What is Hypermobility Syndrome

What is hypermobility?

Hypermobility refers to excessive joint laxity and range of motion. There are numerous causes of joint hypermobility, including genetic factors or development after trauma/ injury.

It is more common to find generalised hypermobility in women, especially children and adolescents. An inherent loss in stability is often a result of an issue in the development of collagen, or other proteins, in the ligaments that stabilise the joints.

Hypermobility spectrum disorder (HSD) is precisely that, a spectrum. And therefore, hypermobility can look different for everyone.

Asymptomatic hypermobility can be a significant advantage in several sports (think dancers, gymnasts or yogis), but there are many people with connective tissue disorders whose daily lives can be affected. Some people are affected mostly by pain and musculoskeletal problems such as recurrent sprains, strains and subluxations/ dislocations. Others may experience gut issues, fatigue, dizziness or cardiovascular symptoms.

Pain associated with hypermobility comes from difficulties with stability. It is expected to experience symptom flares, particularly after overactivity or inactivity due to injury, illness, or stressful life events. In people who aren’t hypermobile, there is a greater level of joint stability created by strong, stable ligaments, so it is not an issue if their dynamic (muscular) movement control is not perfect. Those who are hypermobile have more flexibility or give in to their static stabilisers (ligaments) and rely more on their muscles for stability. If there is a lack of control, it can lead to an overload of the soft tissues and result in pain.

How is hypermobility diagnosed?

There are several classifications of hypermobility, which your physiotherapist can provide more details on. One simple test you can do at home that can give a general type of individual joints’ mobility is called the Beighton Scale. The maximum score is 9 if all movements are positive.

Tests for hypermobility:

1)  Can you bend each little finger backwards to over 90 degrees? (1 point per finger)
2)  Can each thumb reach your forearm? (1 point per thumb)
3)  Do your elbows hyperextend more than 10 degrees? (1 point per elbow)
4)  Do your knees hyperextend more than 10 degrees? (1 point per knee)
5)  Can you place your hands flat on the floor without bending your knees?

Children are more naturally flexible, so a positive score is considered 6/9 and above.

For adults, a positive score is 5/9 and above.

How can we manage it?

We often see people on the flexy side who crave stretch and want to go further into each stretch to find it. This may feel good at the time, but they often need to build control and awareness (or proprioception) around the joints.

This is where physio steps in. While we cannot “cure” hypermobility, we can help manage its symptoms. We can help by

Hands-on treatment to manage muscular pain and tension
Advice around techniques and strategies around joint position and modifications for daily tasks
Tailored exercise programs to care for our joints by strengthening around them to provide the support and control needed to maintain joint health as we age.
Collaborating with other health professionals to address other associated
Guidance on bracing and splints where appropriate

If any of this strikes a chord with you, get in touch to book an appointment with one of our physiotherapists.

https://discovery.ucl.ac.uk/id/eprint/10137358/3/Simmonds_Masterclass-%20Hypermobility%20and%20hypermobility%20related%20disorders_AAM.pdf

Published November 28, 2023