Understanding Hyperextension and Hyperflexion
Hyperextension refers to extending a joint beyond its normal range of motion, while hyperflexion involves flexing a joint beyond its typical limit. Both can lead to injuries if not managed properly. Hyperextension is often associated with joints like knees and elbows, where the joint moves past its straightened position [5:1]. Hyperflexion, on the other hand, involves bending a joint too far, which can also cause strain or injury.
Exercises: Hyperextensions vs. Reverse Hyperextensions
In terms of exercises, hyperextensions focus more on the spinal erectors in the lower back, whereas reverse hyperextensions target the glutes and hamstrings [1:6]
[3:1]. Reverse hyperextensions are often considered superior for rehabilitation purposes as they help decompress the spine and release pressure
[1:9]. They are also recommended for individuals with lower back issues due to their ability to reduce strain on the spine
[4:1].
Managing Hypermobile Joints
Individuals with hypermobility should be cautious about their joint movements. Hypermobile joints can lead to instability and injuries if not supported by strong muscles [5:1]
[5:3]. Strengthening exercises, such as yoga, calisthenics, and pilates, are beneficial for maintaining joint health and preventing injuries
[5:6]. Engaging all joint-supporting muscle groups, especially the core, is crucial for stability
[5:7].
Memory Tricks for Flexion and Extension
To differentiate between flexion and extension, one can use simple memory tricks. Flexion can be remembered as "folding," where the angle at the joint becomes smaller, similar to flexing a bicep [2:1]. Extension, on the other hand, can be thought of as "elongating" or making the body longer
[2:2]. These tricks can help visualize the movements and understand their implications better.
As part of the RR extensions progression, I see they are each listed as alternate paths. Does one have an advantage over the other? Or is it a personal preference thing? Thoughts?
Reverse hypers are superior IMO. Both in rehab and strength.
They're harder to load than back extensions though, which is why lots of people prefer back extensions.
If you don't mind, will you explain briefly why reverse hyperextensions are superior?
Aren't donkey kicks similar to reverse hypers? Prone, bilaterally on a bench under a smith machine? Cable kickbacks?
Aren't donkey kicks similar to reverse hypers? Prone, bilaterally on a bench under a smith machine? Cable kickbacks?
They're similar and you can try them, but they are definitely not the same.
Reverse hypers are far superior with my experience as a trainer and PT for strengthening and rehab.
You recommended this exercise to me, which was entirely new to me, last Summer. I've been doing them every since and I really enjoy them. As I wrote above, I currently do:
I'm probably ready for the next progression, would you recommend I increase the reps per set to ~30 or add more ankle weight? After my dynamic RH work, I do those static holds ... do you recommend this as a finisher exercise?
> but I'm inconvenienced The reason is biomechanical and much more confident that it is psychological.
I don't think it's psychological.
There is some movement (a bit of hollow/arch/hollow) in the lumbar vertebrae in reverse hypers while you can keep the low back completely still in back extensions (just isometric).
There is also something to be said for the difference between moving upstream versus downstream effects on the nervous system, but I think more research needs to be done on that to see if there's anything there. I've heard of it, but not seen too much concrete research.
Could be wrong though, but I've personally seen better results from rev hypers
Hello. I'm sorry to necro this post, but I was wondering, how has your experience been regarding reverse hypers vs the 45° back raise? I am currently undecided on wich one to focus on in regards to lower back health.
They both use the entire body but normal hypers focus on the spinal erectors in your lower back while reverse hypers take the back out of the equation and focus more on the glutes/hamstrings. Very different focuses.
Actually, the spinal erectors are more targeted (relative to glutes and hams) in the RHE compared to the HE. Check out the data in table 1 here: https://www.sci-sport.com/en/articles/biomechanical-comparison-between-Reverse-Hyperextension-and-Back-Extension-179.php
I do reverse hyper extensions from a high box so my straight legs have full range of motion 90° or greater and I feel it in my lower back, Not just glutes and hamstrings.
For a dynamic exercises I am currently doing 4x25 RH ankle weighted +10lbs, Then I do 2x30-40 second static holds with the ankle weights and my legs straight out hanging over the box.
