The Hidden Connection: Hypermobility and Your Pelvic Floor

"You're just really flexible!" It's a phrase many of my patients have heard throughout their lives - from dance teachers, yoga instructors, and even healthcare providers. But for those living with joint hypermobility, this seemingly positive trait can have surprising implications for pelvic health that often go unrecognized and unaddressed.

Beyond Being "Double-Jointed"

If you can (or could) easily do splits, put your palms flat on the floor while standing, or bend your thumb to touch your forearm, you might have joint hypermobility. While these party tricks might have impressed friends in your younger years, hypermobility is more than just being flexible - it's a unique way your body's connective tissue is built that affects everything from your joints to your pelvic floor.

The Pelvic Floor Puzzle: Why Hypermobility Matters

Think of your pelvic floor like a trampoline. In someone with typical connective tissue, the springs (muscles and ligaments) have just the right amount of give and support. But in someone with hypermobility, those springs might be more stretchy than springy. This can lead to some confusing symptoms:

• Feeling both "tight" and "weak" at the same time

• Experiencing pelvic pressure or heaviness

• Having trouble finding the right balance in Kegel exercises

• Dealing with unexpected leaks despite having "strong" muscles

• Struggling with pelvic pain that seems to come and go

  
  

Why Traditional Advice Often Falls Short

Here's where things get interesting - and why I'm so passionate about this topic. Traditional pelvic floor advice often focuses on either strengthening or relaxing these muscles. But for those with hypermobility, the answer usually isn't that simple. Your pelvic floor might actually be working overtime trying to create stability that your joints aren't providing.

Signs You Might Need a Different Approach

If you have hypermobility and any of these sound familiar, your pelvic floor might be trying to tell you something:

• You've tried Kegels but they either make things worse or don't seem to help

• Your symptoms change significantly based on your activity level or time of day

• You feel like your pelvic floor is "gripping" or "holding on"

• Traditional relaxation techniques don't provide lasting relief

• You experience symptoms in patterns - better or worse depending on hormonal cycles

  
  

Understanding Your Body's Unique Needs

The Stability-Mobility Balance

When you have hypermobility, your body often compensates for loose joints by creating tension in your muscles. For the pelvic floor, this might mean:

• Muscles that stay contracted to provide stability

• Difficulty fully relaxing even when you try

• Challenges coordinating these muscles with breathing and movement

• Increased sensitivity to stress and anxiety

  
  

The Hormonal Connection

Many of my hypermobile patients notice their symptoms fluctuate with their hormonal cycles. This isn't coincidental - hormones like estrogen can affect tissue laxity, and these effects are often more pronounced in those with hypermobility. This can be even more profound during pregnancy, when the body releases the hormone relaxin which increases ligamentous laxity in preparation for childbirth.

A Better Approach: Building Sustainable Support

1. Start with Understanding

Before diving into exercises, it's crucial to understand how your body creates stability. We focus on identifying your natural movement patterns, understanding how your body compensates for joint laxity, and learning how to feel the difference between stability and muscle tension.

2. Build Your Foundation

Rather than jumping straight to pelvic floor exercises, we start with the fundamentals. Core and breath coordination forms the foundation of all our work together. I guide patients through gentle movement exploration, encouraging curiosity rather than performance.

We experiment with different position changes that provide natural support for your joints, reducing the pelvic floor's need to overcompensate. And perhaps most importantly, we work on identifying your unique triggers and early warning signs, so you can intervene before symptoms escalate.

3. Create Whole-Body Support

For those with hypermobility, isolated exercises rarely provide lasting relief. Instead, we work on integrating pelvic floor awareness into daily movements, developing strategies for high demand activities, and creating sustainable self-care routines.

Special Considerations for Different Life Stages

For the Young and Active

Working with younger hypermobile patients requires special attention to managing sports and high-impact activities. Building body awareness early is invaluable – it's much easier to establish healthy patterns than to change entrenched ones. I emphasize understanding limits without limiting life, encouraging young people to explore activities that celebrate their natural flexibility while building the strength to support it.

During Pregnancy and Postpartum

Pregnancy represents a unique challenge for hypermobile bodies. The hormonal tsunami of pregnancy requires extra attention to joint support, especially as the body becomes increasingly lax. Utilizing a combination of strength and stability exercises with external supports can help make pregnancy more comfortable.

Building postpartum recovery plans that account for hypermobility is essential, as is understanding the long-term impact of pregnancy on already hypermobile tissues. The standard "return to exercise at 6 weeks" guideline rarely serves these bodies well, with a more gradual progression of exercise required.

In Perimenopause and Beyond

As hormones fluctuate during perimenopause and beyond, many hypermobile people notice changes in their joint stability and pelvic symptoms. Adapting to these hormonal shifts requires thoughtful attention to how they affect tissue laxity.

I work with patients in this life stage to maintain strength without creating tension – a delicate balance that becomes increasingly important. Together, we focus on building sustainable movement practices that can evolve with changing bodies and developing strategies for managing the sometimes unpredictable changes in joint stability that come with hormonal fluctuations.

Your Path Forward: Finding the Right Support

If you're living with hypermobility, your pelvic health journey might look different from what you've been told to expect. That's okay - and actually, it's important to acknowledge. Working with healthcare providers who understand the connection between hypermobility and pelvic floor function can make a significant difference in your treatment outcomes.

When to Seek Help

Consider working with a pelvic floor physical therapist who understands hypermobility if:

• Traditional pelvic floor exercises haven't helped or have made things worse

• You're experiencing pelvic pain or pressure that changes with activity

• You're having trouble finding the right balance between stability and relaxation

• You're planning for or recovering from pregnancy

• You're noticing changes in your symptoms as you age

  
  

Moving Forward with Hope

Living with hypermobility can feel overwhelming, especially when it affects such a personal area of your health. But understanding this connection is often the first step toward finding relief. Your body isn't broken - it just needs a different kind of support and understanding.

Remember: Your hypermobility is part of who you are, but it doesn't have to define your pelvic health journey. With the right approach and support, you can build a stronger foundation for your body while honoring its unique needs and abilities.

Ready to start understanding your body better? Consider reaching out to learn more about your options. Your path to better pelvic health might look different from others', and that's exactly as it should be.

Request a Consultation with Christine