[books, embodiment] Hypermobility Without Tears, Jeannie Di Bon

[kaberett]

Jeannie Di Bon is a "Movement Therapist" who "specialis[es] in Hypermobility, Ehlers-Danlos Syndrome and Chronic Pain." In the introduction, she talks about her own experiences in a way I find very sympathetic:

I've lost count of the number of times a doctor has told me it's all down to IBS and instructed me to eat more fibre and try Pilates or yoga to relax. Dismissive in its nature and kind of ironic now, as I trained to become a Pilates teacher in 2008.

And, you know, the actual core (yes I did that) of her Integrated Movement Method is sound: she's giving advice about fostering body awareness, of when and where you're tense and when you're not, working through a pretty standard sequence of breathing exercises and gentle movements. All the exercises in this book are the kind of thing that show up pretty early on in any full-body physiotherapy programme, that have loads of progressions available (particularly within the Pilates model), and they're absolutely fine and probably useful to folk who've not been able to access care covering this kind of topic.

If it were just the exercise programme, it would be ... fine. More or less. I think a bunch of the ways she explains movements are unclear and counterintuitive, but hey, presumably they work for at least some people.

Unfortunately, there are all of the bits in between.

Chapter 4 is where they went from "okay, you're simplifying to the point of lies-to-children but you are also explaining why" to "... either you're deliberately misrepresenting things for personal gain or you're wildly incompetent", and I'm still not sure which of those it actually is. (I am trying not to think too hard about the possibility that the answer is "both".)

The chapter opens with a quotation from The myth of core stability (Lederman 2008):

It is doubtful that there exists a "core" group of trunk muscles that are recruited to operate independently of all other trunk muscles during daily activities... Muscle by muscle activation does not exist.

A couple of pages later, we get another quote from Lederman (2008):

To specifically activate the core muscles during functional movement the individual would have to override natural patterns of trunk activation. This would be impractical, next to impossible and potentially dangerous.

In between those two, we get some of Di Bon's own words:

How many of you have been told that you have a 'weak core' and that the only way out of pain is to strengthen your core? Invariably exercises then follow that involve the engagement of pelvic floor and transverse abdominal muscles -- recruited by drawing up your pelvic floor and drawing your naval [sic] to your spine, thereby hollowing your stomach.

... clarified with "Pilates being one of the worst offenders".

The thing is, though, that I've just looked through all four of the Pilates books I've got here (one of them Body Control i.e. one of the major schools of contemporary Pilates, and another boasting about a different specific pedigree) and... they are all really clear that when they refer to "centring" or "the powerhouse" ("core" not being a term that's used much in purist materials), what they mean is at minimum all of the musculature between about the bottom of the ribs and the bottom of the buttocks -- which is very much not the same thing as Just The Pelvic Floor And Transverse Abdominals. (One of the books contains anatomical diagrams with muscles from the trapezius' extension up to the neck down to the calf muscles labelled as essential introductory material!)

So I start out grumpy about the misrepresentation of what the Pilates method is actually focussing on, and then we get:

When we are instructed to engage our pelvic floors and transverse abdominals, how do we know that these are the only muscles getting involved?

WE DON'T. THEY'RE NOT. THAT'S THE POINT. The point is that those are two sets of muscle it's fairly easy to cue engagement for (common approaches including "zipping up a tight pair of jeans" and "various stages of toileting") which will then recruit a solid chunk of the rest of the core. Nobody that I've come across is suggesting that "core" refers only to a subset of the muscles of the trunk!

Which this is a neat encapsulation of my Problems with this book: within a couple of pages, interleaved with each other, we've got:

1. the argument that muscle-by-muscle activation isn't possible, and that the pelvic floor and transverse abdominals aren't the whole story; and
2. the quotation immediately above, that cuing recruiting those muscles doesn't isolate those muscles, with the implication that this is somehow a bad thing.

(You might have noticed the line quoted above about "natural patterns of trunk activation". I'm going to be coming back to that.)