To add to the discussion, if you have lower back issues, reverse hypers actually help to release the pressure on the spine and is a great exercise for rehabilitation.
I get so confused which is which. I think I have it and then I'll read flexion in a post and I'm like, 'which posture are they in?' I find it hard to keep a mental picture in my head of what's flexion and what's extension, anyone got a good memory trick?
When you "extend (extension)" you become longer.
You flex your bicep (make the angle at the joint smaller, can be applied to any joint in the body). Another way to remember flexion, is to think of folding… F=folding. Extension = eeeeeeeelogate (make longer)
I want to strenghten and reduce aches in my lower back.
I first heard about hyperextensions, and the lyrics seem pretty straightforward. However, I'd either need to join a gym or save money long term and buy a hyperextension chair. Kind of expensive and barely fits in my room.
I've also heard of reverse hyper extensions which I can more easily do just laying and holding onto my chair. I have heard the reverse one is better for decompressing, rehab and prehabilitation.
I guess I'm asking if regular hyperextensions are really needed also, or if i will still get a lot of strenghtening and benefits if i soley so reverse hyperextensions?
Just do the cheaper ones. Only issue is once u do them for a while it’ll be too easy to do with just ur legs and no added load
Regular hyperextension focuses on the spinal erectors in your lower back while reverse hyperextension focuses more on the glutes and hamstrings.
Are reverse hyperextensions superior to regular hyperextensions for low back strength and health?
I want to strenghten and reduce aches in my lower back.
I first heard about hyperextensions, and the lyrics seem pretty straightforward. However, I'd either need to join a gym or save money long term and buy a hyperextension chair. Kind of expensive and barely fits in my room.
I've also heard of reverse hyper extensions which I can more easily do just laying and holding onto my chair. I have heard the reverse one is better for decompressing, rehab and prehabilitation.
I guess I'm asking if regular hyperextensions are really needed also, or if i will still get a lot of strenghtening and benefits if i soley so reverse hyperextensions?
Extensions bias the low back more than reverse hypers, but if you're limited by what's available with start with reverse hypers and see where that gets you. There's no "objectively superior" movement.
You need to find what works best for you and your goals
thought i wasn't. but my knees look weird. and also my elbows. im 19 and the only pain i feel is in my back and sometimes intense cramps in my calves. never felt nothing more. usually i see people with hyperextension saying they feel to much pain. i don't.
You appear to have hypermobile joins, which is generally painless but can lead to injuries if you're not careful. Meaning, people who are hyperflexible like you might get into a position very easy, but then not engage their muscles and pull something accidentally.
I always hear this, that hyperflexible/mobile people should be careful. I've been told by a physio that I have hypermobile joints and I should be careful but... what does that even mean? How does one be careful about that?
I used to do some weird party tricks where I can pull my shoulder out of its socket (?) on command and physio obviously told me to not do that anymore, which I don't, but other than not performing any party tricks how do I take care of my joints as a hypermobile person?
If it helps you qualify it a bit. I have hyper mobility. Recently hurt my shoulder while planking on my elbows -__-
It is easy to go too far/ask your muscles to go way past their limit because you have the range of motion available at the joints.
An example that comes to mind happened in my acrobatics class recently. One of my classmates is hypermobile and naturally flexible, but doesn't have much athletic experience. So we were doing some movements on trapeze and she looked really cool because she was bending in these graceful ways that the rest of us couldn't, but by the end of class she'd injured both her wrist and her back. This happened because she didn't have the engagement that you need when moving your own bodyweight around in space like that. She was kind of just throwing her body into positions instead of using her core or arm strength to hold poses safely.
I think the thing to keep in mind when you're hypermoile is to just make sure you have strength as well as flexibility, that the momevements you make are deliberate, and that you warm up when appropriate. Like if you're able to do party tricks with your flexibility it's unlikely that you're warming up first, and popping joints in and out suddenly or bending limbs backwards just to do it can easily hurt something because you're basically just moving your joints around suddently with no active engagement or prepation.
I'm not hypermobile myself but there's probably a subreddit for how to take care of yourself when you have hypermobility.
if ur strong, get flexy. if ur flexy, get strong. fit muscles will help keep ur joints in place. u dont need to be a body builder, light yoga / calisthenics / pilates will go a long way to prevent hypermobility injury.
