Hypermobility describes joints that move beyond the typical range, often referred to as being “double-jointed.” When this increased flexibility causes chronic pain, instability, or frequent injury, it is classified as a Hypermobility Spectrum Disorder (HSD) or Hypermobile Ehlers-Danlos Syndrome (hEDS). The connective tissues, which include ligaments, are looser than usual, meaning the joints are not held securely in place and are more vulnerable to subluxations and strains. Running is certainly possible for individuals with hypermobility, but it requires a careful, highly structured approach focused on stability rather than flexibility. This intentional strategy is necessary to mitigate the higher risk of injury associated with the repetitive impact of running.
Prioritizing Stabilization Training
Ligamentous laxity means that the muscles surrounding the joints must work harder to provide stability, compensating for the lack of passive support. Therefore, pre-running preparation must focus on building endurance and coordinated firing in the deep stabilizing muscles. Low-impact strength training should target the core, glutes, hips, and intrinsic foot muscles, as these areas form the foundation for a stable running posture.
Isometric exercises are frequently used as a starting point, involving muscle contraction without movement to activate the muscles safely. Controlled, slow movements within a shortened range of motion ensure that the stabilizing muscles engage properly without overstretching the already lax joints. For the hips, exercises like glute bridges and controlled leg raises are commonly prescribed to reinforce stability during the single-leg stance phase of running.
Proprioception, or the body’s sense of joint position in space, is often diminished in hypermobile individuals due to the increased joint play. Training for this involves exercises like single-leg balances, gradually progressing from firm ground to slightly unstable surfaces with the eyes open. These drills teach the nervous system to recognize and control the body’s alignment, helping to prevent the joint from drifting into an unstable position during dynamic movement. This foundational work is paramount before introducing the high-impact demands of running.
Modifying Running Form for Joint Protection
Making specific, subtle adjustments to running form can significantly reduce the impact forces transmitted through hypermobile joints. The primary goal is to minimize overstriding, which occurs when the foot lands too far ahead of the body’s center of mass, acting as a braking force. This braking force increases stress on the knees and hips, which are already susceptible to instability.
A simple and highly effective modification is to increase running cadence, or the number of steps taken per minute. A small increase of 5% to 10% from the current cadence naturally shortens the stride length, causing the foot to land closer to the body. This subtle change reduces the vertical oscillation and the absorption of impact energy at the ankle, knee, and hip joints. Runners should focus on a light, quick foot strike, using the cue to “land soft” rather than attempting a specific mid-foot or forefoot pattern.
Maintaining a slight forward lean from the ankles helps to align the body over the landing foot, further reducing the braking force of the stride. Posture should remain tall, avoiding excessive torso rotation or arm swing, which can introduce unnecessary movement into the already unstable spine and shoulder girdle. All form changes should be introduced gradually to allow the muscles and nervous system time to adapt to the new load distribution.
Essential Gear and External Support
External equipment plays a supportive role by limiting excessive motion and enhancing proprioceptive feedback for hypermobile joints. Footwear selection should prioritize stability and motion control, which are designed to limit excessive inward rolling of the foot (overpronation) that often occurs in hypermobile individuals due to flexible arches. These shoes feature stability elements built into the heel and midsole to help maintain neutral foot and ankle alignment.
In contrast, maximal cushioned or highly flexible running shoes should generally be avoided, as they can decrease the foot’s sensory feedback and allow for too much movement within the shoe. Custom orthotics, molded specifically to the foot, can provide targeted arch support and a solid base to prevent the ankle from collapsing. Additionally, specific taping techniques, such as using Kinesio tape, can be applied to vulnerable areas like the ankles or knees. The tape provides a constant tactile cue that enhances proprioception, reminding the body to engage stabilizing muscles.
External equipment also enhances proprioceptive feedback for hypermobile joints by limiting excessive motion. Stability and motion control are key footwear priorities, specifically limiting excessive inward rolling of the foot (overpronation) that often occurs due to flexible arches. Stability elements built into the heel and midsole help maintain neutral foot and ankle alignment.
Highly flexible running shoes should be avoided, as they can decrease sensory feedback and allow for too much movement within the shoe. Custom orthotics provide targeted arch support and a solid base to prevent the ankle from collapsing. Taping techniques, such as using Kinesio tape, can be applied to vulnerable areas like the ankles or knees, providing a constant tactile cue that enhances proprioception.
Injury Monitoring and Pain Management
Hypermobile runners must adopt a cautious approach to training and recovery due to a higher susceptibility to injury and increased delayed-onset muscle soreness (DOMS). Dynamic warm-ups are required before every run to prepare the body for activity, involving movements like leg swings and high knees that mimic running motions. Static stretching, where a position is held for a period, should be avoided before exercise because it can temporarily increase joint laxity and the risk of injury.
Following a run, gentle static stretching as part of the cool-down can aid in muscle recovery, but it should never be forced into an end-range position. It is important to distinguish between typical muscle soreness and joint instability or pain. Muscle soreness is diffuse, often bilateral, and typically peaks 24 to 72 hours after exercise, but hypermobile individuals may experience this pain more intensely and for a longer duration.
Joint pain, however, is often sharp, localized, and may persist or worsen with rest, indicating a potential strain or instability issue that requires immediate attention. Rest and recovery are non-negotiable components of the training schedule, and cross-training activities like swimming or cycling are excellent, low-impact alternatives to maintain cardiovascular fitness. Gradual mileage increases are paramount, with a conservative approach that avoids sudden spikes in training volume.
Consulting a physical therapist who specializes in hypermobility or running biomechanics is strongly recommended for a personalized assessment, helping to ensure the running plan supports long-term joint health.
Hypermobile runners must adopt a cautious approach to training and recovery due to a higher susceptibility to injury and increased delayed-onset muscle soreness (DOMS). Dynamic warm-ups are required before every run to prepare the body for activity, involving movements like leg swings and high knees that mimic running motions. Static stretching should be avoided before exercise because it can temporarily increase joint laxity and the risk of injury.
Following a run, gentle static stretching as part of the cool-down can aid in muscle recovery, but it should never be forced into an end-range position. It is important to distinguish between typical muscle soreness and joint instability or pain. Muscle soreness is diffuse, often bilateral, and typically peaks 24 to 72 hours after exercise.
Joint pain is often sharp, localized, and may persist or worsen with rest, indicating a potential strain or instability issue that requires immediate attention. Rest and recovery are non-negotiable components of the training schedule. Cross-training activities like swimming or cycling are excellent, low-impact alternatives to maintain cardiovascular fitness.
Gradual mileage increases are paramount, with a conservative approach that avoids sudden spikes in training volume. Consulting a physical therapist who specializes in hypermobility or running biomechanics is strongly recommended for a personalized assessment, helping to ensure the running plan supports long-term joint health.