Neurodivergents and Flexibility Training

Neurodivergent is an inclusive term that celebrates the attributes and positive impact of individuals with different ways of interacting and understanding the world, while recognising the challenges, stigma and bias they face.

If you identify as neurodivergent and train flexibility, you will recognise that you are not alone. Not only does flexibility training encourage positive expression of favourable attributes, it can be a way for neurodivergent individuals to foster self-efficacy by supporting autonomy, relatedness and competence (Self-determination Theory. Deci and Ryan, 1985; Ryan and Deci, 2000).

This first blog post in this series reviewed factors that commonly influence flexibility training in neurodivergent people. Read the blog here.

This post will suggest strategies and accommodations that may help to support inclusive, safe and meaningful flexibility training for neurodivergent people.

Remember: Everyone is unique, with their own strengths, challenges and preferences. These are suggestions only.

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Hypermobility and Connective Tissue Disorders

Neurodivergent people are more likely to have joint hypermobility and connective tissue disorders (Csecs, 2021).

alt=” Five decorative graphics with text on a blue background. Text reads- Seek a diagnosis if you have symptoms of a connective tissue disorder. Prioritise active flexibility. Thoroughly rehabilitate injuries. Work on balance, proprioception and coordination. Work on strength through range and joint conditioning.”

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Pain Hyper/Hypo-sensitivity

Neurodivergent people are more likely to experience chronic pain (Failla, 2022)(Kerekes, 2021). They may experience pain hypersensitivity (Feel pain from things that are not typically painful. Example: light tough) or hyposensitivity (Feel little pain from things that are typically painful. Example: a joint dislocation).

Neurodivergents may have high pain tolerance (Function well when they are in a lot of pain) or pain intolerance (Have difficulty functioning when in pain).

Pain sensitivity and tolerance will fluctuate.

alt=” Six decorative graphics with text on a blue background. Text reads- Work to your current tolerance level. Practice pain acceptance*. Gradually build up to more challenging exercises. Utilise braces, supports and compression. Be mindful and present. Communicate your pain experience honestly with your coach.”

alt=” Graphic of a brown woman sitting with a blanket on their lap holding a mug. Text reads- *Pain acceptance is the non-judgmental acknowledgment of your pain experience that encourages positive action, over avoidant behaviours, and recognises abilities without denial of symptoms. Practising pain acceptance increases physicological flexibility, resilience and functional capacity (Gentili, 2019).”

Sensory Hyper/Hypo Sensitivity

Neurodivergent people may experience hypersensitivity (Notice inputs that are typically unobtrusive. Example: clothing against the skin), or hyposensitivity (Be unaware of inputs that are typically noticeable. Example: holding awkward postures).

Neurodivergent people may be less tolerant of sensory inputs (Function is affected by specific stimuli. Example: Difficulty around a strong smell) and more prone to over-stimulation (Function is affected by the sum of sensory input. Example: Difficulty spending a lot of time time at a social function).

'Sensory overload' can lead to meltdowns, shutdowns and contribute to burnout (Casinova, 2020)(Murray, 2022).

alt=” Six decorative graphics with text on a blue background. Text reads- Comfortable clothing. Favorite drinks. Compression garments.Listening to your own music. Stim* if you feel comfortable. Quiet space available.”

alt=” Graphic of a fawn-coloured hand rubbing thumb and index finger together. Text reads- *Stimming (usually familiar repetitive movements) relieves overwhelming emotions and excessive sensory stimulation (Kapp, 2019). Stimming increases confidence and sense of safety. Stimming is considered an important and valuable part of flexibility training.”

Autonomic dysregulation

Neurodivergent people are more likely to experience autonomic dysregulation, impacting their ability to regulate temperature, blood pressure and heart rate, sometimes leading to sudden loss of consciousness (Owens, 2021).

alt=” Six decorative graphics with text on a blue background. Text reads- Cool clothing or layers. Fluids before, during and after. Train in a cool environment. Take care with inversions and sudden changes in posture. Lay down with your feet up if you start feeling symptoms.”