Strengthen EVERY joint-supporting muscle group, especially your core. There are really good strengthening workouts on IG and YT for hypermobile people, and you don’t need to train a specific discipline or use equipment you don’t have (although a set of resistance bands can be really helpful). Remember that everything is connected and joint pain can be connected to many other muscle groups than you’d actually expect. Part of following a strengthening program is identifying weaknesses and focusing on engaging properly.
Physiotherapist here (and a hypermobile lady).
For us, our passive range of motion far exceeds our active range. Because of that, we tend to rely more on our "static/passive stabilizers" (aka ligaments, joint capsules, bone) rather than our "dynamic/active stabilizers" (aka muscles, tendons). The problem with this, is that ligaments don't really repair themselves very well, and over time they weaken. Without proper dynamic control, joint instability usually follows.
So, the #1 rule is to avoid end range positions: We want to reduce the strain on our ligaments when possible. So whatever activity you're doing, make sure you have "a little extra" range. If you're leaning on your hands with elbows locked, ever so slightly bend them.
It's also really important if you're doing ballistic movements (like swinging from a bar, throwing a ball, kicking, etc) make sure not to reach the very end of the range. Have the active muscle decelerate, rather than just the passive end point.
And of course - strength/resistance training is really important for that dynamic stability.
You didn’t prepare us for the transition from those perfectly normal legs to those arms lmao
“What is THAT” as I laughed 🤣😂
The elbow jump scare 😱
Is that a leg or arm? 😂
Knees no. Elbows heeeeell yea
Does anyone else feel like their joints are straight when the are hyper extended and that they are bent when they are at a normal extension so like 180 degrees for your knees but that feels bent.
Yep, feels like I’m crouching down a little bit when I try to allow my knees to sink forward. Then my hips are like WOAH NO and then my glutes are like HEY NOPE
Your hips are polite, wow. Lately mine are more "bitch, I'll kill us all."
My joints are all very polite, they are very bad at communicating their limitations and have no boundaries.
My body is just as bad at people pleasing and ignoring it's own needs as my brain is.
Brain: Hey fingers, we're going to do some crotchet, that okay?
DIPs & PIPs: sure, I guess, Maybe? we don't know, crotchet away, that sounds fun.
2 hours later
DIPs & PIPs: Um, sorry, we were wrong, that was a bad idea, we weren't really capable of that, but we tried anyway, now we are in a full flare up, so much inflammation, so much instability Waaaaaaaaaaaaaa 😭
Nerve endings: 😵💫Yes, thank you, we've got the message now, letting the brain know that we will not be moving our fingers for a few days because of the pain.
Brain: ....Seriously! Can I get some warning before I push myself past my limits next time!
Fingers: Yeah, Can we?
Interoception: I'm doing the best I can. It's not my fault someone made me dysfunctional
SHANK3 Gene: Yeah...sorry about that.
Yep. Spent a lot of time in PT this past year working on “soft knees”. For the first few weeks I felt like I was doing a weird squat walk, lol!
Yep, when I stand with my knees how a normal person would, they feel bent, like I'm crouching.
It feels to ME like I must look like an absolute idiot, when really my knees look like everyone else’s.
Yep. "Straight" means straightening the joint until it stops, right? ...Right? 🥺
of course. we're used to hyperextending them so our brain is programmed to see that as the maximum which should align with straight if we weren't hypermobile.
Not asking for advice, just personal experiences.
I’m hyper mobile, and I’ve been trying to figure out if I have experienced subluxations or partial dislocations. When I’ve explained previous experiences, some doctors say that I have had one and others say it’s not possible because the pain is insane. I guess I’m just seeing if anyone experiences partial dislocations that slip back into place, and what that feels like. Thanks!
The pain isn’t necessarily insane and that is really subjective anyways. Dislocations are really painful for me and I would describe subluxations as terribly uncomfortable depending on the joint. It’s honestly so subjective and personal. My right shoulder subluxates and it hurts like hell and doesn’t want to go back in place but then my left one subluxates and then easily moves back. When my right shoulder doesn’t get back into place, which happens a lot, it starts a chain up my neck and shoulders and down my arm because it pinches nerves and pulls on muscles improperly. That nerve pain is so fucking painful, similar to sciatic nerve pain down the back of a leg. The only want I’ve been able to get tricky joints back into place is with my PT. He then tells me what has rotated out of place and helps get them back. I also twisted my spine while SLEEPING and that took a month to undo.