My next point is that despite all this criticism of a misrepresentation of Pilates, prominently featured on the front page of her website at time of writing are courses titled "Strengthen your Hypermobile Core" and "Reformer Foundations for Hypermobility" (the Reformer being a specific piece of gym equipment specifically designed by Pilates for use as part of his method). She's still teaching it, she's still using the terminology of "core" despite all the criticism in this book, and to my immense amusement the 2025 paper she's a co-author on, that she's pushing as evidence that her Integral Movement Method works, is titled... A qualitative study exploring participants’ feelings about an online Pilates program designed for people with hypermobility disorders (Russek et al. 2025).

My frustration here is that, see above: the programme she has developed and is advocating for is perfectly sound but not actually particularly novel, so I... really start to feel like the combination of misrepresentation of specifically Pilates (for which there are many free resources available) together with the pushing of her Integral Movement Method as the one true way (when, again, it's not actually doing anything novel so far as I can tell) is primarily about pushing people to give her money.

And so in turn I feel really Distinctly Icky about the deliberate invitation to identify strongly with her in the introduction to this book, and the way she shills her app as "Hypermobility safe, affordable and effective movement, education and community in the comfort of your own home." For £13.99 a month. When, again, free Pilates resources are widely available.

This kind of misrepresentation keeps showing up, all the way through the chapter and indeed the book. In the same handful of pages as all the quotations above appear, we get a perfectly reasonable discussion of the propensity of hypermobile people (with generally poor proprioception) to over-recruit muscles (implicit: in response to standard cues)... and "Now imagine I asked you to keep that contraction for an hour while we do our exercise class." The implication that this contraction (that she explicitly acknowledges is likely to be over-recruitment) is what any competent teacher will actually ask for is... not reasonable, and the part where she's directly addressing people who are scared of moving full stop and asking them to imagine carrying out an hour-long exercise class feels frankly coercive: you can't trust any of these other people.

(Sarah Russell, in material she makes freely available, also talks explicitly about over-recruitment... and how not to do it, while still engaging the relevant muscles to an appropriate degree. The contrast with Di Bon's approach is... stark.)

And there's more in this vein:

... Lederman also states that if you are taught to do these contractions lying on your back, there is no guarantee this will even translate to a functional movement like standing, running, lifting and so on.

Leaving aside the bit where she appears to think "person X states..." is synonymous with "it is a fact that...": a significant proportion of the exercises she describes... are performed lying down. Because apparently when they're standard Pilates exercises that she's presenting as part of her Integral Movement Method, this concern magically doesn't apply.

Which, in a roundabout fashion, brings me back to the way she talks about "natural" movement, treating "natural" as synonymous with all of "good" and "healthy" and "desirable". There's the line quoted above ("overrid[ing] natural patterns of trunk activation ... would be impractical, next to impossible and potentially dangerous"), and there's more in the same vein, also from this same chapter:

You only need to look at children or animals moving if you want the answer. Do children get taught to draw in their abdominals before playing soccer or gym? Do dogs lift and tighten the pelvic floor before running for that ball? I don't think so. What we see is natural, free and fluid movements that they also enjoy.

Which, of course, is not a description that would apply to a lot of my movement in childhood. Again: she's spent a solid chunk of this book explaining all the ways that hypermobile folk's intuitive ways of moving are actively bad for us; the point of her method is relearning how to move in a way that doesn't make us weaker and increase our risk of injury. My hypermobility absolutely could have been picked up in childhood, and I could absolutely in childhood have been taught how to move in ways that didn't cause damage, which is why I'm so angry about the implication that If We Just Moved Like Children It Would All Be Fine!!!

And just -- oof, again, the whole thing. There is some solid info sprinkled through it, but overall it adds up to, again, either incredibly self-servingly disingenuous, or straight-up incompetent. The idea that it's "impossible" and "dangerous" to "override natural patterns of trunk activation" is arrant nonsense completely at odds with the whole point of the damn book... but it sure does serve to steer people away from, again, widely and freely available resources. That teach exactly the same movements and patterns of muscle activation that she is attempting to teach, just with cues (instructions) that actually make any damn sense.

