FLIPPYS, FLOPPYS & STIFFYS! WHAT? with Brad Beer
In this post we will look at the three sorts of people in terms of their ‘natural’ or genetic mobility status.
People inherit one of two ends of the mobility spectrum. They are either very mobile or flexible (hypermobile), or the opposite – very ‘stiff and tight’ (hypomobile).
The hypermobile person, generally speaking, has greater than normal mobility around all of their body’s joints. ‘Hyper’ means ‘in excess’, so by definition these people have ‘excess mobility’ in the joints of their body. Hypermobile people were often called ‘double jointed’ in the schoolyard. At the extreme end of hypermobility are the body contortionists you see on talent shows and performing as circus acts. They can perform bizarre and often disturbing movements with their impossibly mobile joints – for example, the feet behind the head and head between the legs type of tricks that intrigue, perplex and, at times, disgust us. However, not everyone who inherits hypermobility around their joints has this degree of movement.
Hypermobile people are characterised by several body traits, such as the ability to bend their thumb towards their forearm, hyperextend their knees and elbows, and bend forwards and put their hands on the ground. Naturally hypermobile children tend to do very well in and enjoy sports such as swimming and gymnastics where a high level of movement around joints is favourable. Because of this large movement range around the joints, in my practice I affectionately refer to such people as ‘floppies’. That is, their joints are often just that – very floppy!
It is worth noting that you can be a hypermobile person but still have very tight specific muscle groups. For example, it’s not uncommon for the hypermobile person to have tight muscle groups such as the gluts, calves, hamstrings, quadriceps and hip flexors, while at a joint level exhibiting large ranges of motion due to their genetically determined hypermobility.
In contrast, the hypomobile person is characterised by lesser than normal movement around the joints of their body. For example, on testing they have difficulty getting anywhere near touching their toes, cannot hyperextend their elbows or knees and, when flexing their thumb, it does not get anywhere near their forearm. Hypomobile children often gravitate towards and find natural ability in sports such as football and other contact sports. In my practice I (again affectionately) refer to such people as ‘stiffies’ because they don’t bend much – they are ‘stiff ’.
It is also possible to be in the middle of the mobility scale. That is, you may not be hypermobile or hypomobile; rather, your overall joint movement range is somewhere in-between. I refer to these people as ‘flippys’. I estimate through my clinical observations that 20 to 30 per cent of the population are flippys, with approximately 30 per cent being stiffies and 30 per cent being floppies.
In addition to floppies, stiffies, and flippys, a condition known as benign joint hypermobility syndrome (BJHMS) exists, and people with this condition are at the extreme end of joint hypermobility. People who have BJHMS have connective tissue disorders, whereby the tissue that holds ‘things’ together in the body are defective. The result is extreme mobility that creates joint pain and symptoms. BJHMS is distinct from people who are hypermobile in that, although hypermobile people have joints that move through greater than normal ranges of motion, they do not experience joint-related pains or symptoms.
Children naturally have a greater range of motion than fully developed adults, with the prevalence of hypermobility in children being reported to be as high as 30 per cent.1 Unfortunately, such mobile children are more susceptible to joint sprains, growth-related pains and, at times, back pain, and do often go on to experience a greater incidence of injuries through their years of growth into adulthood. It’s important to note, however, that the presence of hypermobility of the joints in children does not equate to having BJHMS.
It’s also worth noting that it is more common for females to have more joint mobility than males at any given age. Additionally, as we mature in years, we all become ‘tighter’ with smaller joint ranges of motion.
The impact of joint hypermobility can be problematic for runners. Unless the greater than normal joint movement ranges of the hypermobile runner can be stabilised, the runner is at greater risk of succumbing to injury.
Next post we will look at how to determine your mobility status.
Brad Beer (APAM)
Physiotherapist, Author, Founder POGO
