Hypermobility

Find out more about Hypermobility from one of our Physiotherapists Jean

Have you ever been told that you are ‘double jointed’? Or had a crazy flexible party trick when you were younger? Hypermobility is actually quite common and roughly 1 in 10 people have some form of hypermobility that can range from one joint to throughout the entire body. 

 

What does hypermobility look like?

Hypermobility looks different in everyone so it’s hard to describe what it may typically look like. Some people may just be a little more flexible in joints but without causing any issues while others can experience recurrent subluxations, dislocations and even gastrointestinal or cardiovascular distress. There are many subtypes of hypermobility, with more being discovered as research continues. If you are unsure whether you are hypermobile or not, one of our physiotherapists will be able to run through some tests to determine whether you are hypermobile, and whether further referrals are needed to ensure you are as healthy as you can be. As some types of hypermobilities can lead to connective tissue defects e.g. blood vessels, heart issues, it is important that these are examined if this is suspected. 

 

What causes hypermobility? 

Local hypermobility (hypermobility in one joint) can be caused by a previous injury – like when you badly sprain your ankle and it has just always been more loose than the other side since. Other causes of hypermobility can be genetic, such as Ehlers-Danlos (hEDS). 

 

How is hypermobility diagnosed?

There are many ways to diagnose hypermobility, depending on what kind of hypermobility you are looking for. There are 12 subtypes of Ehlers-Danlos syndrome which can be diagnosed with genetic testing except for the hypermobile Ehlers-Danlos (hEDS) variant which has still not been discovered. You can, however, be hypermobile without having Ehlers-Danlos – lots of people lie in the hypermobility spectrum instead. 

 

One of the many diagnostic tests for hypermobility include the Beighton Score as pictured:

beightonscore physiotherapy

The criteria are:

  • Being able to extent/pull your pinky finger back by over 90 degrees (1 point for each side)
  • Being able to touch your thumb to your wrist (1 point for each side)
  • Extending your elbow beyond neutral by > 10 degrees (1 point for each side)
  • Extending your knee beyond neutral by > 10 degrees (1 point for each side)
  • Being able to put palms flat on the ground with knees straight 

As children are more naturally flexible, a positive score is considered 6/9 and above

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

 

The Beighton score is not a comprehensive tool for diagnosis – you can test negative on it and still be hypermobile, or score positive on it and not be hypermobile. Having previous injuries can make your joints more flexible than usual, causing false positives in the Beighton Score. As we age, we also become less flexible and may score lower on the Beighton when there would have previously been a positive score. 

 

If you are at all unsure about whether or not you are hypermobile, your physiotherapist will be able to discuss your signs and symptoms, assess your joint mobility, discuss any family history or history of injuries and point you in the right direction for treatment and management.

 

How is hypermobility treated?

 

There is no cure for hypermobility but it can be treated and managed. It is so important to take care of our joints by strengthening around them to provide the support and control needed to maintain joint health as we age. In particular, people with hypermobility will have poorer spatial awareness of their joints (proprioception), slower healing and sometimes problems with building muscle. They may have joints with repeated subluxations or dislocations that need to be strengthened to prevent further injury as well. Many people with hypermobility also struggle with posture, leading to chronic neck, upper and lower back pain. 

 

If you are hypermobile and are experiencing any of these symptoms, it is highly recommended that you see a physiotherapist who can guide you to build up your joint stability, control on strength. As those with hypermobility often struggle with joint stability and control, they tend to compensate with other muscles. Clinical Pilates is an excellent low-impact way to build up our stabilisers and control. 

 

To book an assessment with one of our Physiotherapy team click here