🦴 Lifting with Loose Joints: Exercise Adjustments for Hypermobile Powerlifters
- JHEPCxTJH
- May 15
- 27 min read
🦴 Lifting with Loose Joints: Exercise Adjustments for Hypermobile Powerlifters
How to Train for Strength with hEDS: Regressions, Substitutions, and Setup Tweaks That Actually Work
General Coaching Principles for Hypermobile Lifters
If you’ve got Ehlers-Danlos Syndrome (EDS), especially Hypermobile hEDS (hEDS) - or you coach lifters who do - you already know the deal: your body moves differently, and not always in ways that help you lift heavy or stay pain-free. Hypermobility, subluxations, and connective tissue fragility all throw a wrench into the standard powerlifting template. And if you ignore those differences and try to train like everyone else? You'll break. Simple as that.
This article builds on what I covered in The Efficacy of Powerlifting for Ehlers-Danlos Syndrome Management - so if you need more context on what hEDS is, how it affects lifting, or why the Conjugate Method works so well for it, start there.
It’s worth noting that hypermobility isn’t exclusive to hEDS. While this article centres on hypermobile Ehlers-Danlos Syndrome, the coaching strategies and movement adaptations outlined here are also relevant to anyone with Generalised Hypermobility Spectrum Disorder (G-HSD), other connective tissue disorders like Marfan Syndrome or Lipoedema, or presentations of joint instability that overlap with neurodivergent conditions like autism and ADHD. For ease (and laziness), I’ll be using “hEDS” and “hypermobility” interchangeably from this point forward - but if you see yourself somewhere on that spectrum of mobility, pain, and proprioceptive weirdness, this still applies to you.
Right now, we’re diving into the how. Let’s talk about what needs to change in your actual training setup if you want to make progress without wrecking yourself.
✅ Start Within a Comfortable Range of Motion - and Build Out From There
Just because your joints can move into extreme ranges doesn’t mean they should - especially under load. hEDS often tricks lifters into thinking they have excellent mobility, when what they actually have is a total lack of structural resistance.
Start small. Stay in the middle 60–70% of your available ROM. Build strength inside that range before chasing more depth or extension. With time, your stable range will increase - but forcing it too early is how you get subluxations, chronic pain, or worse.
This isn’t about playing scared. It’s about earning the right to load positions that your joints can actually control.
🔁 Repetition Over Perfection
Forget perfect reps. Aim for consistent ones.
Hypermobility often comes with impaired proprioception - your body’s sense of where it is in space is compromised. That’s why a new movement might feel fine, but still look loose or misaligned. The fix? Repetition. Muscle memory. Patterning.
Instead of cueing lifters to “stay tight” in vague ways, focus on exposing them to quality reps at lower intensities, higher frequency, and slower tempos. Over time, that input builds neurological awareness and muscular control. That’s how you reinforce joint stability - not by maxing out early and hoping your muscles catch up to your ligaments.
📉 Load Trumps Range (Especially Early On)
One of the most common traps for hypermobile lifters is chasing full ROM at the expense of actual tension. If you sink into a full ATG squat but there’s no muscular control keeping you there, you’re not building strength - you’re just hanging off your connective tissue.
In the early stages, a controlled half-range squat with a loaded bar is infinitely more valuable than a deep bodyweight squat you collapse into.
Get strong first. Then expand the range once you’ve earned it.
🧩 Joint Congruency: The Hidden Key to Stability
One of the most useful adjustments for hEDS lifters is learning to lift from positions of joint congruency - where the bones are best aligned and the joint capsule has the most support. That usually means avoiding end-range lockouts and starting lifts from mid-range positions until strength and control are established.
For example:
Pressing to full elbow lockout? Skip it early on.
Deadlifting with a hyperextended lumbar spine? Modify your setup and limit range.
Just because you can lock out a joint in a way others can’t doesn’t mean you should. The goal isn’t just to move weight - it’s to move it in ways that make you stronger, not sorer.
⚠️ hEDS Isn’t Just About Flexibility - It’s a Whole-Body Condition
Keep in mind: hEDS doesn’t just affect your joints. Many lifters also deal with:
Subluxations and dislocations, especially in the shoulders, hips, or knees
Chronic fatigue and pain that fluctuate daily
Autonomic dysfunction, like POTS (Postural Orthostatic Tachycardia Syndrome), which can cause dizziness, rapid heartbeat, and low blood pressure during training
Sensory issues and neurodivergence (like autism or ADHD) that affect environment tolerance and programming needs
So if you’re reading this thinking “that’s not me - I’m just bendy,” make sure you’re not overlooking the bigger picture. hEDS is a systemic issue. Managing it with strength training requires more than just stretching less and lifting lighter. It takes an intelligent framework with built-in flexibility - like Conjugate - and the awareness to adjust things based on your body’s feedback.
⚠️ DISCLAIMER
This article is for educational purposes only and is not a substitute for medical advice. Always consult with a healthcare professional, physio, or specialist familiar with hEDS before starting any new training programme.
Even with good intentions, the wrong exercises done the wrong way - or even the right way, but too soon - can cause more harm than good in a hypermobile body. Your safety comes first.
