Those that know me know I've been pretty active all my adult life and can outdo a lot of the boys in my peer group when it comes to cardiovascular fitness and even some strength related tasks. In addition, my physical resilience, if I don't mind me saying so; is excellent. My idea of light day is a minimum of the equivalent of about 15,000 steps which with normal day to day activity, is a bout 10km or 6 miles deliberate walking. When exposed to hard, intense physical activity day in and day out, or slightly lower intensity but of long duration, I can cope quite easily and bounce back. Despite having joint hypermobility, I find that being sedentary aggravates it and my body has adapted over the years to cope with the lax joints etc. Because of this, I tend to stay relatively injury free and even though I may not bio-mechanically work as one "should" the fact that my body has adapted means I can keep going.
It is my anecdotal opinion that as no two people are the same, they should also need not move the same way to produce the same outcome safely. Having spent years (since I was about 3 or 4) in and out of physio and specialists and trying to get into the routine of the exercises they set, I found that I never got any noticeable results and I'd find myself with worse injuries than the niggles I was going for in the first place (which for your context would be shin, knee and bad ankle pain, occasional groin strain and shoulder pain too. At one point I had compartment syndrome in my shins, although it was managed as they caught it early and I didn't need a fasciotomy although they monitored closely over the initial 48 hours of diagnosis and treated me with various things such as massage, anti-inflammatories, heat and ice treatment and the big one, rest)! The same applied to when I was prescribed various different Orthotics.
It wasn't until about 2012 when a civilian locum physiotherapist saw me that the cycle seemed to really stop; in particular with shin, ankle and knee pain. Knowing my 10km time and as an ex athletic coach and physio, he told me to stop trying to continually correct everything because with me, nothing was equal or balanced anyway so the net difference would still make me feel off kilter, just in different ways or places! He explained it a lot more scientifically and anatomically to me at the time so it's not quite as simple as that but it's not far off.
Having been in a lot of pain and having the energy of a 5 year old (like a digital battery; full of energy until I just switch off!) I thought I hadn't much to lose. So first of all he advised me on running footwear, he suggested neutral shoe with a low heel to toe drop. This doesn't have to mean barefoot or uncushioned footwear but footwear that has a low gradient heel to toe for your foot. I didn't get any right away but the following month I was reading a Runner's World article on low foot drop profiles and the benefits (they were talking about barefoot running) and so I took some advice from them and went out and tried and subsequently bought a pair. If I remember rightly they were made by Saucony and had a trail style footbed and sole. I also had 3 of these pairs because I ran so much and improved so much that I wore them out and needed new ones. When that model stopped I looked elsewhere and ended up with a variety of different shoes, some by Brooks (had a few excellent pairs of Cascadias), Mizuno Waves and back to the Brooks PureGrit2.
The major thing I realised was that the low foot profile made me run on the balls of my feet more. I am NOT a bio-mechanical specialist or physio but I have studied mechanical engineering and just the simplest of trigonometry and thoughts of suspension etc make me reckon that this change in my gait aided me to not only get faster, but reduce the amount of pain I experienced. Perhaps the motion of the ball of my foot taking the initial strike and rolling the force back toward my heel meant that my lower legs and heels weren't getting 70Kg of body-weight and the additional forces imposed by running going through them as directly as they had been when I was running as a heel striker!
So that was a defining moment in my running "career" and I haven't looked back since and select shoes on the feel and low foot drop; not on what it claims to do on the side of the box. I've made some real progress since then too, even when doing the majority of my training on treadmills (due to work). I've gone from running 11KPH to averaging 14KPH and even higher than this on shorter runs (like the 5km). On top of that I won a Bronze medal at an athletics event running the 1500m in less than 6 minutes!
What is worth noting is that I have been struggling with sciatica, lower back pain, neuralgia and generally quite a bit of discomfort on my right hand side. Also strange sensations in my right hand arm like tingling, numbness and sometimes pain. After several examinations from a doctor, physio and neurologist, I was told I did have abnormal reflexes and was sent for head, neck and full spine MRIs. So far the results of those have shown no issues (such as scarring of the nerves or brain stem, no indication of herniated discs etc). Whereas I don't want to assume they have found nothing wrong, I thought as much that they wouldn't find anything like that. I have a feeling it's something to do with my piriformis, my glutes have always been weaker than I think they should be. I am seeing the physiotherapist tomorrow which will be interesting to know what her thoughts are now and the battle plan. Since I first saw her in March, I haven't run once. I've been confined to using only the elliptical/X-trainer (holding the centre handles as not to twist my back) as a main workout piece of equipment. And walking. LOTS of walking.
