Why does joint hypermobility cause fatigue?

A common question is why does joint hypermobility cause us to be more fatigued during day to day activities and exercises. If you’re hypermobile and you’ve had this experience, it’s NOT in your head. There’s a reason why this happens even if you are fairly active.
I’ll use myself as an example. I’m a fairly “fit” person. I lift three times and week and can walk 6 miles without stopping. I’m also hypermobile and it’s taken me years to get to a place where I can handle this level of activity – and even still, sometimes it’s too much and I still get exhausted faster than my non hypermobile counterparts.
This exhaustion doesn’t feel like a lack of muscle strength or stamina. Rather, feels like my brain is glitching out and my nervous system is shutting down. There’s a technical term for this known as central nervous system fatigue.
We know that hypermobile people are more likely to experience this, so let’s talk about why.
Hypermobility and central nervous system fatigue
The way I often think about this is that hypermobility is like having decision fatigue for all of your joints. A non-hypermobile person has joints that can’t move as much, so they don’t have to work as hard to control where they are going during movement. Non-hypermobile people are also more easily able to feel their muscles. These factors combined means that it takes less cognitive and physical work to performa. task. Moving as a non-hypermobile person is like bowling with bumpers.
For a hypermobile person, we have no “bumpers.” Even if we’re concentrating, when we roll the ball it can go in a lot more directions, because we have so much more range of motion and therefore movement options.
This is why we have to concentrate so hard during exercise. Our brains are trying to figure out what direction each joint should move in and our muscles have to engage through a larger range of motion or work extra hard to stabilize our joints in the range that we are cognitively trying to maintain.
How to navigate hypermobility during exercise
One of the big challenges in learning new exercises when you’re hypermobile is that it’s hard to feel where you are supposed to be. This is why it feels so shitty if you’ve ever been in an exercise class and someone yelled at you to correct your joint position – especially on the first try. It’s pretty much impossible.
Most of us need to feel out at exercise and explore different ways of using our range of motion to sense where we need to be. This is why the first couple repetitions may not look very clean, but the last few reps will look much better.
This is also why your form will often look better when you are using a heavier weight and less controlled if you are using a light weight. The lighter the weight, the less feedback there is for your muscles to respond to the load.
If the idea of letting yourself try different versions of an exercise imperfectly, here’s some important things for you to know. As a hypermobile person, your alignment will never look like someone whose joints have a natural “stopping point,” so this shouldn’t be a deterrent from working on getting stronger.
Personally, even as I’ve gotten significantly stronger, my posture hasn’t changed much and I can still move into pretty extreme ranges of motion with little to no effort or sensation. I’ve also noticed that this is the same for most of my hypermobile clients.
This isn’t to say that you should do things with purposely poor form or a lack of control. There is something to be said for thoughtfully and progressively working towards greater strength and more joint control. However, you’re hypermobile, let yourself explore movement outside of that tiny box you think you have to live in. You have the range, so you might as well learn to control it and progressively strengthen it.
And a note for any coaches or teachers working with hypermobile clients. Please stop micromanaging us. We aren’t going to suffer terrible pain or injuries if our range looks different than someone else’s. Before going into “rescue mode,” I would suggest asking your client what their experience is of the movement is. Let them feel it out. Give them something to push or pull against through the use of props, such as bands, the wall, yoga blocks, or weights.
This is a much more constructive and empowering way to teach someone how to perform an exercise versus telling someone that a specific placement of a joint is the best or “safest” position, when we now have a lot of evidence telling us that alignment doesn’t correlate well with pain or injury and what is more important is that we have strength and control in our movements.
Being hypermobile does not make you or your joints defective
It’s true that we do fatigue faster and take longer to get stronger, but it’s because we have to work harder to find and feel things AND we have more range to use.
I’ve found that with this in mind, the best approach is to let yourself or your hypermobile clients develop strength even in positions that look a little wonky. I find it’s also helpful to practice exercises that focus on a specific joint to develop stability and strength around the most affected body parts.
Strength matters more than posture if you want to have less pain and fewer injuries
Ultimately, I think the emphasis needs to be control and strength over alignment. Your alignment won’t always change. However, if your overall ability to function, do more, and live with less pain increases, then who cares?
Want to get stronger, but not sure how to do this while navigating hypermobility and the challenges that come with it?
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There are 2 comments on this post
Thanks so much, Nikki! My granddaughter is hypermobile. She’s 13 and hates any form of exercise (except swimming). I have been helping her to navigate the learning difficulties associated with hm, but am just now starting to help her with her physical conditioning. Your blog has given me some great points to remember as I work with her!
Hi Tam! Thanks for sharing and you’re welcome! That’s great you’re working with her. Anyways, my 2 cents re hypermobility is a lot of the things that they tell us will “harm” us are actually quite helpful. Unfortunately there’s a very old school mentality about how to manage it (aka only use light weight and be as careful as possible) that newer research, nor my lived experience, doesn’t support at all. Deconditioning and fear do way more harm than getting stronger and pursuing physical interests from what I’ve observed.