I want to be clear: this book is not without good parts. But they're mixed in with incoherent or just plain incorrect and poorly sourced claims that aren't necessarily straightforward to distinguish from said good parts without a lot of background knowledge.

I'd hoped, earlier on, that it might be something I could stick in a resources list with a brief disclaimer. Given how much I feel like I've only barely sketched in in the foregoing, however, that... has not turned out to be the case.

tl;dr there is nothing you will get from the Integral Movement Method that you won't get from competently-taught or -explained Pilates except scaremongering and misdirection... and unlike IMM, you can get decent Pilates resources for free. Don't bother with this one.

Comments

[kaberett]

Further clarification: it is absolutely the case that Pilates can be and almost certainly is (I don't have direct experience) widely taught badly. In, you know, the same way that PE classes are taught badly, and everything else is frequently taught badly.

One of the things that's Going Into The Book is very much: if you're reading this, then I'm really sorry, but you will almost certainly benefit from sinking a fucktonne of time and energy into learning a bunch about physiology and biodynamics and psychology. I'm sorry. It's not fair that you have to, and it's not fair that you have to learn how to spot when someone is bullshitting beyond their competence, but unfortunately our choices are Develop Those Skills or Keep Going As We Are, and you're reading this, so I'm willing to bet the latter isn't working out brilliantly for you.

The foreword is the bit where I explain what my actual qualifications are, and how to assess whether I'm talking out of my arse. Because that, too, is really damn important. Actually.

[kaberett]

ONE MORE BONUS WHAT THE FUCK: after MULTIPLE CHAPTERS of going on about Gravity Being Your Friend and Don't Fight Gravity!!! and so on and so forth..........

Try not to allow gravity to drop the leg quickly to the floor.

[ewt]

Oooof. Good to know, thank you.

(I keep thinking I should learn Pilates "properly" i.e. not the class at a gym that I took getting on for 25 years ago now with someone whose grasp of anatomy was sufficiently poor that she confused the diaphragm with the pelvic floor. Yes, Pilates is absolutely taught abysmally badly in many contexts.)

I wonder if she cribbed the "children and animals move Naturally and that's Good" thing from Alexander Technique. (Alexander was, iirc, quite a bit less hand-wavy about this, but it has been a long time so my recollection may be iffy.) I did find Alexander Technique helpful during undergraduate studies, but I wonder whether I would have found the same of just about any technique that involved paying careful attention to how I moved my body and held my instrument, with feedback from a non-judgemental instructor.

[haggis]

Yes, I have done a bit if Alexander Technique and that bit sounded familiar to me.

[cesy]

Thank you for the explanation and warnings. I'm glad to know there's unlikely to be much useful behind the paywall that I'm not already getting from my physio and Pilates instructors who are reasonably competent and explain things enough that I understand.

[aldabra]

I was legally old enough to be a grandparent before anyone told me what activating my core muscles meant. I'm still not sure I've got it. Or that it does anything useful.

I think maybe we need a national curriculum in PE (have we got one yet?) which specifies that infant school dance lessons show you how to move right and that you get a lesson on hockey rules before anyone tries to make you play hockey.

[haggis]

Speaking of free Pilates resources - are there any that you can recommend?

[kaberett]

My favourite is the Pilatesology exercise lists [and encyclopaedia]](https://pilatesology.com/exercise-encyclopedia/)!

For folk who are not already your level of physically active, and especially for people who are approaching all of this as rehab from the ground up, I'd point to Sarah Russell's videos for people who have just had abdominal surgery -- even if you haven't had or won't be having surgery they provide clear explanations of the fundamental movements (in both video and text format) and a gentle progression.

The NHS provides a range of videos -- from pretty gentle to somewhat harder work. And another progressive sequence linked helpfully from the Torbay and South Devon website!

I haven't properly rummaged through PilatesLive but on a skim it looks pretty good.

[haggis]

Thank you!

[silveradept]

Aigh. That's the most insidious kind of bullshittery, when someone mixes things that can be useful and helpful in with things that are meant to fearmonger and dissuade someone from picking up useful things.