Edit: Basically any of my joints that are surrounded by weak muscles will subluxate or dislocate a lot easier and the longer it is out of place the more it hurts. I’ve been working for about 6 months to work on muscle imbalances and get my joints in the right places.
This actually really helps thank you! Your explanation makes a lot of sense and sounds pretty familiar haha
Oh good! When my shoulder starts subluxating it sort of feels wrong and kind of gross like it’s a chicken wing being pulled apart (ew so gross sorry). It makes me want to throw up lol and it definitely hurts but I’d imagine the level is different for everyone
I have sacroiliac joint (connecting the pelvis to the hip bones and spine) subluxations and it’s kinda like walking with a sharp stone in your shoe. Not impossible to walk with it but you would defo rather stop and fix it than walk with it. I don’t notice it coming out just notice the pain. Popping it back is sometimes easy, (for years the triangle yoga pose was a solid fix), sometimes I just have to wriggle and stretch and throw the craziest shapes for hours meanwhile walking with said stone in my shoe. It feel painful as well as unstable to walk with it, sharp stabbing pain and sometimes as if I “lost a leg” feels like the tendons are just stretching and fell into a black hole? It’s weird. When I manage to pop them back I can always hear a pop (others near me hear it too) and literally feel the gears getting back into place.
I would describe it as a slight pop…sometimes bigger and with pain but often more like cracking a knuckle maybe? I’m fortunate that I’ve been able to maintain good muscle tone so don’t often struggle with much joint instability. I highly recommend getting on the floor daily and just using your body to move in various directions. Throw in some pushups, planks, sit-ups etc. start small!
I have slipping rib syndrome. I often get sore ribs but I know it’s subluxed when it hurts to breathe or lie on it. It’s proper take your breath away pain. It can pop back in on its own, but doesn’t usually for me, so I just immediately book into the physio.
My jaw and two ribs (slipped) sublux. For me, it only hurts if I do it repeatedly. Basically I hear a pop and feel it sort of “shift”, like it literally moves is position. My ribs will push back into my chest a bit and my jaw will push back towards my ear. Once I stop pressing on my rib/sucking in my stomach or close my jaw it automatically goes back into place with the exact same thing (a pop and a shift) just in the opposite direction.
I would like to add mine are much smaller than most people’s, and some can be extremely painful or be very hard to put back as others have pointed out. It’s different for everyone and it varies from joint to joint.
Hi all,
I have a few questions about range of motion and hyperextension, particularly with the elbows and knees.
For the Beighton score, I understand the criteria for elbows and knees are met if the limbs hyperextend beyond 10 degrees. However,
What is the normal degrees that one can extend? Is it just 0 degrees?
Lastly, is it possible to have an increased range of motion of your elbows and knees but NOT meet the Beighton diagnostic criteria for your knees and elbows? Is there a middle? For example, would a measure of 5 degrees be said middle?
I’m all new to this so I apologize for the noobie questions.
Gonineter readings should always be used IMHO. Most of my joints exceeded 60° degrees of hyperextension, inherently and passively til I reached around 50 years old. But the dysfunctionality can occur with less laxitity. Injuries are a very telling predictor of dysfunctionality.
- What is the normal degrees that one can extend? Is it just 0 degrees?
Depends on the joint and who you ask. There's no universal consensus.
- Lastly, is it possible to have an increased range of motion of your elbows and knees but NOT meet the Beighton diagnostic criteria for your knees and elbows?
Yes, 0-9°.
Is there a middle? For example, would a measure of 5 degrees be said middle?
I guess if you're trying to force a middle classification that doesn't exist onto this yes, but...why? That kinda defeats the purpose of the Beighton Score being black and white.
In case it's relevant or you're interested, criticisms of using the BS to establish GJH include...
