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Is hypermobility making you clumsy: a frequent cause of injuries like ankle sprains

Hypermobility can be pretty awesome for giving you loads of party tricks to do, but, at the same time, it might cause issues in your day-to-day life that you just didn't realise.

A male corntortionist with his feet and shoes on a desk while he's on the phone.
Perhaps he was just walking along, and then went head over heels..?

When people talk about being 'hypermobile', the uninitiated will often think of contortionists, acrobats and maybe even the circus. What they don't often think of is the:

  1. Tripping over your own feet

  2. Constantly aching

  3. Always having an injury in one joint or another

  4. Fatigue

  5. Unwanted attention

Unfortunately, the clumsiness associated with hypermobility can also increase your risk of injuries, like ankle sprains.

So, what is hypermobility?

Hypermobility has lots of definitions based on your age, what parts of your body it affects and whether or not you have other issues to go with it.

A lady doing a yoga pose to stretch out her hip flexors and her hamstrings.

To avoid diving into the complexities of it, being hypermobile is a description for a joint, group of joints, (or a person), that have an increased range of motion - effectively meaning that they bend in a direction much further than they should.

What is the problem with a hypermobile joint and how does it cause injuries?

First of all, there isn't a problem: not as a blanket rule.

Lots of joints and groups of joints are hypermobile for lots of people, and they have no issues. But...

If you are hypermobile, one problem you might find is that you keep on bending in a direction that the joint is not prepared to bend in, and so, the body does then becomes unable to protect you from bending too far in that direction.

A picture of a male soccer player sitting on a massage table with a crutch in one hand and a Controlled Ankle Motion (CAM) boot on the opposite foot.

What does this mean for the body, and why does this cause clumsiness?

Quick exercise to help you understand this:

Hold your arms out to your side, completely straight. Point your index fingers outwards and then bring the tips of your index fingers together. Hopefully, that's pretty easy. Now, try it with your eyes closed - no cheating though!

You managed to do it, even with your eyes closed though, right? The body is impressive, but just wait, it gets better... but for now, just remember this word: proprioception.

Hypermobility: the effects on movement

When we go to move a joint, the brain sends a signal to a muscle, which pulls on a tendon, which pulls on a bone the other side of the joint. [Phew, I'm tired typing that, you still with me?

The brain also relies on special nerves inside the tendon to tell the brain when the tendon is being stretched too far... that's one thing the doctor's are testing when they hit your knee with the hammer!

A doctor completing a physical and doing a tendon relfex test

So, when a joint is bending too far, this might damage it and cause it to stretch the tendon or the muscle and make it longer than it was before.

Now, do you remember that word I asked you to remember? It was 'proprioception'. This is like a sixth sense for us, and it's the sense that tells us where our body is 'in space'. It's basically how our fingertips found each other.

So, now, imagine that one finger was suddenly shorter, your brain would be confused that the fingertips found each other later than it was expecting... kind of like when you're walking down the stairs in the dark and there's one more step than you remembered... confusion is one word for it. There are lots of other words but this is a classy blog so we won't say those!

Well, now, if you take that idea that the brain is 'surprised' by the change in length of the fingers, let's consider what happens when we roll an ankle.

How hypermobility leads to sprained ankles

A hiker walking on an outdoor trail about to sprain their ankle

You're walking along and then you're on the floor. An all too common story, right? What happened in the run-up?

Well, looking back at our friend proprioception, something 'went wrong' and led to your foot getting in the way of your direction of travel, so you tripped. A whole load of processes happen, whilst we walk, but for people with hypermobility, one of the important ones is your brain knowing where your foot is.

Sprained ankles as a result of hypermobility - what really happens

One of the ways that your brain knows your foot's location is by how 'long' the muscles are or how much strain the tendons are under. BUT YOU'RE HYPERMOBILE. This means the muscles might be a bit longer than planned or the tendons are under a bit less strain because they stretched. Oops. So then you roll your ankle a bit, and this creates a little stretch of the tendon/muscle and your calibration is that little bit further out.

A lady balancing on a physio cushion
This is one method (of many!) that may be used to help with recalibrating. It may not be suitable for you, however, so make sure to check with your clinician before trying!

Anyway, eventually, the calibration really ends up out of whack and you might be one of the hypermobile types who really has to focus when they're walking, otherwise it can end up like one of those viral video clips of a lady who isn't very good at wearing high heels.

How to fix the clumsiness with hypermobility

There's a well-known and popular fact that you cannot balance without your big toe. It's not entirely true, but it's not entirely false either. The idea behind it is that we use each foot and toe's positions on the ground to work out where we are, and if we are leaning. Then, we respond by tightening muscles up or loosening muscles off accordingly.

A patient standing on some orthotics.

So, if you can improve your calibration, then that's where you start.

This being said, you can also cheat a little bit and give the body some other 'signals' to work with. So tricks like taping and orthotics can be useful as they:

  1. increase the amount of contact your feet have with the floor

  2. improve the function of your foot muscles so that they fire better*

  3. give the nerves in your skin a signal that your brain can use to identify when you're on tilt

  4. protect you from going over on the ankle so much so that you are less likely to do more damage whilst fixing your calibration.

A lady taping up her patient's ankle after an injury

Hypermobility-induced clumsiness: a summary

  • It's not your fault that you're clumsy.

  • The stretchiness of your joints makes it hard for your brain to know where your limbs are - that's why they're easy to trip over.

  • Each time you damage a joint, you need to retrain/recalibrate it so your brain knows where that joint and limb is going to be when you move.

  • If you do not recalibrate it, then you are more likely to have an injury again.

  • Some simple exercises which are targeted at your weak muscles and tendons can be highly effective in reducing the clumsiness and preventing further injuries.

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