Have you been told that you are double jointed? You may have heard this term before to describe being more flexible than usual. Well, your joints are not “ double” but passive structures such as ligaments and connective tissue allow more stretch than normal.
Connective tissue holds our cells together in our different organs. Tissue elasticity is very variable and some people are more stiff than others and some are just more flexible than others. If you are more flexible than usual, you may have joint hypermobility. This
is a condition that affects 1 out of 20 people and is not very uncommon.
It has been reported that 10-25% of children have hypermobility, with girls being more affected than boys. Usually symptoms are more evident between the ages of 13 and 19 years old with ¾ of adolescents presenting with symptoms at 15 years of age. ( Simmonds, Keer 2007).
So is there a relationship between musculoskeletal problems and hypermobility?
Children can present with weakness of leg muscles and have poor position sense while adults who have hypermobility can have a history of dislocations, subluxations, fatigue, chronic headaches, back pain, paresthesias or tingling in their extremities. In one study, there was a high incidence of hypermobility in adults who have been diagnosed with Fibromyalgia (Sendur et al 2007). It is also important to note that not only does hypermobility affect muscles and joints but it can affect neural , vascular structures and even the digestive system.
Hypermobility can present itself with many symptoms aside from being more flexible and it is important to recognize it especially if you regularly have injuries. In fact, hypermobility is a risk factor for musculoskeletal problems as passive structures are more prone to small but repetitive injuries. Being hypermobile can increase your risk of shoulder dislocation, failure of ACL ligament repair and injuries relating to ballet and gymnastics.
Since hypermobility has a lot of symptoms that go with it, treating each symptom individually may not be as effective as understanding the whole syndrome. Understanding all the symptoms that go with it will mean, understanding the rationale behind treatment , management
and prevention of symptoms.
The key to addressing hypermobility is early detection and understanding your symptoms. This is followed by a progressive exercise program that improves strength, position sense, body awareness and physical activity level. For children, screening them for certain sports and going through a prehabilitation program to prepare them for their sport is important for decreasing their risk of injury.
If undetected and not diagnosed early enough, then it can lead to poor understanding of musculoskeletal problems, and inappropriate physiotherapy management.
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If you are, then talk our physiotherapists, Sharon and Megan who can guide you towards the best way to manage this problem.
Bridges et al (1992) Joint Hypermobility in Adults referred to Rheumatology clinics. Annals of Rheumatic Diseases. 51: 793-796
Fatoye et al (2009). Proprioception and Muscle torque deficits in children with
Hypermobility Syndrome. Rheumatology. 48: 152-157
Grahame (2001). Editorial: Time to take Hypermobility seriously in Adults and Children. British Society of Rheumatology.
Sendur et al (2007). The Frequency of hypermobility and its relationship with clinical findings of Fibromyalgia patients. Clinical Rheumatology. 26 (4):485-457
Simmonds, Keer (2007). Hypermobility and Hypermobility Syndrome. Manual Therapy. 12: 298-309