○ Neither Carter and Wilkinson (1964) nor Beighton et al. (1973) provided any evidence-based justification for the selection of joints (Malek et al., 2021)
○ Only 4 joint sites are measured (Malek et al., 2021)
○ Validity not adequately researched (Juul-Kristensen et al., 2017)
○ Appropriateness for paediatric populations (Patel, et al., 2017)
○ Inability to capture degree of hypermobility
○ Developed as an epidemiological tool (Malek et al., 2021) (Beighton et al., 1973)
○ Inclusion of ligament laxity measurement (Corten et al., 2020) (Castori et al., 2017)
○ No consensus-based cut-off values (Remvig et al., 2014)
○ Bias towards upper limb hypermobility, that might fail to capture lower limb hypermobility resulting in false negatives (Ferrari et al., 2005)
○ Only assesses ROM in 2 dimensions. For some joints ROM occurs in multi-dimensions
○ There are no consensus values for normal ROM (Soucie et al., 2011) (Moromizato et al., 2016) (Remvig et al., 2007) and the values chosen in the BS scoring system are based on tradition, rather than evidence
Thanks for the response.
The reason I ask is because I saw an EDS geneticist and in her notes she mentioned I have an increased range of motion in the knees and elbows during exam, but she did not check me off for hyperextending past 10 degrees in the Beighton score.
I’m confused because those seem contradicting, and I was looking for further clarification.
Well, we can only guess or speculate. She's the only one who can clarify.
I have searched the FAQs and rest of the subreddit (this is my first time posting on Reddit so it's possible I unintentionally missed something) but nothing seemed to answer the totality of my question. I've been practicing yoga since high school and it's one of the only forms of exercise I enjoy. I've known for a long time that I hyperextend my knees and have tried, with varying degrees of success, to ensure that I microbend them. More recently, I realized that I hyperextend my elbows and was giving myself tennis elbow by doing Downward Dog, so I started trying to microbend my elbows as well, which helped. Then, I started having hip flexor pain and after a lot of effort got a video appointment with a Kaiser physical therapist who diagnosed me with mild hypermobility. She said that I could continue doing yoga as long as I focused more on strength-building than flexibility, which was fine with me. But since, then, I've been noticing a plethora of other things in my practice that I'd just been ignoring or discounting that cause non-muscle pain. For example, my right ankle always hurts when I do wide-legged forward folds. On this subreddit I found someone who said that this was also a ligament issue (and provided a solution — thank you) but it made me wonder how many other things are ligament issues that I wouldn't even know to guess. Is the painful clicking in the back of my knee when I do knee-to-nose pose a ligament issue? I have tried to get a follow-up visit with the physical therapist to no avail. At this point I'm worried about harming my body to the point that I'm scared to do yoga at all and am feeling quite discouraged. I guess my question is if there is some sort of list of things to watch out for or modifications to make that will allow me to safely practice? Or was my doctor wrong when she told me that it was OK for me to keep practicing yoga?
The blanket answer is that if you're hypermobile and going to the end of your ROM - especially if you're doing so without supporting the joint - you're risking damage. Clicking isn't necessarily ligaments, and you'd need to have an exam (and quite possibly imaging) to know for sure if it's meniscus damage or something else. This isn't to say we should never go to the end of our ROM, but doing so requires care and ensuring there's muscular support due to the laxity of the connective tissue.
I have students with a regular EDS diagnosis (before hypermobility was moved into that spectrum), and even in my mid forties I score a 6 or 7 on the beighton scale depending on the day - I've been practicing for about 25 years.
Work on strength. Don't dump weight into your joints (triangle and head to knee are often good examples of this). Don't pull on them unsupported (the shoulders in binds can be a good example). If you practice yin, do so with less intensity than you might prefer. Be sure you're supplementing your practice and any stretching or flexibility work with additional strength training.
I think my trouble is that I can understand all that when I read it but I would never have connected standing with my feet wide apart preparing for wide-legged forward bend with going to the end of my ROM or pain in my ankle with a joint issue. But I'm not sure that the internet can help me with that.
If it's not too much trouble can you explain specifically what you mean by pulling on joints unsupported means?
