Joint hypermobility (“double jointed”) is the term used when someone’s joints bend further than usual. Hypermobile people sometimes find they perform some activities better than others, e.g. dance, gymnastics or swimming. Up to 10% of the population have some joint hypermobility and women are affected three times more often than men.
Hypermobility may exist by itself and have no other symptoms or be part of a more complex diagnosis such as “Hypermobility Spectrum Disorder” or “Ehlers-Danlos Syndrome”.
For some people it can be associated with:
- Joint hypermobility can be associated with complete or partial joint dislocations called subluxations. This may result in injury to surrounding ligaments, tendons and muscles. Sometimes hypermobile people take longer to recover from injuries.
- Joint hypermobility can impact the autonomic nervous system which regulates the heart, blood vessels and the stomach. This may cause palpitations, dizziness, fainting, reflux, nausea, vomiting and constipation.
- Soft stretchy skin, which bruises easy bruising and skin scarring can be seen. Sometimes, the abdominal organs and pelvic floor may also be affected increasing risk of prolapse.
- Hypermobility may be associated with an increased risk of a chronic pain. Muscle stiffness and poor sleep may occur.
There is no blood test to diagnose generalised joint hypermobility. The diagnosis is usually made by history and clinical examination by a Doctor or Physio with experience in hypermobile patients.
The Ehlers-Danlos Syndromes (EDS) are a group of inherited disorders associated with hypermobility and soft tissue fragility. When there are signs of other organs being involved, a Geneticist may review you to consider whether genetic testing would be helpful. If present, cardiovascular and gastrointestinal symptoms should be investigated and managed by a specialist.
The most common form of EDS is the hypermobile type. There is no genetic marker for this syndrome. Diagnosis is based on a set of criteria including joint hypermobility/instability, soft tissue fragility, pain and family history.
The treatment of EDS and joint hypermobility spectrum disorder are the same. The treatment of joint hypermobility involves treating the symptoms, including pain and joint instability. Joint instability can be improved with consistent physiotherapy exercises aimed at strengthening the muscles surrounding the affected joints. Graded exercise and muscle strengthening is important to improve joint pain and fatigue. Hydrotherapy can be helpful to manage pain and the water provides resistance, it is very safe for unstable joints. Massage, taping and splinting are also therapies that a physio will use to help manage pain and instability in the hypermobile patient.
At Everybody Physio our whole team has experience managing hypermobile patients both in the hydrotherapy pool and in the clinic gym.