Hypermobile lumbar spine:  Some people call this double-jointed.  Just really flexible in the spine.  (Once, I was behind a soldier sitting on a stool while completing her back exam.  When I asked her to bend backwards, she bent backwards 180 degrees and came face-to-face with me, just upside-down.  She startled me so much I fell off the stool.)

History: You do not have any history of trauma.  These are the folks who can do ‘flexible joint’ tricks at parties.  They usually do not have any pain at rest and the pain gradually increases with any increased activity.  It is often worse at night or at the end of their run.

Exam findings: Your loose joints are pretty symmetrical on the right and left sides.  If it is loose on the Right, the same joint is loose on the Left.  As you may have guessed it, their range of motion is waaaay beyond normal.  Most of the time their strength is normal.

Self-Exam:  Here are some things you can look for in yourself. 

1)      When you look in the mirror everything looks pretty normal. (But you are a runner, so there is nothing normal about you.)

2)      You can probably touch your thumb to your wrist or some other cool, weird trick.

3)      It is probably pretty easy for you to touch your toes.

4)      Most hypomobile patients do not have pain at rest.  When their loosy-goosy joints move for a while they begin to hurt.  It can be just one joint or it could be several.

5)      Sometimes if you sit in a different position, all of your joints will be sore because the chair did not give you good support.

Treatment: We gotta Y’all stronger.

1)      Manage the pain:

a.      Most of these patients do not have pain at rest.

b.      NSAIDS will help. 

c.       Kinesiology taping to the back muscles will help relieve the pain.  LIN

d.      Ice or heat can relieve your pain.

                                                              i.      Ice right after you get done running

                                                            ii.      Heat on non-running days

e.      Continue running your usual program.

2)      Restore full motion:

a.      DON’T DO NOTHIN!  You are already too mobile.

                                                              i.      Bad grammar, but you don’t need to get more motion.

3)      Begin non-weightbearing exercises to increase your core strength.

a.      Exercises to strengthen your core.

                                                              i.      You probably know the drill.  Here are some videos to remind you.  VID

                                                            ii.      Crunches, plank, side-plank, super persons (Politically correct), the selection is endless.

                                                          iii.      Here is a HUGE hint.  Just pick the exercises you like.  If you like to do them, you’ll do them.  If you do not like the exercises, you will find every excuse in the world to ‘get them done twice tomorrow’.

b.      For people with genetically loose joints, you should be at this level forever. If your joints cannot provide you with adequate support, you will need more muscular strength as you get older.  This is why we suggest you pick things you like to do.

4)      Begin weight-bearing exercises with emphasis on control versus strength and power.

a.      Apply the kinesiology tape to your back before you start your weight-bearing exercises.

b.      There are a lot of whole body exercises you can include which will get the core along with the rest of your body.

c.       Wall-slides, sit-to-stand, static lunges, lateral step-ups, etc.  LIN

5)      Correct running mechanics.

a.      Gradually return to your previous running.  Start on relatively flat ground or even on a treadmill.  The best part of returning to running with a treadmill is that you can actually hear your footsteps.  Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move.  If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running.  Listen and ‘feel’ how you run.  Is one leg hitting the ground harder than the other?  Does one arm swing differently than the other?  Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.

b.      As soon as you can run without pain and without a limp you can return to your normal running routine.

6)      Return to running speedwork and hills.  After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.

7)      My favorite step, get back to full running!  Have fun.  Eventually you will bust something else and be back to the website to fix that. 

8)      If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do.  We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.