs and repeat these steps.
• When this stretch is performed, it should be carried out between 30 to 60 seconds for each calf muscle. 

This should be repeated 3 to 5 times for the client to receive the full benefit of this stretch.

Calf muscle exercises help stimulate calf muscles and increase short-term motion which can help reduce pain and improve physical performance when they move on to exercises that require more effort.

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#4 - Try Knee Extensions With Your Clients With Hypermobility

Ability: Beginner

Energy: Low Impact

When you are training clients with hypermobility should try to incorporate strength exercises as these will make muscles stronger and help support your joints better.

A nice exercise for your client to complete is the knee extension. They can complete this by following these steps: 

• The client sits on a chair
• Slowly they straighten their knee as far as possible
• They hold this position for up to 5 seconds
• They then switch legs and repeat these steps
• They also have the option to use additional weights to make this more difficult

These steps need to be repeated until the client starts to feel their muscles are sore. If they are not feeling anything, it is important to increase the repetition until they do.

This exercise will develop your client’s quadriceps, allowing them to move on their legs a lot easier.

#5 - Hypermobile Clients Can Benefit From Bridge Exercises

Ability: Intermediate 

Energy: Low Impact

Another leg-strengthening exercise for you to complete as a hypermobility personal trainer is the Bridge. 

Like the knee extension, this exercise will help make muscles stronger to support joints. 

To complete this exercise, your client needs to follow these instructions: 

• Begin with your client lying on their back with their knees raised
• It is also important to make sure that the client’s palms are face down
• Keeping their knees locked in the same position, they should raise their bottom from the floor
• They should keep their back straight whilst this is happening 
• When they are not able to raise their hips any further, they should hold this position for 10 seconds
• This will benefit the client as it forces them to use their glute muscles instead of the delicate lumbar spine and help reduce injury. 

Bonus Tip

Don’t forget to include pacing in your client’s workouts.  This will help maintain their energy levels and minimise your client feeling fatigued while they are performing their exercises.

Before You Go!

We hope after reading this article you feel confident training clients with hypermobility. If you are looking to strengthen your personal trainer skills further, don’t forget to check out our Level 4 Nutrition qualification!

You can also download OriGym's prospectus to explore all of the courses that we offer.

References: 

NHS Choices (2019). Joint hypermobility syndrome. [online] NHS. Available at: https://www.nhs.uk/conditions/joint-hypermobility-syndrome/.

Nhsinform.scot. (2019). Joint hypermobility symptoms and treatments. [online] Available at: https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/joint-hypermobility.

Quatman, C.E., Ford, K.R., Myer, G.D., Paterno, M.V. and Hewett, T.E. (2008). The effects of gender and pubertal status on generalized joint laxity in young athletes. Journal of Science and Medicine in Sport, 11(3), pp.257–263. doi:10.1016/j.jsams.2007.05.005.