Hypermobility
What is hypermobility?
Hypermobility is characterized by excessive joint movement beyond what is normal in the general population. People may be described as “double jointed” or notice their joints bend further than usual. Joint hypermobility may affect a singular joint, a few joints, several joints or be generalised (affecting all 4 limbs and the spine). Generalised hypermobility may be inherited as a normal trait, may be part of an inheritable syndrome such as Ehlers Danlos syndrome or other inheritable disorders of connective tissues. Hypermobility or laxity in joints may also come from previous injuries e.g. joint dislocations, sprains, overuse, joint disease, hormonal disorders and/or genetic issues.
Who is usually affected?
Up to 10% of the population have some joint hypermobility. Women are 3 times more likely to be affected than men.
How do you know if you’re hypermobile?
Osteopaths know what a normal range of movement should look like in your age demographic. Women and children are generally more flexible than men and older people. They can identify general or local hypermobility with clinical judgment however may need to refer for further assessment when necessary. Reasons for referral may be if there is a suspected underlying cause, such as undiagnosed connective tissue disorder. It’s important to know that not all flexible joints are problematic, we look at the body as a whole and get a broad understanding of any pain or issues with function to determine which areas require intervention.
Should I worry about joint hypermobility?
Joint hypermobility is not necessarily a problem. However, it can put more pressure on the muscles around the hypermobile joints to help to control the extra movement available. Because of the extra flexibility in our joints, our brain can also misinterpret where our joints are in space, making us clumsier at times or causing poor functional posture because our limbs can move further than our brain expects. Like anyone, if we sit too long or do an activity that is very repetitive, our nervous system can cause our muscles to grip and tighten to try and restrict the extra range of joint movement, making us feel stiff.
What can you do to help?
For rehab of hypermobile joints after injury, strengthening is a first line management strategy to restore joint strength and stability. These injuries may also be old and now contributing to more issues e.g. shoulder dislocation that progresses to neck and upper back pain as well. Both acute and chronic injuries can respond well to targeted treatment and management, however the sooner you start the process, the better and generally faster the results will be.
People with systemic hypermobility joints typically enjoy exercise like Pilates or swimming, because it helps to activate various muscles aiding joint stability and support without stressing the joints.
It is also important when trying to strengthen muscles around hypermobile joints, so that we do not continue to push the joints into their extra range of movement. Just because you are capable of almost twisting yourself inside out does not mean you should try to, as it can damage the joint structure and increase hypermobility.
When exercising and strengthening, people with hypermobile joints often benefit from being able to see their reflection in a mirror to help them control the movement. Finding the right type and sticking to a regular routine of targeted or general exercise is one of the best long term management strategies.
So, key tips for hypermobile people wanting to exercise:
Focus on strength rather than stretch.
Core stability is essential.
Don’t train to fatigue – focus on quality not quantity.
Using a mirror when exercising will help you perform movements well.
How can Osteopathic treatment help my hypermobile joints?
Osteopaths are trained to assess and manage symptoms associated with hypermobility. Osteopaths look at how the body is functioning as a unit. Single joint hypermobility may have neighbouring stiff joints, which then make the hypermobile joint more strained. Osteopaths focus on loosening up the stiff joints, whilst rehabilitating the unstable joint with appropriate exercise and advice.
Focus will be on restoring optimal function and alignment of the whole body, as well as the hypermobile joint. Just because we have hypermobile joints does not mean that we feel flexible all the time!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457547/
https://arthritisaustralia.com.au/types-of-arthritis/hypermobility-adult/
https://www.ehlersdanlosaus.com/hypermobile-spectrum-disorder