‘Don’t worry if you end up teaching someone who’s double-jointed. It just means that they have a different type of collagen in their body. Make sure they keep their elbows soft in four point kneeling’ and so I was introduced to Hypermobility on a (non-Body Control, I hasten to add) Pilates training course. I’m sure that anyone with Hypermobility Syndrome (HMS) will read those words and wish ‘if only’.
Isobel has once again written an incredibly readable account of her never ending journey dealing with (HMS) and the effect it has on her body and those of fellow sufferers.
The book is divided into four parts. The first, ‘The body and the self’ explains why she has written the book as she has in her autoethnographical style and includes a chapter from Professor Howard Bird, her overarching physician and expert in treatment of HMS. The second covers the physiology of the disease with chapters covering a broad range of conditions from digestion and bowel problems to bladder issues, endometriosis and fatigue showing how HMS can affect all areas of the body and how often pain management is an important part of the regime that will be needed to enable the chronic complex patient to continue with life. Part 3 covers Psychology and suggests helpful ways for the patient and therapist to support each other, suggestions of therapies that Isobel has personally found helpful and ways to record and review treatment benefits. Part 4 covers exercise and rehabilitation. There are separate chapters on Imaging, Pilates, movement patterns and neurology along with alternative therapies such as Bowen, Feldenkrais and birth trauma.
As in her first book, A Guide to Living with Hypermobility Syndrome: Bending without Breaking, Isobel’s descriptions are interesting and intelligent going into much detail to enable the reader to understand the ramifications of living with HMS. She suggests that we read chapters 1 to 4 and then the sections that are of interest to us personally, but I would recommend taking the time to read the whole book.
As a Pilates teacher who often works with complex patients, not just those with HMS, but those with back issues who may not have all the same physiology as described by Isobel but who have often been passed from pillar to post through the NHS and privately to get a resolution for their back pain, I found every section helpful
Several areas struck a chord with me. The section on Psychology could be usefully read by any therapist working with complex patients to get new insight on issues that can be faced by the complex patient and it suggests setting up contracts between the client (who can often be needy) and therapist and boundaries that should not be crossed on both parties (such as not contacting the therapist whilst he/she is on holiday and for the therapist to not introduce potentially problematic new exercises just before a holiday) It suggests goal setting and focussing on those patient goals. There is also an interesting section on support for the therapist working with complex patient suggesting that the therapist him/herself also needs to be supported which may be difficult for those of us working on our own but is worth bearing in mind that it ought to be possible to build up a relationship between the therapist, client and their other health professionals.
I must say that I also found the ‘professionals viewpoints’ interspersed within Isobel’s text also fascinating to read the story from the other point of view from those who are aiming to help people with HMS improve their lives. As always, the patient needs to be determined and committed but they also need support from their friends and family who can often be resistant to change.
It is suggested in the book that Pilates is most beneficial for hypermobile people with a very experienced teacher and, certainly initially, on a one to one basis. I would agree with this wholeheartedly and would suggest that anyone with HMS seeks out a teacher who is actually teaching ‘Pre-Pilates’ rather than the classical version of Pilates, even at beginner level. (please also see my blog regarding Pilates teacher training)
As with everything, this raises questions about the affordability of treatment for those with HMS and Isobel herself mentions the cost of keeping on top of her HMS paying for physiotherapy and Pilates privately. In these days of austerity, funding is often an issue for everyone but may be especially problematic for those with complex issues who may find relief and improvement from Bowen or Pilates or other treatments but who, due to those same issues, may find it difficult to work full time or at all. A vicious circle.
To summarise, a useful resource for anyone working with clients with HMS or other complex patients. Isobel’s journey is still ongoing and I wish her well and look forward to her next book!
You can buy it on Amazon here