The Rise of the Hypermobile Flexibility/Mobility "Expert"

Mobility training is all the rage these days and has been on the rise the past few years. There’s a lot of confusion as to what it actually is, but that’s a topic for another day.

What’s becoming even more popular is hypermobile trainers (you know, those people we used to call “double-jointed”) teaching flexibility or “mobility” training to the masses with catchy tag-lines like “stay flexy.”

When you dig deep into those influencers, many of them end up with torn hamstrings, chronic sciatica, meniscus tears and non-contact injuries like broken bones on “routine” drop jumps.

In this article, I’m going to:

1. Briefly talk about the difference between mobility and flexibility (because I can't resist)
2. Quickly define hypermobility and a simple scale that tells you if you are hypermobile or not (and why it's not a complete test either way)
3. Share tips on how to spot hypermobile trainers and questions to ask them (or when researching them) that help you know whether to trust their “system”/methods or proceed with caution
4. Highlight what type of training is best for hypermobile people and how to find the best mobility/flexibility training for your body regardless

Ready? Let's dive in!

Mobility vs. Flexibility, What's the Difference?

Before we dive into the hypermobility topic, I’m going to get on a quick soapbox. Don’t worry, I’ll devote an entire article to that soapbox later (and I’ll have to do this til I’m blue in the face because of what the industry has done to it), but for now I’ll just clarify something..

Mobility vs flexibility. I know I said I wouldn't get into it today, but I need to at least touch base on it.

So, what’s the difference between mobility and flexibility?  HINT: It is not that mobility is active range you can control and flexibility is passive range of motion, though this is exactly what all popular systems teach today.

Very clearly, when you look up the definition, mobility is the ability to move or be moved freely and easily.

Under that definition, guess what falls under mobility training? Literally everything…IF…it helps you move or be moved freely and easily.

That means all types of flexibility training (there are FOUR main types), strength training, speed and agility, endurance training, rhythm/timing/coordination work, etc…literally everything.

Flexibility, on the other hand, is defined as the quality of bending easily without breaking OR the ability of muscles, joints and soft tissues to move in an unrestricted, pain-free range of motion,  whether passive OR active.

There are four main types of flexibility: active static, active dynamic, passive static, passive dynamic. All exercises “mobility” experts prescribe fall under one of those 4 categories. I'll make a separate post on that soon.

So...HOW IN THE WORLD…did those definitions get so confused?!? It literally blows my mind, but gullible trainers and lay people will soak up the rambling of confidently-speaking influencers seemingly from now until eternity because no one questions things at a base level anymore in order to do their own research and think on their own.

It is what it is. Moral of the story? Do your research, friends. Question everything, even what you're about to read. (Steps off soapbox).

Let’s move onto today’s topic…hypermobility and hypermobile trainers.

What is hypermobility?

Most have not heard the term hypermobility before, but that’s the clinical term. Most have heard of being “double-jointed,” but sorry to burst your bubble...that’s not really a thing.

To keep it simple, let’s break it down.

Hyper- means excessive and mobility we’ve already defined. So hypermobility can be thought of as the ability to move or be moved way too easily or even excessively.

As a physical therapist we have ways of assessing this by way of joint feel, a few scales of measurement and a set of symptoms that tend to go along with it like frequent dislocations and instabilities, systemic symptoms like gut irritability and more. Some dead physical giveaways are hyperextended knees, elbows and fingers.

Clinically, we simply define hypermobility as the ability to move beyond established norms for range of motion for a given joint.

How do I know if I'm hypermobile?

There is a series of movements and behaviors we can look to test for this at home. Let’s dive deeper into one of those scales we use, the Beighton scale. This is a simple tool that is easy to score. The disadvantage is that it’s rather limited in scope because it doesn’t cover a multitude of joints and the recommended cutoff for use is below the age of 9. There is another scale called the Del Mar scale that you can look up if you want to dive a bit deeper, but that one has some disadvantages as well.

Here are the markers of the Beighton scale:

1. Passive dorsiflexion and hyperextension of the fifth MCP joint beyond 90 degrees
2. Passive apposition of thumb to the flexor aspect of the forearm
3. Passive hyperextension of the elbow beyond 10 degrees
4. Passive hyperextension of the knee beyond 10 degrees
5. Active forward flexion of the trunk with the knees fully extended so that the palms of the hands rest flat on the floor (I have some issues with this one, but look for collapsed feet AND hyperextended knees with this one for a better guage)

Each movement (except the forward fold) is scored 1 point each for left and right for a final maximum score of 9. Some say a score between 0-3 is normal while a score between 4-9 shows signs of hypermobility and ligament laxity.

To me the biggest flaw with this scale is the forward fold. You actually should be able to bend over and touch the ground with minimal stretch and straight knees, but without knee hyperextension or foot collapse.