🦵 Lower Body Exercise Adjustments for Hypermobile Lifters
When you’re hypermobile, “just squat” doesn’t cut it. And neither does blindly copying the powerlifting elite who live in deep hip flexion and chase depth like it’s a badge of honour.
For lifters with hEDS, lower body training needs to prioritise:
Joint congruency and stability
Gradual, purposeful control
Avoiding end-range loading until you’ve earned it
The point isn’t to avoid training hard. The point is to train smart so you can keep training long term. You’re not fragile - but you do need to move with intent and precision.
Let’s walk through the key adjustments, regressions, and tools that help.
🪑 Squats
Box Squats → Build control. Limit range. Protect joints. The box isn’t just for beginners or geared lifters - it’s a powerful tool for hypermobile athletes. Set the box to a height that keeps you out of your passive bottom range. Control the descent, pause briefly, then stand. It forces you to engage your glutes and hamstrings without collapsing into your ligaments. Bonus: you’ll also move better off the floor in your deadlift and stone work.
Safety Squat Bar (SSB) → Takes strain off the shoulders and reinforces a more upright torso. If you struggle with bar placement, elbow hyperextension, or shoulder subluxation, the SSB is a gift. It also encourages more core engagement and reduces the tendency to dump forward - especially useful if you have proprioception deficits or a history of back pain.
Bulgarian Split Squat Regressions → Not every lifter can dive into single-leg work without toppling over. Start with a TRX, dowel, or hand support. Keep the ROM short. Your working leg should be doing most of the lifting, but your balance doesn’t need to be perfect from day one. Stability can be trained - and it’s better to build it than to force it and flare up your SI joint.
🏋️♀️ Deadlifts
Trap Bar Deadlift → Neutral grip, upright torso, reduced hip hinge demand. This is a fantastic option for lifters with lower back sensitivity or shoulder instability. It distributes the load more evenly and reduces the chances of excessive lumbar extension or shoulder drift at lockout.
Rack Pulls or Block Pulls → Start where you’re strong, not where you’re hypermobile. Limit the range to mid-shin or even just below the knee until you’re confident your start position is tight and controlled. Over time, you can lower the pull height - but only if you can hold that same position without losing stability.
Grip Considerations → If your fingers or wrists are unstable, don’t try to grind through double overhand. Use straps when needed. Grip work can be done separately, in ways that don’t compromise spinal mechanics or wrist joints mid-lift. You don’t earn extra points for making deadlifts harder just to “tough it out.”
🦿 Lunges & Step-Ups
Start Eccentric-Only → Don’t just do a step-up - control a step-down. That’s where most lifters collapse if they lack eccentric control. Tempo-based eccentric work teaches your joints to track properly and your brain to trust the position. Bonus: less knee irritation.
Shorten the Range → Keep the step height manageable. If you’re wobbling, feeling joint slippage, or “crashing” into the bottom, you’ve gone too far. Focus on smooth reps with a reduced range, and slowly build up over time.
Use Feedback → Light band resistance (e.g. looped around the knees or hips) or external support (hands on rack or wall) can massively improve control and awareness. Don’t wait until you’re injured to give yourself permission to use tools.
🛠️ Machines, Bands, and Support Tools
Machines Can Be Your Friend → When chosen carefully, machines provide joint-safe loading and reduce balance demands. Leg press, hack squats, hamstring curls, and glute kickbacks can be programmed with precise ROM and tempo. They’re not “cheating” - they’re joint-safe overload.
Banded Movements Work → Bands offer accommodating resistance, reduce joint strain at vulnerable angles, and help with positional feedback. Great for GPP circuits, core engagement, and building confidence in movement patterns before adding heavy loads.
Purposeful Movement Only → If you're just bouncing through a ROM because it’s there, you're not training - you're surviving a set. That’s not good enough. Control every inch. Own your range. Move like it matters.
🚧 Reminder: Just Because You Can Move Through a Range Doesn’t Mean You Should Load It - Yet
One of the biggest mindset shifts for hypermobile lifters is learning that mobility isn’t always a gift - sometimes, it’s a risk factor. You may be able to drop into a deep squat, fold in half, or lock out every joint like a gymnast… but that doesn’t mean your muscles are doing the work. If you can’t hold it under control, you can’t load it with intensity.
Start in the ranges you can own, then earn the rest over time.
🧠 Use Supports as Needed - and Ignore the Tough Guy Nonsense
If you need wrist wraps, elbow sleeves, a trap bar, or a handrail to train safely, use them. There’s no prize for training in pain or pushing through instability. If you haven’t read it already, check out Strength Is Built, Not Suffered: The Case for Training with Supports - and stop letting social media trick you into thinking support = weakness.
💪 Upper Body Exercise Adjustments for Hypermobile Lifters
If you’ve got hypermobile joints, sketchy shoulders, or vascular weirdness like POTS, upper body work needs to be smarter than just “bench, row, repeat.” You can still build pressing power and pulling strength - you just have to earn your positions, and protect the joints that can unravel under load if you're not paying attention.
You’re not fragile. But you are different. So train accordingly.