I'm looking forward to getting back to running. Within the limitations prescribed, I have tried to retain my cardiovascular fitness and muscle tone as best as I can. Because of that, when I do get back to that and my usual weight training regime, which also incorporates classes such as Les Mills Body Combat, I don't think it will take long to get back to where I was before I started experiencing the symptoms and even improve!
There's a possibility that all the pain I've had may be something to do with my hypermobility as it definitely seems to cycle through good and bad days every few weeks, with nothing noticeable in my routine that may trigger it. Some days, the pain is so bad in my wrists I can barely hold cutlery, other days I'm opening jars that my husband can't! In a gym context, one day I can squat 90Kg on my final set of 5x5s and on another day I barely even get to 70kg before my legs are giving out if I even get to that or complete my sets; or my wrists can't take it when it comes to deadlifts when in previous days they would have been fine! Those that have hypermobility will know what I mean, aside the pain, an overwhelming surge of fatigue spreads through your muscles and body. It personally doesn't really affect my clarity of thought (I don't think) but I know some people report this symptom too. I do get exhausted though. Whereas normally I can cope quite well on 18 hours awake I sometimes struggle to do 12 when it's bad. The good news is that I have noticed that even though I get these spells of pain and exhaustion, the episodes aren't always the same, they're not always so severe and they sometimes last only a couple of days as opposed to a couple of weeks.
I have tried to avoid painkillers at all costs; not least because there are issues surrounding the use of them and my job (you can but they need to be recorded each time and the doctor needs to check for signs that you may be distracted by the issue and not so much because of drug side effects funnily enough), This can then create a false history of your symptoms that they may or may not delve into too much! Also, I prefer to save the usual paracetamol and ibuprofen for when I have really hurt myself or am in a lot of pain so I can use those relatively low grade painkillers to aid me first. There are also multiple studies that make me concerned enough as to the damage these drugs can cause to your cardiovascular system and also things like ligaments. Therefore if I keep usage to a minimum I'm helping reduce those risks.
My hypermobility doesn't get me down quite so much anymore, I know that keeping active helps it and helps keep my weight under control, I know sometimes that activity may be harder at times due to symptoms but that I will benefit from it. I know to scale back when it's really bad and do something less aggravating (I mean if it's bad, why lift weights which are just going to cause unnecessary and untoward pain when I can just do some cardio or something?!)
Keeping my weight around the 70kg mark has meant I've stayed an acceptable UK size 10-12 with some shape and not been too weak or tired; it's also enabled me to be more resilient, particularly with the more physically demanding aspects of my job and it's also fairly sustainable for me even if I do indulge in good food and booze a few times a month. I'm not as thin as I was in 2010-2012 or before my wedding in 2014, but I'm not much different, in fact I have a lot more definition in my upper back and arms because of the training I have done to my lats, triceps, biceps, traps and other muscles.
So in terms of how I go on about my life from now living with hypermobility; I intend to stay very active and enjoy life, I'll remain keeping my weight in check, I'll play the intensity and type of workout according to how I feel at that point (without chinning it off through laziness!). I appreciate everyone is different and there are genuinely people out there in wheelchairs with hypermobility because of their pain. Some people have had this brought about unnecessarily by the crap advice given by doctors in the early noughties and before that. As a child, my consultants told "me" (i.e. my parents; I found the letter they sent) not to run, take on strenuous physical activity etc, and because it was very difficult to stop me when I was little I basically went against this advice. I know my symptoms get worse with inactivity and the cardiovascular benefits weigh out the risk of relatively minor injuries I may get exercising as a hypermobile person. In fact it has improved my condition. I'd kinda like to be able to say "up-yours" to the doctors I saw back then, but the understanding of JHS was (and even now to an extent) poor and complex.
For now, I'm keeping being bouncy and enjoying life! Come join me, the water's lovely!
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