Hypermobility Part 2... Now What?

If you listened to episode 1 regarding hypermobility (and if you haven’t yet, what are you doing!?) you might be asking yourself, now what? Well, in this episode, I still ask you 3 questions, but I do give you some practical solutions for hypermobility and EDS.  We’ll dive into some unconventional approaches including sensory-driven strategies and how pressure changes can act as a powerful assessment tool.  Hypermobile individuals face unique challenges, so let’s challenge the norm and explore these unconventional methods to achieve functional and sustainable movement patterns.

Resources mentioned:
Episode 1: Hypermobility - 3 Questions to Overcome Movement Roadblocks
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Chapters

• 0:00 Hypermobility pt.2
• 1:31 Q1: Setting Movement Goals
• 11:07 Q2: Eye Exercises and Hypermobility
• 18:09 Q3: Vestibular System and Movement

Transcript

Meghann Koppele Duffy: Welcome to three questions where critical thinking is king and my opinions and research are only here to support your learning and understanding Hey, I'm your host Meghann and I'm so honored you clicked on 3 Questions today. And today we are going to follow up, uh, 3 Questions conversation we had previously.

I believe it was episode one where we talked about hypermobility. Now, hypermobility is so complex. To me, it's one of the most complex and least understood conditions. And what I find from my clients or any that have EDS or even hypermobility tendencies at particular joints. Well, it gets really frustrating and the traditional methodology simply does not work.

They're basically trying to fit a round peg in a square hole and, and it just doesn't work. So If you haven't listened to episode one about hypermobility, go back and listen to that. And I'm going to ask three more questions today. And as I mentioned earlier, this podcast is to foster your critical thinking, to think outside the box and find the solutions for yourself.

I'm always here as a resource for you guys, but I want you to feel empowered to ask the right questions and to keep poking that fricking bear until you get the answers you want. All right, let's get into question one. When you are exercising, so I'm not talking about regular movement throughout the day, but when you're exercising, are you creating specific goals or end points of movement?

Now, that sounds obvious, but it's not. So, let me kind of clarify. So, maybe if you're like doing a squat, your thoughts are, Hey, I'm trying to improve my squat. So, if you're not a movement professional, this is probably kind of like, I don't know, I'm just trying to build strength, like, get off my dick, like, what's the problem?

But as a movement professional, I really always want to be clear about what my goal is for my client. Now here's where it gets fricking cool. I mean, your goal could be anything. You could have somebody squatting and your goal is to improve their eye tracking during squat. So what I want you to do right now is there is not one goal.

There's not even five goals for a squat. The goal is whatever the hell you want it to be. Now here's. The second part of this, it's cool to just pick random goals, but how are you assessing and making sure we're achieving that goal? So if it's to do a full range of motion squat ass to the grass and back up, you can use range of motion to guide that.

But like, what if it's just strengthening their quads or getting more activation in their glutes? You really can't test that in a clinic and if you come back to me or comment on any of my posts saying you have X ray vision and I've got really good eyes get out of here and don't get me wrong. I've said the same thing.

Yeah, I got really great eyes I can see a lot of default like bad movement patterns. But again guys those faulty movement patterns often occur because of dysfunction elsewhere along the kinetic chain. So saying you know where the problem is, or you're like, oh, they're flexing their hip too much, is your ego.

Take that shit out of there. Right? And if you're still in the ego stage, stay there. You'll get out of it. Do your thing. I just, I always laugh, like, I kind of had an ego young as a movement professional. I mean, I've been doing this for 23 years. I started teaching movement in college at University of Scranton, whoop, and I taught a work study.

I did, like, kickboxing, like, remember Billy Blank's Tae Bo? And Pilates. Now, I was not a great Pilates teacher back then, but the cues I used helped me feel the exercises in a powerful way. I taught it based off my weird sensory system, and it really resonated with other people, and became a very popular class on campus.

I feel like I had like 50 girls a class, and a lot of my guy friends would also come because there were 50 girls in the class. Anyway, back to the point of this story. So, when you are picking movement goals, it's really critical you have an assessment tool. Right? That assessment tool could be pain. That assessment tool could be range of motion.