🧱 Pressing Variations That Protect, Not Punish
Floor Press → Cuts the range. Protects the shoulder. Builds top-end strength. If your bench press gets unstable or painful at the bottom, floor pressing eliminates that vulnerable stretch and lets you train lockout power and triceps without overstressing the shoulder capsule. You can also sub in board presses or a Shoulder Saver pad if you prefer staying on a bench with controlled range.
Pause Bench Variations → Pausing improves proprioception and motor control. A 2–3 second pause keeps you honest. No bouncing, no passive joint loading. Build that controlled tension under load.
Swiss Bar or Neutral Grip Dumbbells → Keep the wrists and elbows in safer alignment. A neutral grip reduces the torque on hypermobile joints. That means fewer flare-ups and better pressing mechanics for most hEDS lifters. If you’ve ever felt like the bar “floats” in your hands or elbows buckle under pressure - this is your fix.
Skip Overhead Barbells (At First) → Barbell overhead work can be rough on unstable shoulders and hypermobile spines. Instead, start with:
Landmine press: more joint-friendly arc
Dumbbell Z-press: upright posture, no spinal compression
Neutral grip DB press: low-skill, joint-safe staple
And if you’re managing POTS or similar autonomic issues, watch your breath-holding. The Valsalva manoeuvre - holding your breath during heavy lifts - can trigger dizziness, nausea, or even passing out. That doesn’t mean you can’t train hard. It means you need to build tolerance over time, with breath awareness and positional control.
🪵 Pulling That Builds Without Breaking
Chest-Supported Rows → Save your low back. Focus on your upper back. Barbell rows might look hardcore, but if your lumbar spine is unstable and you’re shaking through reps, they’re not building what you need. Chest-supported T-bar rows, incline DB rows, and seal rows all keep you in place so you can target the muscles that actually hold you together.
Cable Rows with Tempo and Straps → Control the movement. Feel every inch. Slowing down forces your stabilisers to engage - especially the scapular retractors and deep upper back musculature that most hypermobile lifters struggle to recruit. Use straps if grip becomes the limiting factor. This isn’t grip day - it’s upper back day.
Band-Assisted Pull Work → Use bands to scale the difficulty without cheating the movement. Band-assisted pull-ups or rows let you train the full ROM without dumping into end-range instability. As you build strength, reduce band tension - but don’t be afraid to keep them in rotation longer than your ego wants.
Avoid Full Hang Pull-Ups (for Now) → Dead hangs and full-extension pull-ups look strong but can trash unstable shoulders. Until you’ve got full control at every joint - scap, shoulder, elbow, wrist - start your reps from a semi-engaged position. No dead-hanging at the bottom. No flinging your way up. Keep the movement tight, even if it means fewer reps or using bands forever. That’s not regression - that’s maturity.
🔄 Bonus: More Bands, Less Flare
If your joints hate surprise loading or rapid deceleration, bands can change everything.
Band pull-aparts
Face pulls with a band
Banded rows or curls
Band-resisted external rotation work
These movements:
Reduce joint strain
Give tactile feedback
Let you build stability before adding chaos
Perfect for warm-ups, cool-downs, or even your main accessory work on higher-fatigue days.
⚠️ Remember: "Feeling Strong" and "Being Safe" Aren’t Opposites
You don’t need to prove anything by throwing a bar overhead or cranking out sloppy pull-ups just because other lifters do. You’re not behind - you’re playing a different game. The goal is to train in a way that makes you better next month, not broken by next week.
Make the smart trade-offs. Use the tools. Stay in control.
🧠 Core and GPP Work for Hypermobile Lifters
Build control. Build tension. Stop folding under load.
Most lifters think of “core work” as a finisher or accessory. For hypermobile athletes, it’s a requirement. Your core isn’t just about abs - it’s the stabilising centre that keeps your spine, ribs, and hips from drifting into injury. And for lifters with hEDS, poor proprioception, or joint instability, it needs more than just planks and crunches.
You don’t need circus tricks or a Swiss ball. You need controlled, intentional movements that teach your trunk how to resist movement, not just create it.
🚫 Train Anti-Rotation First
Rotational instability is a massive issue for hypermobile athletes - especially around the spine and hips. Rather than chasing “dynamic” core work right out the gate, focus on training your body to not move when force is applied.
Top Picks:
Pallof Press: Cable or band-resisted. Keep hips and ribs stacked.
Bird Dogs: Start with hands-on-wall or knees-on-box regressions if needed.
Deadbugs: Go slow. Focus on pressing your lower back into the floor. Add a band around the feet or use a wall for feedback if needed.
These movements reinforce:
Lumbar-pelvic control
Ribcage alignment
Bracing mechanics under load
They should be part of your warm-up and your GPP or accessory work, especially in early phases of training.
🛷 Sled Drags and Pulls: Low Impact, High Return
Sled work is a game-changer for hypermobile lifters. It trains the entire kinetic chain - core, glutes, quads, hamstrings, lats, grip - without axial loading or impact. That means you can get strong, raise your work capacity, and build positional strength without trashing your joints.
