Keeping fit!

Getting fit is difficult at the best of times. But if you are hypermobile it is harder because there is a greater risk of injury and you may have found exercising painful. Solving these problems is a challenge.

The benefits of regular exercise and being fit have been well documented. These benefits include:

• More energy to sustain the events of the day
• Improved circulation
• Stabilisation of blood pressure
• Improved kidney function
• Improved posture
• Increased muscle strength
• Improved sleep patterns
• Stabilisation of blood sugar levels
• Improved concentration and improved mental function
• Increased ability to cope with stress
• Faster recovery from illness and injury
• Improved heart and lung function
• Prevention of diseases
• Better digestion
• It makes you feel good

The list goes on and on....in other words it improves your quality of life.

There is every reason to believe that the benefits of being fit and exercising regularly with safely prescribed and monitored exercises are the same for hypermobile people as for other people.

Medical research over recent decades has proved time and time again that exercise programmes are beneficial to people who suffer from musculo-skeletal and systemic disorders, e.g; people with arthritis, people who have heart conditions or have had heart surgery, people who have diabetes, people with kidney disease, injured athletes, people with chronic back pain and many more conditions. Information about the types of exercises that are beneficial for HMS sufferers, comes from research, clinical evidence and from you.

Many people with HMS have benefited from Yoga, Pilates and swimming. The main problem with groups or activities of this nature for people who are hypermobile, (or for that matter, anyone who suffers from a medical condition), is that in most cases, the person running the class or teaching has little or no medical training. Therefore, there is a greater risk of injury and inappropriate advice.

Fitness Programmes

To improve your general fitness you need a programme that addresses all the areas of fitness. The exercises need to be interesting and specific to your needs. Your programme should be modified and monitored regularly and should be performed at least three times per week.

A comprehensive exercise programme should include the following:

Posture

Good posture reduces the stress placed on joints, reducing wear and tear. It also improves the available range of movement of joints, which helps to maintain normal joint range and muscle length. Good posture increases lung capacity, aiding oxygen transport and nutrition around the body. Upright open posture allows more room in the abdominal cavity for the internal organs to function optimally. Posture also affects your frame of mind….and your frame of mind can affect your posture, ie, when you are well, feeling happy and on top of things, posture tends to be upright and open. In contrast, people who are depressed and in chronic pain, often sit or stand slumped.

Breathing

reathing is part and parcel of Life…the exchange of gasses in and out of the body and in and out of the each cell is what keeps us alive. Physiotherapists and other health professionals use breathing techniques to help reduce pain. For example, they are used in childbirth to help control the pain of muscle contraction. Relaxed diaphragmatic breathing helps to promote relaxation and improve oxygen supply to the working tissues. The supply of oxygen and blood to the working muscles is of paramount importance when exercising. People with HMS often have pain caused by spasm, learning breathing and relaxation techniques helps to reduce some of that pain.

Aerobic conditioning - For heart and lung functioning e.g. continuous walking, cycling, running, swimming and deep water running* etc.

Aerobic exercise, is exercise that is performed for more than two or three minutes. This type of exercise uses oxygen and glycogen as its main fuel sources. Being aerobically trained helps to; regulate hormones and blood sugar levels, improves the endurance capacity of muscles including the heart, aids digestion and improves circulation of oxygen and nutrients to the body. Aerobic exercise improves your stamina. (*Deep water running/walking will taught at the forth coming residential weekend..)

Muscular Strength, Power and Endurance

These exercises help the muscles to provide sustained support for the spine and other joints.

Flexibility (stretching)

These exercises help to maintain consistent muscle length and maintain joint range. In the case of people with hypermobile joints, often some muscle groups are long and others are short creating imbalances and altered joint mechanics.

Co-ordination/Body awareness (proprioception) e.g. wobble board, half roll and Swiss ball exercises.

Exercises in this category help to improve recognition of where you and your body are in space. They also help you to synchronise limb and trunk movements, reducing the risk of dislocation, subluxation and “tripping over” injuries.

Who Should Prescribe your Exercise Programme?

The most appropriate person to advise you on an exercise program of this nature is a physiotherapist who has knowledge of this condition. Even better if you can exercise regularly under supervision with a group. Group classes provide support and motivation. Government funded and Private Community fitness groups for people with medical conditions are run by physiotherapists very successfully in Australia. Hopefully we will see more groups of this nature available for people here in the UK.

Positive Attitude and Diet

Staying positive and committed when you are in pain and have a chronic disorder is very difficult, but if you can be optimistic and open minded then a change in your health can occur…. without it, unlikely.

In addition to a regular exercise programmes it is advisable to eat a healthy balanced diet.

Your diet has a very direct and powerful effect on your health. I am not suggesting that it will change your genetic structure but it will influence physiological functioning and this in turn contributes to a better quality of life. We have evidence about the connection between diet and heart disease. Diet and exercise are used to control some forms of diabetes. Athletes have special diets so that they can perform at peak level. There is even a school of research that suggests mental functioning can be affected by diet. Try to eat plenty of fresh fruit and vegetables, lean meat and cereals (personally I recommend organic). Cut down on alcohol, sugary and processed foods, they interfere with blood sugar levels and can even make you feel more tired. Reduce the fat and salt in your diet. Your local health clinic/GP clinic will have advice leaflets on diet. You can also obtain information from The National Heart Foundation.

Remember it is always advisable to consult your doctor or consultant before commencing an exercise programme.

Good Luck!

Jane Simmonds (Physiotherapist)
HMSA Summer 2000 Newsletter

References Egger, G., Champion, N., and Bolton,A,.1998. The Fitness Leaders Handbook (Fourth edition) Kangaroo Press Maher, C., et al, 1999. Prescription of activity for Low Back Pain: What works? Australian Journal of Physiotherapy Vol.45 pp121-130 Noakes, T. 1987. Lore of Running. Oxford University Press *Quinn.T., Sedory. D. R., Fisher. B. S.1994 Physiological Effects of Deep Water Running Following a Land Based Training Program Research Quarterly for Exercise and Sport. American Alliance for Health, Physical Education and Dance Vol 65, No. 4 pp 386-389