That assessment tool could be breath. I love breath because the breath never lies. So when you're giving a client an exercise and they cannot breathe throughout the range of motion, like if they have to brace or do a specific movement pattern, it's not safe enough in their brain. They are not getting enough sensory information to move through life.

And you might be like, no, I always do this breath pattern with this. That's fine. But how is that affecting you when you're walking around all day? Because let me tell you, nobody is injuring themselves in the gym as much as they're injuring themselves in real life. I had one of my husband's buddies over the other day, and he's like, Jeez, like, I played professional football, but if I bend over to pick up a pen, my back goes out.

And I explained to him, well, there's not a lot of sensory intel there. You don't have something heavy in your hand. You're not wearing something on your head. Think about it. Football players wear a heavy helmet. And what's going on with your feet? Where are your eyes looking? And he was like, oh man, I never thought about all those things.

So when you're working with hypermobile people, stay with me. I'll get to the point eventually. I always do. What is the goal in the end point of the movement? Hypermobile people, you know, you don't feel end range. Dude, that sucks. You often feel a stretch in the tendon or pain in a joint. And that's when it tells your brain to make end range.

And that's like not fair to you guys, right? That actually sucks because your brain doesn't know when to stop. I mean, how do you know when to stop when you're driving? Well, we know when to stop when we see brake lights in front of us or a yellow or a red light. It's a sensory input visually to tell us to stop.

So when you're hypermobile, and your proprioception is not giving you good intel, how the hell do you know when to stop? Okay? So, I want to leave you with just a little bit of solutions, and not like, Jesus Christ, Meghann where do I even start? So when you're doing an exercise, determine what your goal of the movement is.

And then focus on a specific sensory input to get you there. Now, in previous episodes, I've talked about sensory input. Let me be more specific. A proprioceptive sensory input, a visual sensory input, or a vestibular where your head is in space that kind of simplifies shit, right? The problem is my hypermobile people, you guys love focusing on proprioception.

However. It's not always a reliable narrator. Focusing only on proprioception, when you have hypermobility, would be kind of the same as yelling at a deaf person and expecting them to hear. Now, I don't know that many deaf people. I actually only know a handful. But I do know they would probably give anything to be able to hear.

Right? There's cochlear implants, there's hearing aids, there's different things to help people hear because when you lose the ability for one of your senses, it, I don't know, can I say this? It freaking sucks. Now, being born deaf or blind, okay, well your brain can accommodate around for it, but I bet if you asked any of those people, they would love to have that sense back.

So I, I want to apologize to the movement industry because I'm sorry that you guys don't feel things in the way that we were taught to describe it. You feel things differently, and that's cool. But we have to adapt to what you're feeling and tap into different senses. Because if we don't give or find an assessment point and determine and range for things, you're just gonna be running through red lights.

Okay, now before I go on question two, I would like all my hypermobile people listening or anybody who works with hypermobility to help your clients create yellow and red lights. Now most people go to their red lights, oh shit I just dislocated, or oh shit that really hurt, oh shit I'm going to pay for that later, that's a red light.

My goal with clients is do not go past a yellow light. So yellow lights are hard to, they're hard to admit to. I have to be honest. You know, you get a little ouchy in a joint, but suck it up, don't be a bitch, like keep pushing through. That's not it. Doesn't mean you're weak, doesn't mean that something's majorly wrong in that joint, but it's your brain's way of communicating.

So I'm going to encourage everybody the next time you move. to start paying attention to yellow lights. Yellow lights before you hit the red. And for movement professionals, stop giving proprioceptive red or yellow lights to people with hypermobility. Stop asking them to squeeze things or push things.

They don't feel it the way you do. Determine what they feel. Is it changes of pressure? If it is, do it. Okay. It's a way I target the cerebellum through pressure because where pressure occurs is usually where we're dumping into a joint. So if we can create pressure changes and then say to the client, all right, here's your end point.

I want you to do the squat without increasing pressure at that specific spot. Hey, it might sound kooky, but what I'm really doing is saying, yo, you dump in that joint, you dump behind your knees, you dump in your foot. So do that exercise again. And don't dump into that foot. Well, how do I know if I'm dumping?