Sled Drag Variations That Work:
Forward drags for posterior chain and posture
Backward sled pulls for VMO and knee stability
Lateral drags for hip and groin control
Rope pulls or hand-over-hand for core and grip
Banded sled rows or pushes for trunk + arm synergy
SlhEDS don’t require perfect form or fine motor skills. They’re accessible, safe, and adaptable. If you’re flaring, under-recovered, or can’t tolerate barbell work that day? Hit the sled. It still counts.
🧲 Band-Resisted Carries and Modified Loaded Carries
Loaded carries are incredible for building trunk stiffness, scapular control, and grip - but for hypermobile lifters, they need to be adjusted.
Start with:
Band-resisted carries (e.g. band around hips during suitcase carry to cue alignment)
Shorter distances and lighter loads with more time under tension
Farmers handles with straps if grip instability is present
Offset loads (e.g. one kettlebell, one band) to challenge anti-rotation
What matters most isn’t how heavy you go - it’s how well you move with the load. Stay upright. Ribs down. Spine neutral. If it feels wobbly, it is. Drop the weight, fix the pattern, and rebuild from there.
🎯 GPP That Actually Carries Over
Forget burpees and chaos circuits. Your GPP should build work capacity without destabilising your joints. Think:
Sled circuits
Band-resisted step-ups or marches
Slow bear crawls
Wall sits + arm drivers
Modified med ball slams or tosses (no overhead swings unless prepped for it)
This stuff isn’t flashy - but it makes you more capable, more resilient, and more aware of how your body is supposed to move under fatigue. It’s the glue that holds your strength together.
🔁 Joint-Friendly Progression Strategies
Progress without punishment.
Progression for hypermobile lifters isn’t about doing more - it’s about doing better. You don’t need volume PRs or a six-week linear block. You need sustainable overload that respects your joints, your nervous system, and your connective tissue timeline.
This is where most cookie-cutter programs fall apart for lifters with Ehlers-Danlos Syndrome (hEDS) or general hypermobility: they ramp too fast, hammer the same patterns, and assume your joints recover at the same rate as your muscles.
Let’s fix that.
✋ Isometrics First. Then Eccentrics. Then Everything Else.
If you can’t hold a position, you shouldn’t be repping it. That’s true for every athlete - but especially for hypermobile lifters who tend to drift into unsafe positions when fatigue kicks in.
Start by building control through isometric holds:
Wall sits
Plank and side plank holds
Bottom-position split squat holds
Isometric DB rows or trap bar lockouts
Once you can maintain a position under load for time - without shaking, leaking, or flaring - move to eccentric-focused work (e.g. tempo squats, slow step-downs, negative push-ups). These build tissue resilience, joint control, and proprioception under tension.
Concentric power comes last. You earn that by first proving you can control and decelerate load, not just move it.
🔄 Rotate Movement Patterns Weekly to Reduce Joint Overuse
Repetition is a double-edged sword. For neurotypical, structurally “normal” lifters, repeating movement patterns can help drive adaptation. But if your joints are unstable or your proprioception is compromised, repetition without variation becomes repetition of dysfunction.
Rotating movement patterns week to week helps:
Spread joint stress across different tissues
Prevent overuse of vulnerable positions
Keep motor learning high without boredom or overload
Examples:
Week 1: SSB squat
Week 2: Box squat
Week 3: Bulgarian split squat (variation that you can do babes don't be obtuse)
Week 4: Goblet squat to box
All target the lower body - but they do it in slightly different ways, with different demands on your joints and trunk.
The Conjugate Method already has this in spades baby. If you’re not using Conjugate, build this variation in on purpose.
🧱 Use “Strain Rotation” to Control Loading Stress
Strain rotation means adjusting how your body is stressed - not just what lift you’re doing.
If you hammered a spinal-compression-heavy day (e.g. back squats or overhead pressing), don’t come back 48 hours later with another vertical load.
Instead, rotate in horizontal bracing movements:
Front-loaded carries
Pallof presses
Reverse hypers
Crawls, planks, or single-arm rows
These train core engagement and trunk control without crushing your spine. And if your joints are already under chronic stress from hypermobility or instability, this kind of load management is the difference between long-term progress and flare-up city.
Strain rotation is how you train hard and recover smart - especially when your ligaments don’t always have your back.
📌 Summary: Sustainable Strength Means Smarter Progression
Hold it before you move it
Control it before you overload it
Change the pattern before it breaks you
Training for strength with hEDS isn’t about avoiding challenges - it’s about navigating it with precision. These strategies don’t slow you down - they keep you in the game.
🩻 Symptom Management Notes
Strength is possible - but only if you manage your body like it matters.
Hypermobility isn’t just a structural issue. It’s a symptom management game. Fatigue, flare-ups, brain fog, joint instability, pain spikes, sensory overwhelm - if you’re training through hEDS or any connective tissue disorder, your system needs more than a good program. It needs a plan for recovery, regulation, and adaptation.
This section’s about how to stay in the game without burning out.
🔧 Pre-Lift Joint Stability Protocols
You don’t need a 45-minute mobility routine - you need 5–10 minutes of targeted activation that gets your body braced and ready.