Have you ever done a seated good morning exercise? Its easy to test tissue flexibility, but under load, it can all fall apart. I feel like this might help you check if you are compensating hard in your wide legged forward bend
Consider a pose like marichyasana, with the bind. A lot of people, as they're trying to get there, can maybe... barely get their fingers to touch. And then they do, and they use that leverage to pull the hands in closer... without thinking about the shoulders - that torque has to come from somewhere... and if the shoulders are lax, that's what's going to take the yank. And since the shoulder is a ball and socket joint that's got a whole bunch of stuff crammed in there and is super shallow, there's a whole lot of ways that can create issues. Add to that the usual shoulder stuff from yoga that people expect, like the damage that can come from repeated incorrect form or muscle weakness in chaturanga, and you can see how a lot of little insults can add up to a crapstorm of damage over the course of decades.
Just want to thank the OP for posting this! I too am hyper mobile in my knees and elbows and have found this info super helpful. Ty
>Just want to thank the OP for posting this! I too am hyper mobile in my knees and elbows and have found this info super helpful. Ty
I'm so glad!! <3 <3
I'm obviously very new on this journey myself, but my one piece of advice is watch out for your ankles :P
I'd love to hear anything that you find that works for you!!
Stay engaged in the whole leg, and take some time to feel into each shape, thinking about where you need to engage more for stability, then hold to build strength in that shape.
Say you are in a standing forward fold, knee to nose. Start with very bent knees, like rag doll with arms extending to floor. Engage the glutes, actively pushing the outsides of the feet into the floor, like chair in the lower body. Start slowly straightening the legs, keeping glutes engaged. I will rise slightly with inhale, engage actively with glutes on exhale which lets me stretch deeper. The knees are still bent, a little or a lot, and repeat a few times to settle in. The isometric contraction will pull you gently into the stretch with more stability for your ligaments.
The microbend in any shape is just sign of active engagement of those muscles that creates stability in that shape, vs “dumping” into the joints. Your joints need that stability more than most. Over time, that strength and stability will come.
Thank you!! The one question I still have is that actively pushing the outside of my feet into the floor seems to be what is hurting my ankles? Does that sound right?
Not sure if it’s will actually help with the informatjon you’re after, but there’s an insta account & also book for hypermobile yoga practitioners called Too Flexible To Feel Good and the account is https://instagram.com/hypermobile.yogis
Sometimes practicing the 'prep' version of a pose becomes the better version of a pose. Like you said though the internet can't tell you it's gonna take informed experimentation and in your case that sounds like experimentation of the less rigorous flexibility wise. Good luck OP.
​
I have had a few major injuries I have had to work through/adapt to - so I speak from that perspective. Good luck OP
>Sometimes practicing the 'prep' version of a pose becomes the better version of a pose. Like you said though the internet can't tell you it's gonna take informed experimentation and in your case that sounds like experimentation of the less rigorous flexibility wise. Good luck OP.
Thank you!
Dont be afraid of momentum on reverse hypers, let the down swing pull you. The og idea of reverse hypers is the up will strengthen your back, and the down will release pressure from your back
Isnt the down part eccentric though? As in, both up and down activate muscles? I can never get these right, trying to figure out how the “release” would work.
Edit: downvotes for a legit question nice
The down part is the eccentric but you shouldn’t be controlling the weight hard enough for it to matter. When you get to the end range of motion the weight will pull on your ankles which will pull your hips and help decompress your spine.
Thanks still trying to get a feel for this movement.
Reverse hypers help to decompress your spine. So it’s better as an accessory to squats or deadlifts since those are compressing your spine
When i tried reverse hypers in a new gym it kinda hurt when doing them, felt like it was pulling my back apart and not in a good way
These have nothing to do with deadlifts?
I use 25s because the 45s hit my knees.
I do sets of 20 where I divide it so the first ten are strict like you’re doing and the second ten are with more swing. I’m not sure which is correct so I do both.
You are too far forward and are attempting to pull yourself up with the bars.
You should use the holders as holders not a pullup and let the weight swing forwards, then lift the weight with your ass.
You are currently doing a full body back swing super man thing
hyperextension vs. hyperflexion
Key Considerations:
Definitions:
Common Injuries:
Symptoms:
Prevention:
Takeaway: Understanding the differences between hyperextension and hyperflexion is crucial for injury prevention and management. If you experience pain or injury from either condition, it's advisable to consult a healthcare professional for proper assessment and treatment.
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