Hyper-mobility, can you be too flexible?

Hypermobility is a term that is gaining awareness and recognition. With more research emerging about this condition, which has variable awareness among health providers, here is some straightforward information to help you better understand hypermobility for yourself or a loved one.

What is Hypermobility?

Hypermobility is the condition where joints can move beyond their typical range of motion. Some people may naturally have hypermobile joints without any negative effects, while others might experience joint pain, instability, and musculoskeletal problems. Hypermobility can exist on its own (commonly known as generalized hypermobility) or as part of a syndrome like Ehlers-Danlos Syndrome (EDS).

To illustrate, imagine your joint as a cupboard, with the bone as the door and the ligaments as the hinge. Most hinges allow the door to open and close smoothly within a certain range of motion. However, if the hinge is loose, swinging the door open can affect its integrity, causing it to drop, creak, or not close properly. In a similar way, hypermobile joints can result in instability and discomfort.

Why is it a Problem?

For numerous individuals, hypermobility poses no problems and can even be advantageous in specific activities. However, those who seek medical attention often experience issues like joint instability, dislocations, increased pain, or compression of other structures.

Signs and Symptoms

Typical signs and symptoms of hypermobility include:

- Joint Pain: Frequently felt in the knees, hips, shoulders, and back.

- Joint Instability: A higher likelihood of subluxations and dislocations.

- Fatigue: Muscle fatigue arises from the extra effort needed to stabilize joints.

- Soft Tissue Injuries: Tendonitis and other soft tissue injuries occur more often.

- Postural Issues: Poor posture caused by joint instability can result in additional complications.

In more serious instances, hypermobility can impact blood pressure, the digestive system, or lead to secondary issues in other areas.

Assessment and Diagnosis

1. Clinical Assessment: A thorough physical examination is essential. The Beighton Score is a commonly used tool to assess hypermobility, and we may also use other screening measures to assist.

2. Patient History: Gathering a detailed medical history helps identify patterns and associated symptoms.

3. Referral: If a connective tissue disorder is suspected, referral to a specialist may be necessary for genetic testing or further evaluation.

Sports medical practitioners can be a valuable resource in this area. It’s advisable to contact providers who have a specific interest in hypermobility to ensure they are familiar with managing these issues.

Management Strategies

Managing hypermobility often requires a multidisciplinary approach tailored to the patient's specific symptoms. All management should include input from your General Practitioner (GP). Since many people don’t visit their GP first for musculoskeletal issues, it’s essential for allied health professionals to keep the GP informed about any problems or history.

When consulting your GP, focus on discussing hypermobility specifically, rather than presenting multiple concerns. Your GP may suggest various approaches depending on your symptoms, including blood work, specialist referrals, dietary assessments, or a wait-and-see approach.

How We Manage Hypermobility

1. Screening Outcome Measures: These digital or paper forms assess the impact of your symptoms on daily life.

2. Physical Assessment: This often includes the Beighton Score, as well as both active and passive joint range assessments to identify any marked instability.

3. Manual Therapy: Useful for managing symptoms such as pain and muscle tightness.

4. Exercise Rehabilitation: Focuses on postural awareness and strengthening to improve muscle tone to support your joints. We emphasize stabilization-based strength training within a controlled range of movement.

5. Kinesio Taping: This may be used to help you become aware when a joint is moving beyond ideal ranges and prompt you to reposition it.

6. Activity Modification: This may include adjustments to workplace ergonomics, sleeping positions, or using a brace during certain activities.

Referral may be necessary if:

- You have never undergone screening for hypermobility and require a thorough evaluation of potential factors contributing to your symptoms.

- You experience severe, persistent pain that affects your sleep, work, or relationships, suggesting the need for a multidisciplinary approach.

- You are pregnant, and hormonal changes may worsen symptoms. We can collaborate with your prenatal team or suggest specialists, like the Mornington Peninsula Family Physio, for pelvic floor evaluations.

- Your symptoms are not improving, and there are signs of more serious issues. In such instances, it may be necessary to refer you back to your GP or to a sports medical specialist for expert care.

Conclusion

Hypermobility is a complex condition that requires careful assessment and management. Promoting awareness and education within the clinic can improve outcomes and empower patients to lead active, fulfilling lives. If this article resonates with symptoms you are experiencing, feel free to email or call us for recommendations on who may assist you.

Disclaimer : This blog is intended for informational purposes only and does not constitute medical advice. Patients should consult with a qualified healthcare professional for personalized care and treatment.