Try:
Supersetting gentle mobility + activation work (e.g. 1 set of cat-cow → 1 set of deadbugs)
Proximal joint prep (glute bridges before squats, scap push-ups before pressing)
Tactile feedback (bands, walls, foam rollers) to reinforce joint position
Pauses and isometrics in warm-ups to “wake up” the stabilisers
This primes the nervous system, increases proprioception, and helps prevent unwanted joint drift mid-set. You’re not “warming up” - you’re stabilising.
🧤 Use Compression Sleeves, Bracing, and Supportive Tools
This isn’t a purist sport. It’s a survival sport.
Knees feel loose? Use sleeves.
Elbows sublux under load? Use wraps or controlled ROM.
Wrists slip back on overhead work? Use wrist supports or change the implement.
And yes - this includes using orthopaedic bracing or physio-approved supports if needed. Your job isn’t to prove how raw you can train. It’s to build enough resilience that you don’t fall apart between sessions.
You don’t have to earn your gear. You have to earn your longevity.
🪫 Fatigue Flags: Know the Signs Before the Flare
Lifters with hEDS, POTS, or neurodivergent conditions often don’t register fatigue in the same way others do. You might feel “fine” until you suddenly crash - or keep pushing because the numbers say you should.
Watch for:
Sloppy movement despite manageable loads
Joints “giving out” or slipping mid-rep
Hands/feet feeling disconnected
Extra pressure in the head or visual fuzziness
Weird emotional overreactions (crying after a light set = nervous system overload)
That’s not mental weakness. That’s your system saying, “This isn’t working today.”
Learn to distinguish between:
Normal training fatigue (muscle burn, breath, CNS tiredness) vs.
Connective tissue overload (instability, nerve symptoms, structural strain)
When in doubt? Pull back, modify, or sub in something lower impact.
🏋️ Lifting Environment & Equipment Tips
Control your environment before it controls your nervous system.
Small changes = massive returns for symptom regulation.
Gym Setup:
Use flooring with grip - no slippery platforms
If mirrors overstimulate you, train facing a wall
Avoid busy peak hours if sound/movement overwhelm you
Consider bringing noise-cancelling headphones, sunglasses, or tinted lenses
Equipment Choices:
Use gloves if your grip gets sloppy from hyperextension
Add Fat Gripz or foam if bars feel sharp or unstable
Use straps for heavy pulls to reduce grip stress
Stick with neutral grips, Swiss bars, trap bars, or multi-grip cable handles
These aren’t luxury tweaks - they’re joint-saving non-negotiables.
Home Gym Adjustments:
Keep lighting soft and adjustable
Use wall markers or floor cues to help spatial awareness
Install a low-stim music setup or train in silence
Have fallback tools like resistance bands or a sled for flare-up days
If your environment makes you feel braced, calm, and focused - your lifts will reflect that. And your body will thank you.
🚫 Common Mistakes and What to Watch For
These are the traps that sink hypermobile lifters fast - and most coaches won’t catch them unless they’ve been there.
❌ Movements That Seem Safe But Backfire:
Full-ROM deficit deadlifts with loose hamstrings
Barbell overhead presses without shoulder prep
Jumping or bounding plyos with no landing control
Deep pause squats when you collapse into passive structures
Kipping anything - pull-ups, dips, handstands
Losing Focus or Not 'Switching on' - especially in warm ups
❌ Cues That Often Don’t Work:
“Lock it out hard”
“Sink into it”
“Deep as you can”
“Snap under the bar”
“Explode and catch”
Instead, use:
“Brace and float”
“Stop where you own it”
“Control it in, hold it out”
“Move like you’re on a tightrope”
🚨 Warning Signs of Instability or Overuse:
Repeatedly shifting under load mid-set
Sudden increase in joint “clicks” or subluxations
Grip fatigue showing up way too early
Unilateral pain or repeated “nerve-y” feedback
Needing to compensate with momentum every session
If this stuff shows up, it’s not just a rough week - it’s a signal to reassess how you’re loading, recovering, or progressing.
Do your best to be able to train even on your worst days
There’s no award for making your training harder than it needs to be. You’re not weak for using support, modifying exercises, or avoiding your worst symptom triggers. You’re strategic. That’s how you keep lifting five years from now instead of flaming out after six months of pushing through dysfunction.
Take your symptoms seriously. Adjust before you’re forced to. Build strength on your terms - not someone else’s highlight reel.
🧪 Sample Session Structures for Hypermobile Lifters
Build strength. Respect your joints. Make it sustainable.
One of the biggest challenges for hypermobile lifters - especially those new to powerlifting or Conjugate-style training - is finding a structure that allows real progress without creating flare-ups, fatigue crashes, or injuries.
The truth? You don’t need to follow a 5-day bodybuilding split or max effort triples every week. You need a smart, balanced plan that gives you room to learn, recover, and adapt.
Here’s how to start.
