Podcast #55 - Chronic Pain and Hypermobility - Ariana Rabinovitch Yoga and Movement Education Google+



Podcast #55 – Chronic Pain and Hypermobility

The Yoga and Movement Research Series

Catherine Cowey and I discuss an article on chronic pain and hypermobility syndrome (HMS) from the Journal of Pain Research. This article gives a thorough overview of the many kinds of hypermobility conditions and symptoms and makes it very clear that it’s a complicated subject. There’s a wide spectrum of hypermobility syndromes and symptoms which can make diagnosis challenging. The criteria are confusing and overlap depending on the type of syndrome, and therefore, may need to be updated. We also talk about ways to work with people who are hypermobile.

When it comes to exercise and movement, people tend to do what they’re already good at it. Flexible people may love to do yoga because they find the poses accessible. For flexible people who also have hypermobility (joint laxity), only doing yoga and stretching can potentially exacerbate HMS symptoms or create instability in their joints. Couple this with the pervasive idealization of flexibility in yoga asana, as if it is somehow tied to spiritual heights, and you have a potentially injurious combination. Hypermobile yoga students would benefit from incorporating strength work and holding back on how far they go in poses in order to gain more strength and control in the ranges that they have.

Catherine Cowey is a personal trainer and contributor to the Yoga and Movement Research Project (YAMResearch.com)


  • Copers is a term for people with generalized joint hypermobility (GJH) who are also high functioning athletes, gymnasts and dancers. But may be more at risk for GJH symptoms such as musculoskeletal pain.
  • This article reveals that there’s no cohesion right now. There are so many categories of Hypermobility and different diagnostic criteria, which in some cases may be outdated. The Brighton criteria were put together in 1998. Supposedly they’re coming up with new diagnostic criteria.
  • The Beighton score is another diagnostic tool but there are problems with it too.
  • A problem with the criteria and diagnosis is that we only looked at the “gumby” joints and stretchy skin. But because it is a collagen disorder, which is throughout the body, it affects multiple systems: respiratory, cardiovascular, digestive, etc.
  • There are 26 types of collagen. Mostly type 1 is affected in hypermobility. But how it manifests in people is so different, which makes for a huge spectrum of symptomatology.
  • There’s been a documented association between chronic pain and hypermobility syndrome since 1967.
  • Dr. Alan Pocinki’s article on hypermobility and joint hypermobility syndrome
  • Pain management education per David Butler, Lorimer Mosely and Greg Lehman are useful.
  • Cat mentions Dave Tilly The Shift movement science guy: www.shiftmovementscience.com/

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2 Responses to Podcast #55 – Chronic Pain and Hypermobility

  1. Catherine Romanick March 24, 2017 at 11:12 AM #

    Great discussion of this study, which I am glad to have you unearth. I appreciate that you touched on the problems that those dealing with manifestations of hyperlaxity (which I believe to be more accurate than hypermobility) deal with because of a poorly defined diagnostic criteria and misunderstood/unknown symptomatology. You raised helpful topics of potential treatments/modalities for investigation.

  2. Dr. Ariele Foster March 29, 2017 at 5:03 PM #

    Thanks for talking about this important subject. I run a facebook group on yoga for hypermobility, and I’d love for any interested listeners to join us! So many good conversations and resources on there… https://www.facebook.com/groups/YogaforHypermobility/

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