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Hypermobility and the shoulder

Updated: Feb 8


Tim Stevenson shoulder extension mobility exercise

Go to a rugby club, CrossFit box or functional fitness gym anywhere in the world, and you’ll find someone complaining openly about how bad their shoulder mobility is.

 

In the same communities you will often also find someone at the opposite end of the spectrum.

 

They are usually less vocal, even though they have a shoulder challenge of equal magnitude.

 

The ‘I can’t get my hands over my head and I can barely wipe my own arse’ group look on, sick to the stomach with envy as ‘team bendy’ drops effortlessly into another perfectly stacked overhead squat.

 

Yes, having shoulders that don’t go far enough sucks.

 

But having shoulders which go way too far is just as big a hinderance.

 

Let’s unpack the trials and tribulations of shoulder hypermobility and hyperlaxity.

 

[For the record, Tim is someone with hyperlaxity. He dislocated his hip aged 10 and have had multiple shoulder dislocations. He knows what it is like to have too much range of motion and has learnt how to manage it through training.]

 

HYPERMOBILITY + HYPERLAXITY: What is it?

 

Let’s get clear on what we’re talking about. Hypermobility refers to an increased range of motion in joints and hyperlaxity specifically focuses on the structural laxity of the joint capsule and ligaments.

 

The two terms are related and often coexist, but they are not synonymous. Joint hypermobility is a broader concept encompassing a spectrum of ‘disorders’, while hyperlaxity provides a more detailed perspective on the structural aspects of joint flexibility.

 

Hypermobility disorders can be debilitating. The intended audience for this blog is therefore those who are training and exercising regularly and know they have ‘a little too much range of motion’ that they sometimes find it difficult to control. It does not however result in significant instability and repeated trauma.

 

I’M IN TEAM BENDY: What’s the plan?

 

Let’s try and keep a relatively complicated subject as simple as possible.

 

The three key pillars of human movement are Mobility, Stability + Strength.

 

Think about these motor abilities like different sections of an orchestra playing a symphony. For it to work, we need complimentary contributions from each one.

 

When problems arise, we can often find that one element is turned up to a greater extent than the others and we have lost balance or equilibrium.

 

In the case of hypermobility and hyperlaxity, we have mobility in abundance. Therefore, in order to maintain and progress our athletic abilities, we need to bring stability and strength up.

 

SHOULDER STABILITY FOR HYPERMOBILITY:

 

In our personal coaching programmes we have a section labelled ‘Control’.

 

Control exercises are designed to help improve dynamic stability, or in layman’s terms, the ability to keep the ball on the socket.


Whilst isolated exercises for the shoulder play a part, it’s only half the job for someone with excessive range of motion.


Even within sections of an orchestra, the instruments need to be played in way where they work together.

 

In shoulder hypermobility and hyperlaxity, an important part of developing control is by improving proprioception. Proprioception allows us to perceive the position, movement, and orientation of our shoulder and hand in space.

 

Whilst for most people, proprioception operates at a subconscious level, when someone with shoulder hypermobility or hyperlaxity performs an overhead movement like a snatch, they are likely having to divert a significant amount of cognitive effort.

 

For example, you can’t just throw the bar overhead and expect it stop because it won’t, it will keep going. This means to complete the lift, you must decelerate, position and stabilise the bar almost manually.

 

The good news is that proprioception can be trained using exercises that challenge motor control. By doing this you can improve the level of precision, reactivity, and confidence that someone with too much range of motion has.

 

HOW TO IMPROVE PROPRIOCEPTION

 

You need to include exercises in your programme which require you to move with control into positions where you lack confidence and progressively challenge the sensory inputs.

 

In its most basic form, the aim is to improve the quality of information being sent to the brain. In doing so you improve the perception of where your hand is in space and the brains’ ability to deliver the corresponding movement pattern with better precision and timing.

 

Example One:

 

Start by slowly working in and out of overhead positions with intentional precision. You can do this with an inverted kettlebell shoulder press where there is a control challenge resulting in more sensitivity to perturbations. The brain therefore learns how to position your shoulder for more accuracy to prevent the kettlebell from falling.



Progression One:

 

Now scale this pattern to increase the challenge by including more global movement, organisation and co-ordination.

 

Use a ‘Box step up to balance with a single arm overhead press’. To execute this you need to not only manage the overhead press but also organise everything below the shoulder to create a stable base.

 

Level 1 is a dumbbell.  Level 2 might be the same inverted kettlebell.




Progression Two:

 

To bring a different challenge we can play with our sensory inputs.

 

For example, you might do a single arm shoulder press with your eyes closed. By removing the visual input you force your brain to dial in harder to the information it is gathering from other sensory receptors.

 

Now when you train with your eyes open you will benefit from an upgraded sensory input experience.

 

Strength

 

Strength comes in many forms even though it is often framed within the context of higher intensity lifts.

 

A more accurate way to look at strength is a wider spectrum which in fact starts with stability and runs all the way to speed and power.

 

For someone with shoulder hypermobility or hyperlaxity, ensuring there is a focus on stabilisation strength is important. The localised stabilising musculature acting on the shoulder and scapula enhances control and creates better foundations for strength development.

 

There is then of course multiple benefits of increasing overall strength in a range of intensities.

 

Just remember you need to keep that orchestra in balance. So, if your strength work is progressing, you need to make sure your stability training is doing the same.

 

A final word on strength training for shoulder hypermobility and hyperlaxity.

 

Exercises in a closed kinetic chain where the hand is fixed i.e. on the floor, can create training conditions that are favourable for improving stability and strength.

 

These movements will often include some kind of ‘core’ integration which is important in creating a stable base for the shoulder to work on.

 

A GIFT + A CURSE

 

For the challenges it brings, shoulder hypermobility and hyperlaxity can be beneficial to human movement and athletic performance. You will find a lot of elite athletes who can move in greater than usual ranges of motion and use it to their competitive advantage.

 

But to use or manage that range of motion safely and effectively, you need to learn to control it.

 

This is not an easy task and if you’re looking to progress in heavy strength or complex movements in overhead positions, your training programme needs to include a few things that others don’t.

 

Just like the ‘tight shoulder team’ need to do more mobility work, the shoulder hypermobility and hyperlaxity crew need more control.

 

With control comes confidence and with confidence comes strength.


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