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 refers to the ability of joints to move beyond their normal range of motion. While some individuals may be naturally hypermobile without any adverse effects, others may experience joint pain, instability, and musculoskeletal issues. Hypermobility can occur in isolation (often referred to as generalized hypermobility) or as part of a syndrome, such as Ehlers-Danlos Syndrome (EDS).

To illustrate, think of your joint as a cupboard, with the bone acting as the door and the ligaments as the hinge. Most hinges allow the door to open and close smoothly within a specific range of motion. However, if the hinge is loose, swinging the door open can compromise its integrity, causing it to drop, creak, or not close properly. Similarly, hypermobile joints can lead to instability and discomfort.

Why is it a Problem?

For many, hypermobility is not an issue and can even be beneficial in certain activities. However, individuals who seek care often notice problems such as joint instability, dislocations, aggravating pain, or compression of other structures.

Signs and Symptoms

Common signs and symptoms of hypermobility include:

- Joint Pain: Often experienced in the knees, hips, shoulders, and back.

- Joint Instability: Increased risk of subluxation and dislocations.

- Fatigue: Muscle fatigue due to the increased effort required to stabilize joints.

- Soft Tissue Injuries: Tendonitis and other soft tissue injuries are more common.

-Postural Issues: Poor posture due to joint instability can lead to further complications.

In more severe cases, hypermobility may affect blood pressure, the digestive system, or cause secondary problems elsewhere.

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 been screened for hypermobility before and need a comprehensive assessment of potential factors responsible for your symptoms.

- You are suffering from severe, constant pain, which disrupts sleep, work, or relationships, indicating a need for a multidisciplinary approach.

- You are pregnant, as hormonal fluctuations can exacerbate symptoms. We can coordinate with your prenatal team or recommend specialists, such as the Mornington Peninsula Family Physio for pelvic floor assessments.

- Your symptoms are not improving, and you show signs of more serious complications. In such cases, referral back to your GP or to a sports medical specialist may be warranted 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.