Well, put a towel, put something under or next to the joint, put a hand there, put a strap there, but be clear. If they do not feel the pressure change, you are just putting lipstick on a pig. It doesn't matter because if they don't feel the difference, it doesn't fricking make a difference to their brain.

Okay. So that moves us along to question two, because question two, Oh my God, it makes question one a lot harder. So do your eyes or do eye exercises make exercises feel worse? Okay. You might see me do a lot of visual exercises and talk about visual integration. Cool. But we have what I call eye abs, muscles of our eyes, recti's and obliques, muscles that move our eyes up and down and on diagonals and in different directions, just like our lumbar spine.

So I joke, you have three abs in your body. You have eye abs, neck abs, and ab abs. Only people care about their ab abs. They care about their neck abs as they get old and it kind of hangs. And eye abs, nobody gives a shit about until they get older or need glasses. But then they get corrective lenses and don't realize there were things that they could do to improve their eye function.

Eyes do more than see. But here's the bitch about hypermobility. The muscles of your eyes could be hypermobile. So when I'm giving you eye exercises and I'm like, Hey, look to the right, but don't move your head. Or look to the right, their eye is going to track way further. And you're going to be like, what is going on with the eyes?

Also, if you've had major injuries, I see this a lot with my clients with cerebral palsy, um, major spasticity issues, but when we need visual information, because proprioception is so shitty, this might be a person where they kind of have a lazy eye, or one eye is there and one eye is here. Right? So what do we tend to do?

We correct a lazy eye. Before you correct a lazy eye, I want you to think, why the hell is that eye trying to get information from up there? Maybe the eye is trying to get information from up in that upper left quadrant because the brain doesn't know what else is going on up there. Is there a dysfunction in the vestibular system?

Is there dysfunction in proprioception in upper left quadrant? Now don't get me wrong, I'm not saying to not fix lazy eyes. But why are the eyes taking in information in different directions? And why this is important, people with lazy eyes or eyes that cannot focus on the same point, it's a thing. People look at them different.

They're like, I don't know where to look. And I'll never forget one of my CP clients said to me, Oh my God, I'm gonna like get upset. By doing proprioceptive and visual integration, she's like, Oh my god, I can look at my boyfriend, now fiance, in the eyes. For the first time. And like, I take that for granted.

But, best believe when people are talking to her and her eyes aren't focused, they're like, I don't even know what to look at, they're uncomfortable. And she knows that. Okay, so really think about how your eyes are moving and feeling. And if the visual stuff isn't working for you, I don't want to say don't worry because you're worried, but think about this way in order to mobilize or change a movement pattern, we need kind of stability and safety and other parts of the body.

So, if visual exercises are working for you. So, I'll give an example. Say you're very hypermobile, like, you know, L1, and when you rotate, you just rotate at L1, and it's causing a lot of back pain, because the rest of the lumbar isn't rotating. Well, I might give you a cue, and I might say, look your eyes to the right, and then rotate your body to what you're looking at.

So that it's in the center of your visual field. So they're not going by feel of their spine. They're stopping their rotation when they're in line with that visual target. Okay? Another example might be when you're doing a squat. To pin your head and look down and move towards that visual target. When it's going, and stand above it.

When it's going out of your visual field, that's your range of motion to stop. Okay. So in question two, I kind of, kind of gave you more ideas about question one. How do we create endpoints? Well, it could be proprioceptive through pressure or visual through specific eye endpoints. But question two needs to ask, are your eyes hypermobile?

Are you stable enough in your jaw or tongue and upper quadrant to move your eyes? So people who are there like, no, my eyes suck. I hate when you do visual exercises. I want to punch you in the nose. Totally fine. I mean, don't punch me in the nose, but totally fine you feel that way. I want you to notice when you're doing your eye exercises.

I mean, do it right now. Everybody say their full government name. And wherever your tongue is resting, keep it there. Okay, I have been doing my tongue and jaw homework. So my tongue is back to the roof of my mouth where it belongs. For like the past six months it has been on my bottom right tooth. Which is causing, if you're watching on YouTube, my tooth to turn a little.

Now why is that happening? It's from concussion issues where my jaw doesn't stabilize. And also I don't shut up in my personal life. I like talk a lot. I process through auditory. That's why I'm doing a podcast, right? It's not that I like the sound of my voice, I actually hate the sound of my voice, but I process best through talking.

