From a physio who has HSP
US physio Liz W has HSP and so is uniquely placed both personally and professionally to discuss exercise for people with HSP. Because symptoms vary so widely, be aware that what works for one HSPer may not be as effective for another, or indeed may increase the level of some symptoms such as spasticity.
Liz says “I cannot make specific recommendations for any individual because I do not know what their impairments are. We are all at differing levels of ability in this disease process. What I am trying to do is present characteristics of a spastic disease as they relate to deficits in mobility and what specific exercises may be helpful in addressing the deficits.”
Exercise ball exercises
I’ve had inquiries from HSPers about exercising using a gym or exercise ball that you can sit on. They come in different sizes – the right one for you depends on your height and weight. For a good fit, find a size that when sitting on the ball, your feet are flat on the floor with your knees and hips at a 90° angle (thighs parallel to the floor).
Here’s a guide to the right ball size for you:
Height: 150 – 163cm Ball size: 55cm
Height: 164 – 180cm Ball size: 65cm
Height: 181 – 200cm Ball size: 55cm
Without knowing specifics about anyone’s abilities, here is a beginners practice:
Try starting just sitting on the ball and keeping your balance. They are called stability balls, but are anything but that. Sitting on the ball keeping your balance is a challenge for non-HSPers too! Don’t underestimate the difficulty and make sure that you are in a safe place (no obstacles) if you fall off.
Close your eyes and keep sitting there, then slowly turn your head from side-to-side
Then turn a bit further so that your upper body/shoulders turn side-to-side as well, but keeping your hips and lower body still.
Next put your hands on your lower abdomen and breathe in deeply so that you feel it expand and then exhale slowly with rounded pursed lips as if blowing out candles. This starts to activate the abdominal muscles.
Next keep your shoulders still and imagining a hula hoop around your waist, make slow circles with your hips a number of times one way and then the other, making sure to keep your feet flat on the floor. Make the motion smooth and circular. Do this with eyes open and then closed.
You can add – with eyes open, reaching your arms overhead to the right and down to the left, following a diagonal pattern on both sides and follow that pattern with your eyes.
If you’re not fit or haven’t been exercising or experience significant spasticity, then just start with this program.
Set a timer for 10-20 minutes. Pay attention to how it feels with the different movements. Start slowly. You don’t want to go too heavy on exercise initially.
With your hips and knees bent and feet flat on the floor, you are “breaking up” the common extensor muscle pattern, which facilitates tone (contraction or tightness). Extensor muscles straighten or make the leg longer, such as when we stand. These include hip extensors (buttocks / gluteal muscles) knee extensors (front of thigh / quadriceps muscles) and ankle plantarflexors (calf muscles / gastrocnemius). You are activating your core (abdominal) muscles and causing movement in your spine, which is essential.