Hypermobility is a disorder of the connective tissue in the body, which provides the scaffolding to muscles and bones and provides structure to many organs and body parts. The connective tissue is more elastic, resulting in decreased support to the joints and organs.
Joint hypermobility refers to an increased range of movement in a joint and is often referred to as being “double jointed”. This laxity can be an inherited trait or can be acquired due to training and stretching of the joints. It can affect just a few joints in the body or all the joints. Some forms of hypermobility can be diagnosed with genetic testing such as Ehlers-Danlos Syndrome, but the cause of many other types is as yet unknown.
In some cases, joint laxity is the only feature of the diagnosis. In others, it becomes a concern when the individual experiences a variety of medical problems outside of the musculo-skeletal system. These symptoms can be mild or extreme and become part of the diagnosis of hypermobility syndrome.
Hypermobile bodies sit on a spectrum. The number of symptoms associated with joint laxity varies greatly between individuals and will place them somewhere on this spectrum.
Where do you fall on the hypermobility scale?
Not sure? Do this quick screening test.
Each side of the body scores one point with a maximum possible score of 9.
Can you pull your thumb to touch the inside of your forearm?
Can you pull your little finger backward >90 degrees relative to the back of your hand?
Can you straighten your elbow >10 degrees above the plane of the outstretched arm?
Can you straighten your knees >10 degrees past the plane of the straightened leg?
Can you place your palms flat on the floor without bending your knees?
What is your score out of 9?
You have just completed the Beighton examination. If you scored a 5/9 or more, you have joint laxity in both the big and small joints of the body and are therefore considered a hypermobile body type.
Some of the common symptoms of hypermobility syndrome are:
- Low muscle tone
- Changes in bone density
- Increased stretchiness of skin
- Joint pain and joint dislocations
- Fatigue and sleep disturbance
- Chronic pain, headaches and migraines
- Postural hypotension or POTS
- Gastro-intestinal disturbances
- Cardiology problems
These symptoms can be extremely debilitating in some individuals. The condition can have far reaching effects on their quality of life and often requires a multidisciplinary approach to management. It is very important that a person diagnosed with hypermobility syndrome has a good support network around them to ensure early and effective management of the problems as they arise. This is not always an easy task as hypermobility is poorly understood in the medical profession and hyper-mobiles are often left feeling unheard when seeking medical help.
A good support team can include all or some of the following practitioners:
Physio
Early intervention in musculo-skeletal injuries in hyper-mobiles is extremely important. Due to the nature of their connective tissue, hypermobile bodies take longer to heal and require a longer rehabilitation process than the average individual. The injury is often more painful than expected and can easily progress to a chronic pain problem if not managed well.
GP
Finding a GP who understands the implications of a diagnosis of hypermobility syndrome is very important. They will manage the day to day problems associated with the condition and can refer to relevant specialists when needed.
Movement is essential in the life of a hypermobile. The stronger and fitter the hypermobile individual is, the more resistant they are to fatigue and the less likely they are to develop chronic pain. The challenge is to find the balance between pushing the hypermobile body too hard and maintaining a healthy musculo-skeletal system. A Physio can help with appropriate selection of activities that support the condition and manage injuries as they occur.
OT
Occupational therapists play a very important role in supporting the hypermobile individual in their day to day lives. They implement strategies within the school, university, work and home environments to help support the hypermobile individual.
Dietician
Gastro-intestinal issues and food allergies will differ from individual to individual. A dietician that understands the issues relating to hypermobility will tailor a program specific to their needs.
Psychologist
The impact of hypermobility syndrome on the individual can be enormous. Psychological support, career guidance, management strategies for increased levels of anxiety, depression and fatigue can all be implemented by a psychologist.
Pain is a common problem in the hypermobile individual and is one of the biggest challenges that they face in their day to day lives. A multidisciplinary approach involving all of the above practitioners is often required to develop an effective management strategy for these individuals over their lifetime.
Many individuals suffer for years with medical concerns that are investigated as isolated problems. It can be a tremendous relief to discover that they have hypermobility syndrome and that the symptoms they have suffered for years can be explained and managed under one diagnosis. There are not always solutions to the problems that arise with hypermobility, but early intervention, good support systems and life-long management strategies can go a long way in helping a hypermobile individual live a happy and fulfilling life.
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