So, my jaw is always moving. Sidebar. So, anyway, back to you guys. Sorry, big tangent. Wherever your tongue is right now, see I tricked you. Keep your tongue exactly where it is in your mouth, and move your eyes around. Jump them to specific targets.

And notice if you feel the pressure or position of your tongue changing. Now, if you do, dare I say that's good news. Okay, if you feel your tongue moving or even the pressure moving, that's good. That's meaning your tongue isn't stabilizing. Which is, because the tongue is attached to the neck fascially and muscularly, that's going to cause instability in your neck, which makes eye exercises much more difficult.

So if you feel your tongue moving, Move your tongue around your mouth and then try to maintain it in the same position and do your eye exercises again. So yeah, I'm happy when you feel something moving that shouldn't. Because that's telling me your proprioception isn't shit. There are areas of your body you sense and feel and we can utilize that.

Okay, so to close up on question two. If your eyes are also problematic. I have seen this multiple times, especially with people with EDS or extreme hypermobility. That hypermobility can extend to your eyes. Mm hmm. So, if you can find other areas of your body that are moving when they shouldn't, when you're trying to isolate your eyes, you can utilize that information to get better mobility and stability out of your eyes.

And last but not least, do you like fast cars, boats? Dancing. Whipping your hair back and forth. Like, do you like that shit? Do you like skiing? Well, you are someone who relies on a lot of vestibular information. I am not one of those people. I do not like fast cars. I do not like skiing. I remember I went snowboarding with one of my closest friends from college, Kate.

Um, she is a great snowboarder. Oh my god, she like looks so cute. She looks the part. I look the part, like I even did pigtails, a hat, like I was ready to snowboard. And then I'm like, yeah, I don't like this. It's too fast. So I went down the entire hill on my back edge. And she's like, what are you doing? Like, turn the snowboard.

I'm like, mm mm, too fast. No likey. So for me, too much vestibular challenge is problematic for me. I had inner ear infections, ear issues as a kid, nothing major. But because of that, when you have vestibular issues, you kind of move your head less. And think about this, as we developed in utero and as we moved as kids, really determine our ability to deal with different sensory inputs.

Okay? Like, we know about me that I have a lot of sensory issues via the skin. So I didn't like how things felt on the monkey bars. I didn't like holding on to things. It hurt my hands, right? I was kind of like that kid. So is it that surprising that I wasn't doing like backflips on the monkey bars or I was scared to do things?

It's because proprioceptively I didn't feel safe in my own skin. Okay, and because of that I didn't move my head around a lot. You guys might be the opposite. I see a lot of hypermobile people going into dance. Now, let me tell you. Hypermobility looks beautiful on stage. I mean, for real. Nobody's paying to see my stiff ass foot.

Like, I know this is bad, but like, I don't want to see a stiff dancer. I want you to make it look effortless. I want it to like, look like you have a million more joints than me. It just looks so interesting to the eye. It's almost an illusion. But with that range of motion comes a lot of problems. So a lot of these people go into dance and think about dancers.

You never see dancers like move their arm and then weirdly move their head. Unless that's specific in the choreography, dancers like move their head and body in ways that just look, they make it look easy. I remember watching that show, So You Think You Can Dance. And like all these kids are like taking their leg, like straight up doing a split in the air.

And I'm like, Oh, I bet I'm strong enough. I bet I could do that. No, I couldn't. Okay. So what's so interesting about my dancers or people who are hyper mobile. You guys might need and rely on vestibular information. So a big problem comes in when hypermobility causes other issues. So it's very common to have hypermobility and like 30 other medical issues.

And every doctor looks at you like you're crazy and searching and like have, um, what is it? Munchausen's please. You think these people want to be in your doctor's office, told that they're like an idiot? Please, they'd rather be living their life. They are looking for answers. They want someone to hear them and believe them.

People feel like shit for a reason. Okay? So once you have all those other health issues, you might start hating fast cars both. So I always ask people what they liked as a kid and if they've lost that ability. Okay, so if your client or you still likes fast cars, boats, all that speed stuff, adding in faster movements first to really, dare I say, shake that shit up, shake up the vestibular system is crucial.

