Hyper Mobility

Hypermobility, also known as joint hypermobility or hyperlaxity, refers to the ability of a person's joints to move beyond their normal range of motion. In individuals with hypermobility, the joints have a greater degree of flexibility and can stretch or bend more than usual. This can be due to laxity in the ligaments, which are the connective tissues that hold the joints together.

Hypermobility can affect various joints in the body, but it is commonly observed in areas such as the fingers, elbows, knees, and hips. While some people with hypermobility experience no negative effects and have no related symptoms, others may experience discomfort, pain, and an increased risk of certain musculoskeletal issues.

There are two main categories of hypermobility:

Benign Hypermobility Syndrome (BHS): Also referred to as "joint hypermobility syndrome," this is when an individual has hypermobile joints without any associated medical conditions. Some people with BHS might experience joint pain, fatigue, and minor musculoskeletal symptoms, but these typically do not lead to significant impairments.

Ehlers-Danlos Syndrome (EDS): EDS is a group of connective tissue disorders that can cause hypermobility and various other symptoms. EDS is generally more severe than BHS and can lead to issues like joint instability, chronic pain, skin problems, and organ involvement.

Symptoms and effects of hypermobility can vary widely from person to person.

Some common symptoms and considerations include:

Joint pain or discomfort, especially after physical activity

Increased risk of joint injuries, such as sprains or dislocations

Early onset of osteoarthritis in some cases

Fatigue and muscle weakness

Hyperextensible skin (stretchy skin)

Increased risk of developing conditions like scoliosis (curvature of the spine)

Gastrointestinal issues in some cases (more common in EDS)

If someone suspects they have hypermobility and are experiencing discomfort or pain, it's advisable to consult a medical professional. A healthcare provider can perform a thorough evaluation, possibly including joint flexibility assessments and other tests, to determine the extent of hypermobility and recommend appropriate management strategies. Treatment might involve exercises to strengthen muscles around hypermobile joints, pain management strategies, and, in some cases, referrals to specialists for further evaluation.

Hypermobility is often influenced by a combination of genetic and environmental factors. While the exact cause of hypermobility is not always clear, certain factors are known to contribute to its development:

Genetics: Genetic factors play a significant role in hypermobility. It tends to run in families, suggesting that certain genes may influence the structure and integrity of connective tissues, including ligaments and collagen. Specific genetic mutations can be associated with conditions such as Ehlers-Danlos syndrome (EDS), which is characterised by hypermobility and other connective tissue abnormalities.

Connective Tissue Structure: The composition and structure of connective tissues, such as collagen, elastin, and other proteins, can affect joint stability and flexibility. Variations in these tissues can lead to increased joint laxity and hypermobility.

Hormonal Factors: Hormones, such as estrogen, can affect the flexibility of connective tissues. This is why hypermobility can be more common in females and may fluctuate during different life stages, such as puberty and pregnancy.

Physical Activity: Certain physical activities or sports that involve repetitive joint movements or overuse can contribute to hypermobility. Athletes and dancers, for example, may develop increased joint flexibility due to training and stretching routines.

Biomechanical Factors: Individuals with certain body mechanics or alignment issues may be more prone to hypermobility. Poor posture or muscle imbalances can affect joint stability and contribute to joint laxity.

Inherited Conditions: Some genetic disorders and syndromes, such as Marfan syndrome and Down syndrome, can be associated with hypermobility as part of their broader symptom profiles.

Environmental Factors: Environmental factors such as nutrition, physical activity levels, and overall joint health can also influence the development of hypermobility.

It's important to note that while hypermobility can be a normal variation in some individuals without causing problems, it can also be associated with medical conditions like Ehlers-Danlos syndrome or joint hypermobility syndrome. In some cases, hypermobility may lead to joint instability, pain, or an increased risk of injuries. If hypermobility is causing discomfort or impairments, consulting a medical professional is recommended. A healthcare provider can perform a thorough evaluation, provide guidance on managing symptoms, and recommend appropriate treatment options.

Diagnosing hypermobility involves a combination of medical evaluation, physical assessments, and sometimes additional tests. A healthcare provider, often a rheumatologist or orthopedic specialist, can determine if an individual has hypermobility and whether it is causing any related symptoms.

Here's how hyper mobility is typically diagnosed:

Medical History: The healthcare provider will gather information about the individual's medical history, including any family history of hypermobility or related conditions.

Physical Examination: The Beighton Score is a commonly used assessment tool to evaluate joint hypermobility. It involves testing several specific joints for their range of motion. Points are assigned for each joint that meets certain criteria for hypermobility.

Beighton Score: The Beighton Score consists of several maneuvers to assess joint flexibility:

Hyperextension of the elbows beyond 180 degrees

Hyperextension of the knees beyond 180 degrees

Ability to place palms flat on the floor with knees extended

Ability to touch the thumb to the forearm when the wrist is flexed backward

Ability to hyperextend the small finger beyond 90 degrees

Additional Clinical Examination: The healthcare provider may perform a full physical examination to assess for any associated symptoms, such as joint pain, skin elasticity, or muscle weakness.

Diagnostic Criteria: Based on the Beighton Score and the presence of other clinical signs or symptoms, the healthcare provider will determine if the individual meets the criteria for hypermobility.

