Do you remember someone from your childhood who was flexible and bendy? And when I say flexible I mean REALLY flexible!
They probably called themselves double-jointed and could perform eye-watering feats like hooking a foot behind their head, bending over backwards or easily doing the splits.
Perhaps that person was you?
Double-jointed is a layman’s term for hypermobility, a condition where our body’s connective tissue is too stretchy meaning our ligaments and tendons do not provide adequate support to our joints. This leads to more movement at those joints than we would otherwise expect to have.
Hypermobility does not itself cause pain, and most people who have hypermobile joints live pain-free. However, pain can arise when our joints are moving more than normal, past their usual end of range, putting stress on the ligaments, muscles and tendons and on the joint surfaces themselves. When a patient experiences this type of pain for longer than 3 months we call it joint hypermobility syndrome (JHS), sometimes written as benign joint hypermobility syndrome (BJHS).
As well as being overly stretchy, patients with joint hypermobility often have problems with joint proprioceptors, the sensors that provide information about joint angle, muscle length, and muscle tension, which give us information about the position of our limbs in space.
Patients who have been diagnosed with Elhers-Danlos syndrome, Marfan syndrome or Loeys-Dietz syndrome are at greater risk of pain from joint hypermobility.
It is important for osteopaths to identify hypermobile patients as this will allow us to tailor our treatment plans effectively.
Could you be hypermobile?
Take the test!
The Beighton Score is a straightforward series of clinical tests that determine if you have an excessive amount of joint laxity. Those tests are:
1. Passive dorsiflexion of the little fingers beyond 90° – 1 point for each hand
2 Passive apposition of the thumbs to the flexor aspects of the forearm – 1 point for each thumb
3 Hyperextension of the elbows beyond 10° – 1 point for each elbow
4 Hyperextension of the knee beyond 10° – 1 point for each knee
5 Forward flexion of the trunk with knees fully extended so that the palms of the hands rest flat on the floor – 1 point
A score of 4-6 upwards is indicative of hypermobility in a young adult.
The good news for patients is that pain caused by joint hypermobility is manageable and is considered as non-progressive, especially because joint laxity reduces as we age.
If you have symptoms from joint hypermobility then a combination of treatments including rest, exercise and manual therapy, such as osteopathy will often help.
Here's some advice!
- Don’t lock out your joints. For example, don’t allow your knees to hyperextend.
- Your osteopath will be able to advise you on exercises, but you should be careful to avoid over stretching joints.
- Gentle stretching often helps.
- Patients often find that doing strengthening exercises every day helps to strengthen the muscles that control their joints, improve their joint proprioception and reduce their symptoms.
Clinic Blog Author: Phil Waddell BSc.(Ost.)
Phil came to Devon from the West Midlands in 2014. He qualified from the College of Osteopaths and treats a broad range of patients using a structural and holistic approach.
Before quallifying as an osteopath, Phil was a Communications Officer in the Army.
He is married to Julie and they have 2 children, Anna and James. Phil enjoys cycling and coaching the Totnes Rugby Club Under 10s team.