What is Joint Hypermobility Syndrome?


Joint Hypermobility Syndrome is the ability to stretch multiple joints past its expected normal range. Individuals with flexible joints are typically asymptomatic but others can develop fatigue and pain in their joints and muscles. This can limit their ability to participate in physical activity and extra care is needed to prevent common injuries associated with joint hypermobility, such as joint subluxations, dislocations and muscle injuries.


Causes


Causes of Joint Hypermobility are multifactorial, influenced by environmental and congenital factors and associated with many heritable connective tissues disorders such as Ehlers-Danlos Syndrome (EDS). EDS is a group of connective tissue disorders, the most common type is the hypermobile type (hEDS) and out of the 13, it is the only one with no identifiable genetic marker. And as such, accurate Diagnosis of EDS can take on average up to 12 years (Lara Bloom CEO of The Ehlers-Danlos Society).


Diagnosis


Physiotherapy Assessment typically begins with a detailed history including medical background and current sports and leisure activities. Most commonly, your hypermobile person will have naturally found themselves in sport that requires flexibility such as gymnastics and dance. Following, is a thorough physical assessment. One reliable assessment tool used is The Beighton Scoring System, a 9-point scale where higher the score, reflects more joint hypermobility. A referral back to your GP may be necessary where they will further investigate using the 2017 international diagnostic criteria.



Management


Physiotherapy management of joint hypermobility is determined whether the individual is asymptomatic or symptomatic. It must take into consideration other comorbidities associated with joint hypermobility, such as joint instability, chronic pain, fatigue, postural dizziness and gastrointestinal issues. An asymptomatic hypermobile person will benefit from education about the benefits of regular physical activity, postural ergonomics and being mindful of extreme contorting. A symptomatic hypermobile person will require more education about neuromuscular control and exercise prescription should entail joint stability exercises and overall endurance. Further intervention may include joint bracing as an adjunct to exercise to prevent injury whilst exercising, consideration of positions when exercising together with hydration to aid with fatigue and postural intolerances.


Joint Hypermobility Syndrome is a connective tissue disorder where multiple joints have the ability to stretch past its expected normal range. Physiotherapy can aid in assessing and treating by prescribing tailored exercises to enhance joint stability and prevent injury.


If you think you are a hypermobile person, whether that be the person at a family gathering with the flexible joint party trick or enduring in a sports where flexibility is required, reach out to one of our Physiotherapists to obtain evidence-based prevention and self-management tips.