Neurodivergent people are more likely to experience chronic sympathetic nervous system (SNS) dominance (sympathoexcitation) (Owens, 2021). Flexibility training benefits from down-regulation of the SNS to improve tolerance to stretch.

alt=” Six decorative graphics with text on a blue background. Text reads- Avoid coffee before training. Train with animals. Meaningful music. Train with like-minded people. Use a plushy or other support. Controlled breathing.”

alt=” Four decorative graphics with text on a blue background. Text reads- Meditate or practice mindfulness. Fidget. Count. Self-soothe.”

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Learning preferences

Usual ways of imparting information can make processing more challenging for neurodivergents. It's important to discuss your strengths and preferences with your coach or instructor.

alt=” Six decorative graphics with text on a blue background. Text reads- Open communication. Tactile feedback. Copying (same orientation). One instruction at a time. Video feedback. Feedback after a drill is completed (not during).”

alt=” Two decorative graphics with text on a blue background. Text reads- Small group or 1:1. Minimise distractions.

^{In Summary:}

Strategies and accommodations can support inclusive, safe and meaningful flexibility training for neurodivergent people. The factors that commonly influence flexibility training in neurodivergent people include;

-Hypermobility and connective tissue disorders
-Pain hyper and hyposensitivity
-Sensory hyper/hypo sensitivity & sensory seeking
-Autonomic dysregulation
-Learning preferences.

The next post in this series will be directed at coaches, teachers and instructors and will provide guidance on fostering a productive training alliance with neurodivergent people.

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References:

Csecs JLL, Iodice V, Rae CL, Brooke A, Simmons R, Quadt L, Savage GK, Dowell NG, Prowse F, Themelis K, Mathias CJ, Critchley HD, Eccles JA. Joint Hypermobility Links Neurodivergence to Dysautonomia and Pain. Front Psychiatry. 2022 Feb 2;12:786916. doi: 10.3389/fpsyt.2021.786916. PMID: 35185636; PMCID: PMC8847158.

Doyle, N. (2020). Neurodiversity at work: a biopsychosocial model and the impact on working adults. British Medical Bulletin, 135(1), 108-125. https://doi.org/10.1093/bmb/ldaa021

Failla MD, Moana-Filho EJ, Essick GK, Baranek GT, Rogers BP, Cascio CJ. Initially intact neural responses to pain in autism are diminished during sustained pain. Autism. 2018 Aug;22(6):669-683. doi: 10.1177/1362361317696043. Epub 2017 May 17. PMID: 28513186; PMCID: PMC6352721.

Gentili, C., Rickardsson, J., Zetterqvist, V., Simons, L. E., Lekander, M., & Wicksell, R. K. (2019). Psychological Flexibility as a Resilience Factor in Individuals With Chronic Pain. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2019.02016

Kapp SK, Steward R, Crane L, Elliott D, Elphick C, Pellicano E, Russell G. 'People should be allowed to do what they like': Autistic adults' views and experiences of stimming. Autism. 2019 Oct;23(7):1782-1792. doi: 10.1177/1362361319829628. Epub 2019 Feb 28. PMID: 30818970; PMCID: PMC6728747.

Kindgren E, Quiñones Perez A, Knez R. Prevalence of ADHD and Autism Spectrum Disorder in Children with Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome: A Retrospective Study. Neuropsychiatr Dis Treat. 2021 Feb 10;17:379-388. doi: 10.2147/NDT.S290494. PMID: 33603376; PMCID: PMC7882457.

Murray D, Milton D, Green J, Bervoets J. The Human Spectrum: A Phenomenological Enquiry within Neurodiversity. Psychopathology. 2022 Sep 30:1-11. doi: 10.1159/000526213. Epub ahead of print. PMID: 36183692.

Owens, A. P., Mathias, C. J., & Iodice, V. (2021). Autonomic Dysfunction in Autism Spectrum Disorder. Frontiers in Integrative Neuroscience. https://doi.org/10.3389/fnint.2021.787037

Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68-78.

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Neurodivergents and Flexibility Training - Part 2