Differential Diagnosis: The healthcare provider will rule out other conditions that can mimic hypermobility, such as connective tissue disorders like Ehlers-Danlos syndrome, or conditions that can cause joint laxity and pain.

Laboratory Tests: In some cases, blood tests may be conducted to rule out underlying medical conditions, especially if hypermobility is associated with other symptoms.

Imaging Studies: Imaging, such as X-rays or MRI scans, may be performed to assess joint structure, alignment, and any potential joint damage.

It's important to note that hypermobility itself is not a medical condition, but rather a characteristic of joint flexibility. However, if hypermobility is causing pain, discomfort, joint instability, or other issues, it might be indicative of an underlying condition such as Ehlers-Danlos syndrome. In such cases, the healthcare provider will conduct further assessments to determine the appropriate diagnosis and develop a treatment plan tailored to the individual's needs. If you suspect you have hypermobility or related symptoms, consulting a medical professional is recommended for a thorough evaluation and proper guidance.

The treatment for hypermobility depends on whether it is causing any symptoms or complications. While hypermobility itself is not a medical condition, individuals who experience pain, joint instability, or other related issues may benefit from various management strategies.

Here are some approaches that can be considered:

Physical Therapy and Exercises: Working with a physical therapist can help strengthen muscles around hypermobile joints, improving joint stability and reducing the risk of injury. Therapists can design tailored exercise programs to address specific areas of concern.

Pain Management: Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage pain associated with hypermobility. However, it's important to consult a healthcare provider before using any medication.

Orthopedic Supports: Orthopedic devices, such as braces or splints, can provide additional joint support and stability, especially during activities that may strain hypermobile joints.

Lifestyle Modifications: Practicing good posture and body mechanics can help prevent strain on hypermobile joints. Avoiding overstretching or hyperextending joints beyond their comfortable range of motion is important.

Muscle Strengthening: Engaging in regular strength training exercises can help build muscle around hypermobile joints, providing better support and stability.

Joint Protection: Learning how to protect joints during daily activities can help minimise strain and prevent injury. Simple changes in movement patterns can make a significant difference.

Hydration and Nutrition: Staying hydrated and maintaining a balanced diet can support joint health and overall well-being.

Pacing Activities: Individuals with hypermobility may need to pace their activities and avoid overexertion to prevent joint strain and fatigue.

Occupational Therapy: Occupational therapists can provide strategies for performing daily activities while minimising stress on hypermobile joints.

Education: Learning about hypermobility, understanding one's own limitations, and following recommended strategies can help individuals manage their condition effectively.

It's important to note that treatment approaches should be tailored to each individual's needs and symptoms. Consulting with healthcare professionals, such as rheumatologists, orthopedic specialists, or physical therapists, can help develop a comprehensive treatment plan that addresses specific concerns and improves overall quality of life. If hypermobility is associated with an underlying condition, such as Ehlers-Danlos syndrome, the treatment plan may involve managing the broader range of symptoms and potential complications associated with that condition.

Supporting someone with hypermobility involves understanding their unique challenges and offering assistance that helps them manage their condition and maintain their well-being.

Here are some ways you can provide help and support:

Educate Yourself: Learn about hypermobility, its symptoms, and potential challenges. This will help you better understand the person's experiences and offer appropriate support.

Listen and Validate: Be a good listener and offer empathy. Acknowledge their experiences and any difficulties they may be facing due to hypermobility.

Encourage Medical Evaluation: If the person is experiencing pain, discomfort, or other symptoms related to hypermobility, encourage them to seek medical evaluation and guidance.

Offer Practical Support: Assist with daily tasks that might be challenging for them due to joint instability or pain. This could include carrying heavy objects, opening jars, or other activities.

Promote Gentle Exercise: Encourage them to engage in appropriate exercises that help strengthen muscles around their joints. Activities like swimming, yoga, and low-impact exercises can be beneficial.

Help with Joint Protection: Offer guidance on maintaining good posture and using proper body mechanics to avoid unnecessary strain on joints.

Provide Emotional Support: Living with hypermobility can be emotionally challenging. Offer a listening ear, understanding, and encouragement.

Accompany to Medical Appointments: Offer to accompany them to medical appointments, take notes, and ask questions. Having a supportive presence can help them feel more comfortable.

Learn about Treatment Options: Familiarise yourself with the different management strategies for hypermobility, such as physical therapy, exercises, and pain management techniques.

Encourage Self-Care: Promote self-care practices that contribute to their overall well-being, such as staying hydrated, eating a balanced diet, and getting adequate rest.

Be Patient: Recognise that hypermobility can lead to fluctuations in symptoms. Be patient and understanding if they need to adjust their activities or routines.

Respect Their Choices: Respect their decisions about treatment, exercise, and lifestyle modifications. Offer guidance, but ultimately let them make informed choices about their health.

Raise Awareness: If they are comfortable, raise awareness about hypermobility and its challenges among friends, family, and peers to foster understanding and support.

Be Mindful of Triggers: Be aware of any triggers that could worsen their symptoms, such as excessive stretching or repetitive movements, and help them avoid these triggers when possible.

Celebrate Achievements: Celebrate their achievements, whether they're related to managing symptoms, reaching exercise goals, or making positive lifestyle changes.

Remember that each person's experience with hypermobility is unique. By offering practical assistance, emotional support, and understanding, you can help improve their quality of life and make their journey with hypermobility more manageable.