Typically, other signs of hypermobility can include frequent dislocations or subluxations of the jaw, shoulder, or patella along with chronic pain, chronic fatigue, elastic skin, easy bruising, some heart conditions and chronic ankle sprains.

How do you spot a hypermobile flexibility trainer?

Have you ever seen someone do some extreme flexibility feat like the splits and something just doesn’t look right? You may think to yourself, “I don’t think their joints are supposed to do that.” 

These are all the things to watch out for because these people rely on being default extra bendy to get to these positions and here are a few examples...

Hyperextended knees on a hamstring stretch…

hyperextended elbows on a shoulder stretch, feet that collapse heavily and point outward on transitions/jumps/landings...hyperextended backs with a distinct hinge point near the base of the spine instead of nice continuous curve...

Now you know…and knowing is half the battle.

How to know if an influencer’s mobility program is worth taking

There are several questions I would be asking the trainer/influencer if I’ve noticed they have hypermobile tendencies.

It’s important not to be enamored with feats of flexibility on someone like this because their journey to the extremes will not be as hard as someone who is not hypermobile, AND they tend to deal with a fair amount of chronic pain that they don’t share as frequently on their bulletproof athlete, money-making IG accounts (and I get it, but that’s why you, the consumer, need to be equipped).

To be trustworthy, these trainers need to have not only walked the walk themselves, but also walked others with varying body types through the process as well.

So here are the questions I would be asking or researching (because they may not be fully honest about their history):

1. Have you worked with truly stiff people before? How do you assess for that and have you taken someone from truly stiff to really flexible without causing injury?
2. How do you program differently for someone who is hypermobile versus some who is truly stiff?
3. Do you personally deal with chronic joint pain? If so, why do you think your methods have not fixed your body?
4. What is your injury history? Have your methods helped fix those injuries without reoccurrence?

All these questions can give you a clue as to whether the coach is legit and knows that the approach that worked for them may not work for everyone, especially us truly stiff folk!

Here’s the thing…stiff people can get really flexible with the right approach though. I know this because I was one of those people.

I dealt with chronic pain in multiple joints from age 17-25 that were triggered by a severe ankle sprain my senior year of high school.

After training nearly every movement system under the sun, I got really flexible, even acquired the splits at age 36 when I couldn’t even forward fold to reach past mid-shins when I was in my early twenties.

Here are some examples of what I was able to achieve through strength-focused flexibility training (and putting in my fair share of the passive stuff as well).

Given my chronic joint pain history, you may even be thinking, “I wonder if Doc is hypermobile…” It's a great thought, but I don’t fit any of those criteria except for now being able to put my palms flat on the floor in a forward fold (BUT again my knees don't hyperextend and feet don't collapse), so I don’t qualify as hypermobile in my joints at all.

The kicker? All that flexibility did NOT fully restore me and it wasn’t until I started training like a kid again (I re-traced my steps through our original design for movement in the childhood neurodevelopmental sequence) that I was able to restore the last pieces. And it still requires daily work because of my history.

Bottom left was me with the splits and that was my best squat. Bottom right was me simply training like a kid again and I move better now at 40 (in January 2024) than I did as a teenager.

What’s awesome about this developmental process? It’s the best type of mobility training for everyone…Yes, everyone. It is the most human form of training. Let me explain...

What type of training is best for hypermobile people (and everyone else)?

When I work with a hypermobile client I always begin by telling them this, “with great mobility comes great responsibility.”

Ok, so it’s not perfect, but most people remember the first Spider-Man movie with Toby McGuire where Uncle Ben is passing down his quotable nugget of wisdom, “with great power, comes great responsibility” so it clicks.

In a nutshell, a hypermobile person will tend toward instability at most joints. That means there is much greater demand on precision in the way they carry out movement in order to feel best in their bodies. That doesn’t mean they need to move like robot, but it does mean they’re going to have problems if they’re not moving in a way that is connected and secure head-to-toe.

That said, there are few things I recommend hypermobile people completely avoid due to the ligament laxity:

• Passive static forms of stretching. I know the stretch feels good, but you seek the stretch because you’re seeking to feel something, just some form of connection. If you have pain, soft tissue work is ok, but your body needs stability and strength at its end points, not further stretch at the end-points of the ligaments. This is where end-range strength training in ideal alignment can be beneficial, but word of caution on passive variations.
• Banded mobilizations and passive distractions. Your joints don’t need more space, don’t use a band to pull them out. If you hang from a bar, hanging actively.  Use your body to create stability and fascial tensegrity.
• High velocity chiropractic adjustments. High passive velocity on instability is a bad choice and I’ve seen many athletes stuck in the cycle because chiropractic adjustments create an addictive release of endorphins that can help in the short term, but harm a hypermobile person in the long run. Midback adjustments tend to be innocuous, but I would strongly caution away from the neck and low back and opt for movement-based variations that cause natural "adjustment" by moving and breathing through the tight spots.