Also adding head movements in with specific body movements. So I call it spilling a martini. So I'll spill my martini to the right as I lift my arm up. And I'll do that a few times, and then try to not spill my martini and lift my arm up. Okay? So what I did was I mobilized my cervical spine while mobilizing my left arm.

Then, I really want my spine to stabilize when I move my left arm. So then, after that vestibular information, I then ask my vestibular system to say balance and not let any of the fluid in my inner ear move, keep my martini balanced, and then move my arm. It's a concept I call consciously uncoupling. I did steal that from Gwyneth Paltrow, but I'm explaining it differently.

It's not about divorce. I am consciously coupling movements and uncoupling it, so our brain senses the difference. Remember, awareness is important. And to me, awareness is not being like, Oh shit, I'm doing that wrong. Awareness means, yo, I felt that difference. I now own that. I can replicate it based off that awareness.

Okay, so if you're hypermobile, going back to question one, we talked about proprioceptive using pressure. We talked about visual cues. You can use vestibular cues to create your end range, adding in specific head movements with specific movements, and then doing the specific movement without the head movement to map it out differently in your brain.

It might sound weird. But just try it. Don't poo poo my shit until you do it. And if it doesn't work, don't go around yelling this shit doesn't work. Because you probably did it wrong. Which is fine. But I am here. I have a team of teachers that are here. That can help you. Because we are helping people every day overcome these problems.

Rather than offering the same shit to hypermobile people of excessive proprioceptive cues that only help them do that specific exercise with that specific sensory input like a yoga block or this or that. The reason I like using pressure and joint mobilization is you can use that with nothing.

Eventually with my hypermobile people, I get them to use the air against their skin. One of the, my favorite drills I did proprioceptively, I had an intensive with students and it was really windy out. And what I was doing with them was lunges, and a lot of people were moving forward and back, they couldn't stabilize their spine.

So, I asked everybody if they felt comfortable to lift up their shirt so they could feel the wind on their stomach. It was windy as, can I, fuck, windy as fuck, sorry, it's my podcast, I can curse. Um, and what they noticed was, they're like, oh my god, I only feel the wind on my face, not on my belly. So they realize they're leaning their head in.

So I kind of had everybody feel the wind on your belly just as much as your face. Which helped them not flex at spinal segments, and utilize what was around them to change their proprioception. Okay, I'm cutting low on time, I always want to keep these under 30 minutes. So just to rehash, if you are working with hypermobile clients, clients with EDS, or you're one of them, Never settle for bullshit answers.

Okay? If you're struggling, reach out. Book an appointment with me. Call me. Whatever you need. I got you. We will figure something out. I will not. My stubborn ass brain will not stop until I figure out something that works for you. Okay? So use my stubbornness to your advantage. But, stop using shit that doesn't work.

Stop using proprioceptive cues. Stop trying to just lift heavier weight to load your body. Increasing load does not improve proprioception if your brain can't respond to it. Please understand, I believe and I recommend heavy lifting. I do Pilates and heavy lifting. I also box, I also play tennis, I also walk, I also lay on my couch, but I am not against heavy lifting.

But if your hand can't respond to that load, that is going to change how it creates your motor map. What you can do instead is create goals of movements, even if it seems wacky. Create endpoints and end ranges using vestibular, head position, eye positions, or proprioceptive cues of pressure at specific joints you dump in.

These are strategies that can make things that were seemingly impossible be possible again. So I'll leave you with this. It's only impossible until you do it. Don't let anybody, including myself, tell you anything you're doing is wrong. And if in these podcasts something upsets you that I say, I'm going to use one of my favorite comedians, Bill Burr's statement, sit with it.

If it still bothers you in five days, reach out. It probably bothers you because either you're doing what I'm suggesting not to. Or you're not ready to make that change. And what I would say to that is screw whatever I'm saying. It's your life. Do what you need to do. I am just here to poke you and poke the bear to help you get better results.

Not to tell you what you're doing is wrong. So I hope you enjoyed today's episode, part two of hypermobility. And if you have any questions, please do not hesitate to reach out. Thanks guys.