🗓️ Beginner-Friendly Weekly Structure (4-Day Split)
Day 1 – Lower Body Max Effort (ME)
ME Variation: Box squat to a comfortable depth or trap bar deadlift from blocks
Moderate accessory volume: 3–4 total movements
Core + anti-rotation finisher
Day 2 – Upper Body Dynamic Effort (DE)
DE Variation: Speed bench with a Swiss bar or DB floor press
Rows and upper back work: strap up if needed
Band-resisted triceps + light shoulder accessory
Optional GPP sled/carries
Day 3 – Lower Body Dynamic Effort (DE)
DE Variation: SSB speed squats or banded goblet box squats
Hamstring + glute accessory (machine or band-based)
Light sled drag or band walk circuit
Optional core and recovery work
Day 4 – Upper Body Max Effort (ME)
ME Variation: Floor press or neutral grip DB press
Pull variation: Chest-supported row or cable row
Triceps + biceps accessory with tempo
Shoulder stability or prone trap work
🔄 Max Effort (ME) and Dynamic Effort (DE) Regressions
Max Effort Regressions for Hypermobility:
Start with 5RMs or 3RMs, not 1RMs
Use ROM-limited movements (e.g. board press, rack pull)
Pick joint-friendly implements (e.g. trap bar, SSB, Swiss bar)
Emphasise controlled tempo + pauses over absolute weight
Consider using top sets with back-off sets instead of grinding peaks
Dynamic Effort Regressions:
Use bands over chains for accommodating resistance (they’re lighter and more joint-friendly)
Focus on bar control and intent over speed at all costs
Use DE work as a form reset and neurological primer, not just velocity training
If fatigue or symptoms are high, swap DE day for technique volume @60–70% with long rests
✅ What “Good Enough” Movement Looks Like
For a hypermobile lifter, chasing perfection can be paralysing. You’ll never feel exactly symmetrical or fully stable all the time - and that’s okay. What matters is that you:
Maintain joint alignment through the rep
Control the eccentric without crashing
Hit consistent start and end positions
Don’t rely on bounce, momentum, or pain masking
If your reps look the same from set to set, your position holds under fatigue, and your joints aren’t slipping or shifting - you’re doing enough. Trust that foundation.
📉 Programming Volume and Frequency Considerations
🧠 When to Train 3 Days/Week Instead of 4
If you’re:
Having flare-ups more than once a week
Feeling CNS drained after ME work
Struggling to recover from normal accessory volume
Seeing sleep quality or HRV plummet It’s time to drop to 3 days/week. You’ll still get stronger. You’ll just have more room to recover - and you’ll likely stick with the plan longer.
Good 3-day rotation example:
Lower Body ME
Upper Body DE
Lower Body DE + Upper GPP finisher (or alternate upper focus weekly)
📉 Reduce Volume Without Losing Intent
If joint integrity or fatigue is becoming an issue, scale the work while keeping the purpose:
Instead of:
4 sets of 10 rows Try:
2 sets of 10 tempo rows + 1 back-off pump set
Superset band pull-aparts with light cable rows
Extend rest periods to maintain intent on accessories
Intensity doesn’t mean more reps. It means more control.
🔁 Autoregulation Without RPE
RPE isn’t always reliable for hypermobile or neurodivergent lifters - your perception of “hard” may not align with what your body can sustain.
Use alternatives:
Subjective fatigue tracking (am I moving well or wobbling?)
Stop sets: End when control breaks, not when reps end
Pain + stability rating: 0–10 scale for local joint pain and “looseness”
Soreness check-ins: Are you recovering within 48–72 hours, or still limping into the next session?
Autoregulation doesn’t need to be high-tech. It needs to be honest.
⚠️ Disclaimer: Swap DE for RE in the Early Stages if Needed
While the Conjugate Method traditionally includes Max Effort (ME), Dynamic Effort (DE), and Repetition Effort (RE) work across the week, not all lifters with Ehlers-Danlos Syndrome or hypermobility should jump straight into DE work.
Dynamic Effort training is inherently fast, ballistic, and demanding on joint stability - which can be too aggressive for beginners still developing control, proprioception, and bracing mechanics.
If DE work feels unstable, unsafe, or inconsistent, swap those sessions for RE-focused work instead:
Controlled tempo lifts
Submaximal straight weight
High-tension sets with isometric or paused reps
Focused accessories to build joint control and position
You can reintroduce DE sessions later, once you’ve earned the speed under control. There’s no rush - sustainable strength > rushed chaos.
🚨 Massive Disclaimers + Support Resources
This is guidance - not gospel.
Let’s be crystal clear: This article, this program, this framework - none of it is medical advice.
I am not a doctor. I’m a coach - one with both professional experience and personal skin in the game. I’ve lived the ups and downs of hypermobility. I’ve worked with lifters managing Ehlers-Danlos Syndrome, POTS, chronic pain, and complex recovery profiles. But that doesn’t replace individualised clinical care.
If you have hEDS, suspected hEDS, or any comorbid condition, you should be working with a physio, rehab specialist, or medical professional who understands connective tissue disorders. Training adaptations should support - not override - your broader healthcare plan.
🤝 Work With a Team - Not in Isolation
This stuff is hard. It’s messy. It’s nuanced. Trying to self-manage every flare-up, every joint slip, every bad week? That’s not toughness - that’s burnout in disguise.
You don’t need to carry it all alone.
Talk to your physio.
Bring your coach into the loop.
Coordinate your care.
Build a support network of people who get it.
