At PhysioTec we assess whether joint hypermobility could be associated with the presentation of your pain/injury. In a single joint, hypermobility is a larger than normal joint range. This can be genetic or acquired through sport (eg dancing, or sports involving sharp changes of direction) or repetitive use.
Around 10% of the population are generally hypermobile and have multiple joints with a larger than normal flexibility. This simply means that they might consider themselves bendy or double jointed (or may have felt this way when they were younger). The collagen in their ligaments is stretchier, allowing the joints to move further than the average person. This is now termed Hypermobility Spectrum Disorder, which refers to those flexible people who do not have Ehlers Danlos Syndrome or any other Heritable Disorders of Connective Tissue.
A small percentage of those who are extra bendy may have a genetic condition such as Hypermobile Ehlers Danlos Syndrome, which is associated with joint hypermobility (greater than normal joint movement). This is a more complex condition that can involve joint pain, fatigue, subluxation/dislocation, digestion issues, headaches, dizziness, anxiety and sleep disturbances.
Not Sure if you are Hypermobile? Take this quick screening test.
(Hakim and Grahame, 2003)
- Can you now (or could you ever) place your hands flat on the floor without bending your knees?
- Can you now (or could you ever) bend your thumb to touch your forearm?
- As a child did you amuse your friends by contorting your body into strange shapes or could you do the splits?
- As a child or teenager did your shoulder or kneecap dislocate on more than 1 occasion?
- Do you consider yourself double-jointed?
If you answered ‘Yes’ to 2 or more of these questions there is a high likelihood that you have joint hypermobility.
Hypermobility can also sometimes be associated with rare conditions such as Marfan’s syndrome and other types of Ehlers-Danlos (eg Classic or Vascular type etc). Our physiotherapists are happy to treat clients with these conditions and are willing to liaise with other medical professionals on your behalf as necessary.
At PhysioTec we are aware that being extra bendy may be of very little daily issue for you or may be a major problem (this is a condition that is as different in each individual as your fingerprint). Those with hypermobility are more likely to develop arthritis and with an earlier onset than others, particularly if their muscles are not offering adequate support. We can provide a detailed physical assessment to accurately assess you and guide you in achieving your goals through advice and education, hands on techniques as required and the use of graduated muscle strength training. Prevention is even better than managing a problem that has already arisen, so if you are hypermobile or have hypermobile children it is often wise to have an early assessment and gain advice and an exercise programme for long term protection of those extra-bendy joints.
At PhysioTec we are also aware that many “hypermobile” individuals actually experience a feeling of joint stiffness. The stiffness often develops as the body tries to find a way to become more secure. The large, superficial muscles will increase their activity all around a joint, in effect splinting it and restricting motion. Unfortunately this often creates its own problems of pain and injury. This excessive gripping makes movement and prolonged standing or sitting tiring. It can also worsen secondary problems such as dislocation, fatigue and dizziness.
Initially we may use Real Time Ultrasound Scanning to retrain the deepest layer of muscles to provide a protective ‘corset’ around your joints. We can then train you to maintain good control around your joints during everyday movements or sporting techniques. Then once you have improved postural control the joint stiffness described above can improve.
Our physiotherapists can also answer questions about how hypermobility can affect different systems of your body. Sharon, Annie, Chen and Megan are our physiotherapists with a special interest in this area.
Hakim AJ, Grahame R (2003). A simple questionnaire to detect hypermobility: an adjunct to the assessment of patients with diffuse musculoskeletal pain. Int J Clin Pract. 2003 Apr;57(3):163-6.