Navigating Hypermobility/EDS
What is Hypermobility?
Joint hypermobility is when your joints are more flexible and have a greater range of motion than is expected. Most children are naturally flexible and become less flexible as they grow, however in about 20% of the population hypermobility continues into adulthood.
Joint hypermobility exists on a spectrum from increased mobility in a single joint, a few joints, or many. People with hypermobility do not necessarily have a connective tissue disorder or syndrome. Some people are simply hypermobile but do not have any symptoms that impact their daily lives.
Joint hypermobility is classified as: local, peripheral or general based on which joints are affected. Our physical therapists at Refuge Physiotherapy can evaluate your joints to determine if they are hypermobile.
One way to assess joint hypermobility is with the Beighton Score, which evaluates motion at the: fingers, thumbs, elbows, knees and spine. A positive Beighton score is any score greater than or equal to 5/9 points in adults or 6/9 points in children.
Ehlers-Danlos Syndrome (EDS) is a common condition that we do treat that is associated with hypermobility. According to the Mayo Clinic, EDS is a group of inherited disorders that affect your connective tissues, primarily your skin, joints and blood vessel walls. Connective tissue is a complex mixture of proteins and other substances that provide strength and elasticity to the underlying structures in your body. So, this makes sense why the need for rehab in many cases is necessary. There are different types of EDS but the most common is hypermobile EDS. EDS is more diagnosed in women vs men at a 7:1 ratio.
Is hypermobility a problem?
Hypermobility in itself is not a problem and it can be an asset in sports and dance. The problem occurs when joints become unstable. Hypermobility can overstretch ligaments and joint capsules, leading to increased joint laxity and reduced stability. This laxity allows for greater joint motion and can decrease your proprioceptive feedback, which allows for the control necessary to maintain a healthy range of motion. Proprioception is the body’s ability to sense its position in space, allowing for coordinated movement and balance without the need for direct visual input.
Hypermobility is not the same as instability but people with hypermobility are more prone to unstable joints, pain, and injury. Joint instability means the muscles around the joint may need to work harder which can lead to muscle fatigue and strain. Joint instability can cause both acute and chronic pain and may lead to heightened risk of injury, motor coordination issues, joint subluxations, dislocations, sprains, and other injuries.
The most common sports with hypermobile athletes include gymnastics, dance, figure skating, martial arts, swimming, and hockey. Although these athletes can have pain and injuries, being more mobile has its advantages too, such as running faster, jumping higher, avoiding certain injuries, throwing further due the mechanical advantages or having more motion.
Why do some people’s joints remain flexible while others tighten up?
This is due to the body’s production of collagen. Collagen is a protein that holds our joints and tissues together. In people with general joint hypermobility, collagen is not as strong or plentiful and this permits excessive joint motion.
Frequent injuries, such as sprains, strains, and even joint dislocations are common in people with general joint hypermobility. This is because their joints are more flexible than normal, making them more prone to injury.
Other symptoms that can accompany general joint hypermobility include: thin and fragile skin that bruises easily, digestive issues, chronic fatigue, anxiety, poor balance and coordination, or heart problems. This is because the body’s connective tissues, which include the tissues in the digestive and cardiovascular systems, can also be affected. According to the Ehlers-Danlos Society, people with the same type of EDS may experience different signs and symptoms ranging from: joint instability, pain, fatigue, GI issues, dysautonomia, headaches, and anxiety.
How do you treat a hypermobile joint?
Regular exercise that’s tailored to your specific needs and goals can help retrain your body and leads to improved joint control. Our therapists at Refuge Physiotherapy will guide you through an individualized exercise progression. We will work on slow, controlled movements in a moderate range of motion to help promote body awareness, joint proprioception, and joint control.
We will incorporate core strengthening exercises. Core strength provides better support for the entire body, helping to stabilize the spine and reducing strain on other joints.
You will be taught to limit overstretching and avoid pushing your joints beyond their natural range. Overstretching can cause microtears in connective tissue, making the joints even less stable.
We will work on promoting postural awareness and maintaining a neutral pelvis during sitting, standing, and walking.
If you have hypermobile joints, intentional, regular exercise will help you improve muscle tone and retrain your body to adapt to the unique challenges you face on a daily basis.
If you are prone to sprains and strains, reach out and schedule an initial evaluation with Refuge Physiotherapy so we can help empower you to improve your motor control and joint stability to improve your overall health and well-being!