If you're looking for community or peer resources, start here:
Specialist physios or clinics with hEDS experience
UK-based support groups like HMSA or allied charities
Online forums or moderated Facebook groups focused on hypermobility in sport
Just be cautious with social media influencers pushing miracle fixes. What works in a 15-second reel often doesn’t work under a barbell.
🧠 Why I Coach This Population - And Why I Care
I write about this because I’ve lived it. Not in some abstract, inspirational-post kind of way - but in the real-world grind of dislocations, unpredictable fatigue, self-doubt, and rehab setbacks that make you question whether you even belong in the gym.
I’m here to say: You do.
And if you want someone who gets it - someone who can help you build a training system around your body, not in spite of it - I offer online coaching for lifters with hEDS, chronic joint instability, neurodivergence, and other “outside the norm” training profiles.
You’ll get:
Individualised programming
Full access to me for troubleshooting and adaptations
A coaching environment free of shame, fuckery, or fragile thinking
Because strength isn't reserved for the genetically gifted. It's built - rep by rep - by those who keep showing up on their terms.
Appendix A: Programming Around Flare-Ups and Low-Spoons Days
Strength training with hypermobility, hEDS, or chronic illness isn’t linear - and your program shouldn’t pretend it is. Some days, you’ll feel strong and stable. Other days, just getting to the gym is a win. The key is to adapt your training to match your current capacity, not punish yourself for having limits.
Here’s how to structure your plan around flare-ups, illness, or "low-spoons" days:
1. Low-Spoons Training Templates
If your energy or symptom load is high:
Skip Max Effort work and replace it with:
Tempo accessories (3–4s eccentrics)
Isometric holds (e.g. wall sits, planks, split squat holds)
Light machine-based circuits (e.g. row, leg press, ham curl)
Swap barbell work for bands or dumbbells
Reduce session volume to 2–3 core movements
Use a stopwatch: 20–30 minutes of focused work, no fucking around
Prioritise movements that feel neurologically calming, like:
Sled drags
Pallof presses
Band pull-aparts
2. Auto-Regulated Session Types
Use these three templates when modifying:
"Reset Day": Focus on warm-ups, mobility, band circuits, and positional isometrics
"Primer Day": Light technique work for main lifts (50–60% for 3x5) + 1–2 accessories
"Restore Day": All GPP - sleds, carries, core, breathing drills
Remind yourself: these are not skipped days. They’re programmed responses to a body that needs different input.
Appendix B: Alternative Progress Tracking Methods
Standard PR tracking doesn’t cut it for hypermobile athletes. Improvements don’t always show up in load lifted - and chasing numbers too aggressively can set you back. Instead, use a multifaceted approach that reflects progress in ways that matter to your body.
1. Movement Quality Logs
Keep notes on:
Reps that felt stable or aligned
Positions that held under fatigue
Tempo control and consistency
Stability in setup and lockout
E.g. "SSB squat felt more stacked through ribs/pelvis. No knee wobble. Hit same depth as last week but 2s slower on descent."
2. Symptom-Based Tracking
Track trends, not episodes:
Frequency of dislocations/subluxations
Flare-up triggers and recovery time
Energy levels post-session (1–10 scale)
Sleep quality after training days
E.g. "No hip instability during lunges for 3rd week running. Reduced post-session crash from 6/10 to 3/10."
3. Joint Stability Notes
Use weekly check-ins:
"Which joints felt loose or secure today?"
"Was I able to brace and hold positions better than last week?"
"Any sudden shifts mid-rep?"
Progress here might look like:
Needing fewer warm-up sets to feel "connected"
Going from two failed reps per set to zero
Completing a set without compensatory patterns
4. Non-Scale Victories (NSVs)
Celebrate:
Training consistency during rough weeks
Swapping a flare for a reset session
Learning a new regression that works
Feeling more confident in one movement
Progress isn’t just PRs on the bar. It’s reduced pain, improved recovery, and training with more autonomy and less fear.
Tracking these variables shows growth that matters - and gives you data to adjust training more intelligently over time.
🧠 Appendix C: Training With and Around POTS & Dysautonomia
How to Keep Lifting When Your Nervous System Doesn’t Want to Cooperate
If you’re training with Postural Orthostatic Tachycardia Syndrome (POTS) or other forms of dysautonomia, you already know the challenge: it’s not just about muscle or joint issues. It’s your entire autonomic nervous system throwing curveballs - heart rate spikes, dizziness, nausea, cold sweats, visual fuzziness, blood pooling in your legs, or just a sense that your body short-circuited.
These aren’t mindset problems. They’re physiological issues - but they can be managed intelligently, and yes, strength training can help. Let’s break it down.
🧪 What’s Actually Going On?
In POTS and similar conditions, your autonomic nervous system struggles to regulate:
Heart rate and blood pressure, especially during position changes (like standing up from a bench)
Blood flow, particularly to the brain and extremities
Thermoregulation, meaning you overheat or go cold more easily
Digestive and fatigue systems, often slowing recovery and throwing off hunger or sleep
Training, particularly progressive strength training, has shown promise (Fu et al., 2015) in:
Improving blood vessel tone
Raising plasma volume
Enhancing sympathetic nervous system function
Reducing orthostatic symptoms over time
But to get those benefits, you have to train on your own terms, not the textbook plan.
