What are the symptoms of joint hypermobility?

If you think you might be hypermobile, you’ll be happy to know you’re not alone. In fact, hypermobility or double-jointedness isn’t all that unusual.

We’ve all seen the “bendy” performers that can lay on their stomach, bring their legs over their own head and then somehow rest their feet on the ground next to their head!

But what does it mean for people like me and you, and how can you ease the symptoms if your joints are hypermobile?

What is hypermobility?

Joint hypermobility means you have a joint, or a group of joints, that are capable of moving passively and/or actively beyond normal limits. In other words, you’re more flexible than most people.

You’ll be amazed to know that 10% of the population are hypermobile but don’t worry, most people have no symptoms!! The majority of teenagers that are hypermobile excel at certain sports, such as: swimming, gymnastics, ballet, tennis, acrobatics, athletics and dancing.

The different types of hypermobility

Isolated hypermobility

If your joint hypermobility affects less than 5 of your joints, it’s known as isolated hypermobility. In these circumstances, it may be inherited, from past trauma, joint disease, surgery or training, for example, gymnastics.

Generalised joint hypermobility

If you’re got hypermobility in more than 5 joints, we use the term ‘generalised joint hypermobility’ (GJH). GJH has a spectrum; on one end it may not even be symptomatic and cause no pain…but you might be better at yoga than most (there’s always one!).

On the other end of the spectrum you could be experiencing a ton of issues including:

Widespread pain
Poor wound healing
Dislocations
Gastrointestinal problems
Fatigue
Dysautonomia (POTS)
TMJ (jaw pain)
Osteoarthritis
Osteoporosis
Scoliosis
Headaches
Migraines
Incontinence
Dental crowding and more.

Hypermobility type Ehlers-Danlos Syndrome

Even more uncommon is hypermobility type Ehlers-Danlos syndrome (hEDS), which is a hereditary connective tissue (collagen) disorder characterized by joint hypermobility, skin hyper-elasticity and widespread tissue fragility.

1 in 5000 people are thought to have Ehlers-Danlos Syndrome and 80-90% of those are cases of hEDS. There are now 13 different types of EDS. Research and understanding of hypermobility syndromes are continuously developing which means that the 2017 classification only best describes the current state of knowledge.

The Ehlers-Danlos Society have written a great article for “non experts” to explain all about hEDS.

Hypermobility Spectrum Disorders (HSD)

Hypermobility spectrum disorders (HSD) are a group of conditions related to joint hypermobility (JH).

HSD can only be diagnosed when other conditions have been excluded, for example Ehlers Danlos Syndrome (EDS), Rheumatoid Arthritis, SLE (lupus), Marfans or Downs syndrome, where joint laxity is part of the condition.

HSD is different from localized joint hypermobility and other disorders that have generalized joint hypermobility (GJH). GP’s often provide a referral to a Geneticist or Rheumatologist, for diagnosis, though diagnostic testing isn’t straightforward.

How can Physiotherapy help with joint hypermobility?

In lots of ways!

It’s widely accepted amongst the medical community that Physiotherapy forms one of the mainstays of managing the conditions of hypermobile EDS and hypermobility spectrum disorders.

Assessing your hypermobility

First, we can assess your level of hypermobility using the Beighton score. This is a nine-point scale that will look at areas such as hyperextended knees, thumb tips folding down onto the forearm and little fingers that bend back to 90 degrees.

When we assess teenagers, we often find that one parent, or both, are often hypermobile too. In many cases, the parent(s) are still struggling with the symptoms and appreciate the importance of understanding the condition at a young age and getting physiotherapy treatment. That’s why we like to assess young adults or children as soon as they start experiencing symptoms to make sure they can enjoy a pain-free life.

There’s a lot of great information for kids and teenagers with hypermobility to help understand their level of pain and how to control it.

Support, strengthening and sport

In some cases, we’ll suggest additional joint support using taping or bracing. Other times strengthening (resistance with body weight, theraband or dumbells) and closed chain exercises are needed to protect and stabilise the joints.

Sometimes we find that parents want to discuss which type of activity or sport is preferable for their child. It is really important for children with hypermobility to remain active to keep their muscles strong. Sometimes children with hypermobility experience pain when they exercise. When this is the case, low impact exercise is a gentler approach. Exercise in the pool and bike riding are good examples of low impact exercise.

The areas we can improve

Over time your physiotherapist will address impairments, compensatory movement patterns and fatigue. We will treat what we assess and find but unfortunately there isn’t one treatment that will suit all individuals.

We’ll work with you to improve:

Endurance
Balance
Co-ordination
General fitness
Proprioception (joint position sense
Postural muscles.

The treatment we offer at Progressive Physiotherapy Group in Warragul

There isn’t a magic wand to take away your pain, but our experienced physiotherapists will certainly be able to alleviate any discomfort.

The solutions we offer include:

Gentle hands-on treatment
A home exercise program
Teaching you some self-management techniques
Hydrotherapy
Educating you on pacing and sleep hygiene.

At Progressive Physiotherapy Group we offer longer appointments and the option of exercise rehabilitation groups for patients with hypermobility, so that with careful management your quality of life can improve.

Chronic pain and stress, anxiety and depression are common with HSD or hEDS. This is why pain neuroscience education (1:1 or in a group at Progressive Physiotherapy Group) can help greatly with this complicated syndrome.

All our physiotherapists will work closely with your team of health professionals to make sure you get a comprehensive and holistic treatment approach.

Move. Learn. Strengthen. Function.

What are the symptoms of joint hypermobility and how can Progressive Physiotherapy Group help?