Ok, so what is best then?

Remember, that fancy term I used, childhood neurodevelopmental sequence? Well, that OG movement development process houses the absolute best template for hypermobile people because most of movement development and how kids interact with the environment follows a guiding set of organizational principles.

Most of the movements involve interaction with the ground on your back (supine), on your stomach (prone, aka “tummy time”), hands and knees (quadruped) or hands and feet (like a bear crawl). What does all of that mean? Feedback. Pressure. Connection.

Because of this connection, you get increased proprioception (joint spatial awareness) and an abundance of what is called closed kinetic chain exercise, which has been shown to cause increased activity in the stabilizing muscles of the arms and legs along with core control that adapts to the demand of the movement.

This process follows a logical, predictable and stepwise progression that forms basic shapes and simply adds layers and nuance to them in increasingly more broad contexts. In order to progress, you MUST have head-to-toe connection where the whole body must coordinate to produce the movement and continue to upgrade.

Here’s an example. Notice how the supine ring position (top left), the quadruped rock (top right), deep squat (bottom left) and jump (bottom right) are all the same shapes, just oriented differently in reference to gravity.

This is exactly how the developmental sequence works. It slow drips control, stability, strength and flexibility through connection and progressive exploration with the environment. The same process works for running where moving our arms and legs in a reciprocal fashion on our backs becomes the crawl (army crawl), which becomes the creep (the technical term for what most people know as the baby crawl), which becomes the bear crawl and eventually the walk, which becomes the run. That same exact pattern shows itself in the throw and swing, just in a slightly different sequence.

The guiding principles that occur are:

• The foot organizes a certain way to collect the bones and form the rigid arch when under pressure (similar to old school arches in architecture)
• The body tends to use open shapes to collect pressure (similar to pulling the string on a bow and arrow, but in more of a wrapping spiral pattern) where the knee will trend outward during loading/landing (not by pushing the knee out intentionally though) and then will snap back inward as it naturally releases from the ground, which you can see in the image above.
• It is forward movement focused where the hips tend to stay subtly or significantly behind the ribcage and ground contact point (center of the ankle in standing, knee if kneeling) depending on context (subtle during posture, significant during a sprint or broad jump). Most of modern training is reverse movement focused. Think of a squat or deadlift where the hips move forward as the chest moves backward. Our human design ratios are closer to 10,000+:1 forward:reverse. This is a big disconnect between our design and the industry at large in my opinion. The challenge? We’re not taught this in school, so it takes personal observation and willingness to forget pervasive knowledge to remember what is already inside you.
• There is a specific rhythm to fluid movement where the arms lead the sequence in walking/running tasks and the hips lead in the throw and swing.
• Land before leaving. Kids jump down off of stuff (depth jumps anybody?) far before jumping up off the ground, much less up to a higher surface. This installs the shocks and breaks before the turbo boosters, which is backward from most of traditional training

The best exercise program…ever?

The most amazing part about childhood neurodevelopmental sequence is that it is fundamentally human. It is how we were supposed to move. It’s how all of us learned to move in the first place before modern innovations like cushioned shoes and furniture, desks, unnatural foods, screen time and a host of other things started pulling that design out of us.

So not only is it the best option for hypermobile people, it is the most natural option for any human to train and keep complete athleticism, whole body mobility and lifelong durability from head-to-toe.

And remember, this covers literally every movement you can think of that’s natural. Core work, crawling, walking, running, pushups, hang, climb, swing, throw, carry, squat, hinge, get up and down from the ground, jump, hop, bound, sled push even, etc…It’s all there and develops connection and athleticism predictably when you follow the process and have an environment that allows for it to flourish.

This is the exact framework I use when I work with people face-to-face or online. It covers rehab, prehab, general fitness and elite performance training.

Let’s recap…

We talked about:

• Mobility vs flexibility briefly and how the industry gets it wrong and confuses the public daily
• Hypermobility and how to evaluate hypermobile flexibility trainers and "mobility experts"
• What type of exercise is best for hypermobile people and why the neurodevelopmental sequence fits the bill
• Why following child development stages through to performance levels makes the most sense for everyone, regardless of whether you are hypermobile or not.

I created an online course called Athlete Reborn that walks you through my exact system for helping people of all ability levels, including progressing back through the childhood neurodevelopmental sequence on an adult scale. Everything you would need to restore yourself and feel connected in your body is found in that course. If the toddler is the developmental powerhouse, you can become an athletic powerhouse with the same process as an adult. You can check that out here:

CHECK OUT ATHLETE REBORN

I’ve also created a free guide, “5 Steps to Pain-Free Athleticism from Home,”  to help navigate the industry and understand the necessary steps to break out of a cycle of chronic pain, recurring injury and plateaued performance. Click the button at the bottom or side of the page to grab that free PDF.

Thank you for being here!

Train less. Play more. Live well.

Doc