✅ Key Training Adjustments for POTS
1. Start Horizontal or Semi-Reclined
Many POTS symptoms worsen in upright positions - especially early in training.
Begin sessions with recumbent or floor-based exercises, like:
Supine band pull-aparts
Floor press variations
Glute bridges and hamstring curls
Bird dogs and deadbugs
Use reclined machines (leg press, cable row) early in training before moving to vertical work.
2. Use Compression Garments
Medical-grade compression (20–30 mmHg) below the waist helps prevent blood pooling in the legs.
Sleeves, leggings, or even athletic tape can assist circulation and reduce lightheadedness.
3. Salt + Electrolyte Strategy
Before training, many lifters benefit from:
500–1,000mg sodium (e.g. LMNT, Precision Hydration, or table salt + juice)
A low-sugar electrolyte drink with potassium and magnesium
Staying hydrated isn’t just about fluid - it’s about keeping the right stuff in the fluid.
Avoid caffeine pre-training if it worsens symptoms.
4. Include Isometrics and Slow Transitions
Isometric holds (wall sits, planks, carries) build blood pressure tolerance without rapid shifts.
Cue transitions like:
“Exhale before standing”
“Pause and brace before moving from floor to standing”
“Rest between posture changes”
5. Avoid Overheating
Heat dilates blood vessels - and for POTS patients, that’s a problem.
Wear cool, breathable clothing, train in cool environments, and take long rests if needed.
A fan pointed at your face or body can prevent mid-session crashes.
6. Use a Symptom-Led Pacing Model
Instead of reps or RPE, use:
Stoplight system: Green = full session, Yellow = reduced session, Red = recovery only
Heart rate awareness: if you spike >30 bpm standing vs. lying, delay vertical work
Perceived symptom scale: rate dizziness/fatigue 1–10 and adjust accordingly
7. Prioritise Recovery More Than Most
Your nervous system needs longer to bounce back. Build that into the plan:
Schedule restorative “zero-pressure” sessions (light sled work, band circuits, breathwork)
Spread intensity across the week instead of stacking it
Prioritise sleep, salt, and slow mornings post-training
🧰 Practical Low-Spoons Day Template
When you want to train but feel like trash, try this:
“Low-Spoons” POTS-Safe Session (20–30 mins):
Supine breathing or banded deadbugs – 3 x 5 per side
Floor press or band press – 3 x 8 @ moderate RPE
Leg press or glute bridge – 3 x 10
Sled drag or rope pull (if available) – 3 x 10–15m
Cool-down breathing (hands on belly, legs elevated) – 2–3 mins
It’s not about chasing fatigue - it’s about maintaining capacity and blood flow without system crash.
📈 Progress Beyond Numbers
With dysautonomia or POTS, tracking only PRs is a setup for disappointment. Use broader metrics:
“Symptom logs” – Was I less dizzy today? Did I recover faster than last week?
Joint stability – Did my knees stay stacked? Did my shoulder feel more locked in?
Exercise tolerance – Can I do more reps/sets without crashing?
Recovery quality – Was my HRV/sleep better after this session vs. before?
Strength is only one part of the picture. Autonomic regulation is progress - even if it doesn’t show on the bar.
🔗 Further Resources & Credits
Strength Space: "Strength Training to Manage POTS"
Standing Up to POTS: "Exercise and POTS"
Fu et al., 2015. "Exercise Training in the Management of Orthostatic Intolerance"
Dr. Kate Skinner's video: "Strength Training for People with POTS"
Strength training with dysautonomia is possible - but only if you train in partnership with your body, not in defiance of it. Know your patterns. Honour your pacing. Use all the tools. Progress won’t be linear, but it will be real.
If you need individualised support, you already know who to call.
🙏 Thanks for Making It This Far
If you’ve read this far, truly - thank you.
Whether you’re a lifter navigating hypermobility, dysautonomia, chronic illness, or all three… Whether you’re a coach trying to do right by your clients in a world that wasn’t built for them… Or whether you’re just curious about how to make strength training safer, smarter, and more sustainable for bodies that don’t fit the “norm”…
This kind of work matters. And you matter.
The goal of this article - and all the work I put out - isn’t just better training plans. It’s building a better lifting culture. One where chronically ill lifters, disabled lifters, neurodivergent lifters, and anyone “outside the standard template” don’t have to choose between strength and safety, progress and pain, or community and caution.
You belong here. You deserve support. And your training deserves to be taken seriously - with nuance, honesty, and respect.
🚨 Bonus Disclaimer: A Stronger Culture, Not Just a Stronger Body
This is not a medical document. It’s a coaching resource, built from lived experience and professional practice. I am not a doctor or rehab specialist, and nothing here should replace the guidance of a qualified healthcare provider.
But I am someone who’s walked this path. And I know the difference it makes when someone meets you with knowledge and belief - not dismissal.
So if you’re navigating a diagnosis, a flare, or a body that doesn’t respond like the textbooks say it should… You’re not broken. You’re not fragile. And you’re not alone.
Here’s to more lifters finding their place in strength - and more coaches learning how to hold space for them when they do.
Let’s build something better, together.
- JH
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