For most of my life, I didn’t know I was hypermobile–a condition where your joints can move beyond the regular range of motion.
I did know I was experiencing a lot of back pain, constipation, chronic urinary tract infections and pain with intercourse. My yoga practice felt more painful than peaceful.
Do these symptoms sound familiar to you?
You might be surprised to learn they can sometimes be traced back to hypermobility, including Hypermobility Spectrum Disorder (a group of conditions involving hypermobility pain that can impact the whole body) and Ehlers-Danlos Syndrome (an inherited connective tissue disorder).
How Hypermobility Affects the Pelvic Floor
In physical therapy school, I connected the dots between my pelvic floor-related symptoms and my flexible joints.
The pelvic floor is a key muscle group responsible for stabilizing our hips and core. When hypermobility causes instability in these areas, pelvic floor muscles react by getting tighter, making it hard to fully relax.
This can create a whole host of issues, including:
- Pelvic pain
- Bowel and bladder issues
- Pain with intercourse and other sexual dysfunction
- Urinary incontinence and overactive bladder
- Constipation or IBS
- Pelvic organ prolapse
- Hip and low back pain
These symptoms can unfortunately lead to pelvic surgery, birth trauma, chronic stress and chronic pelvic pain.
By identifying hypermobility and seeking physical therapy, you can avoid many of these outcomes, and learn to embrace the unique strength of your hypermobile joints!
How to Tell If You're Hypermobile
If you’re experiencing any of the symptoms above, you can do an at-home assessment to see if hypermobility might be a factor.
The Beighton Scale is the standard assessment tool for joint hypermobility. It tests five physical maneuvers, asks five questions about your joint health history, and scores your responses on a nine-point system.
Questions include:
- Can you now [or could you ever] place your hands flat on the floor without bending your knees?
- Can you now [or could you ever] bend your thumb to touch your forearm?
- As a child, did you amuse your friends by contorting your body into strange shapes or could you do the splits?
- As a child or teenager, did your kneecap or shoulder dislocate on more than one occasion?
- Do you consider yourself “double-jointed”?
The test is positive for joint hypermobility if you:
- Score five or more points in the physical portion
- Are positive for at least two of the health history questions
- Have a history of pain in at least four joints for the past three months
While the Beighton Scale is helpful, it can sometimes overestimate your actual joint hypermobility. The most thorough assessment is the Lower Limb Assessment Scale (LLAS) which your physical therapist can administer to get an even better understanding of your mobility.
How to Treat Hypermobility
If you think hypermobility might be affecting your pelvic health, a pelvic floor physical therapist can provide the best treatment.
Through my training, I’ve learned how to help myself and my patients get stronger while supporting our joints' special capabilities. This knowledge has helped me immensely in my yoga practice, where I can now freely stretch and move while protecting my pelvic floor muscles. And I'm happy to report that I no longer suffer from the pelvic health symptoms that used to slow me down.
My hypermobility journey has taught me the importance of awareness and adaptation—something I hope you can embrace too!
Dr. Emily Mason
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