Joint hypermobility is the ability of the joint to move through a range more than what is considered normal. This may or may not result in problems for someone who is hypermobile. It can increase the risk of injury or enhance sports performance and is found to be more common in females than in males. Joint hypermobility can present in one or more joints and can be caused by trauma, training or genetics. For example, swimmers often have hyper-extended knees and gymnasts have increased hip range of movement.
Signs of hypermobility using the Beighton Hypermobility score
- Able to bend your pinky beyond 90 degrees.
- Able to touch your forearm with your thumb.
- Your elbow extends 10 degrees beyond the normal range.
- Your knee extends 10 degrees beyond the normal range.
- Ability to place the palms of your hands flat on the floor while keeping your knees straight.
Problems associated with joint hypermobility
- Skeletal symptoms such as joint instability (subluxation* and dislocation), persistent joint pain, reduced bone density and scoliosis.
- Soft tissue symptoms include tendinitis, tendinosis, fasciitis, bursitis and tendon ruptures.
- Gastrointestinal issues such as acid reflux, nausea, abdominal pain, etc.
- Neurological issues such as proprioceptive** deficits, headaches, migraines, paresthesia***, attentive deficit hyperactive disorder, etc.
- Dermatological conditions such as hyperextensible**** skin, slow wound healing and easy bruising.
- Urogenital conditions such as urinary incontinence, urinary tract infections, prolapses, pelvic pain, etc.
How can physiotherapy help?
Physiotherapy can help with exercise training which would improve strength and proprioception. Physiotherapists can help you progress your training appropriately to avoid overloading and irritating unstable joints and muscles. Exercise prescription and progression can help with endurance and cardiovascular training, while ensuring that there is decreased risk of injury. Your physio can also help with bracing which provides external support and provides proprioceptive inputs. They can also help with pressure garment prescriptions which allow for venous flow.
* A subluxation is an incomplete or partial dislocation of a joint or organ.
** Proprioception is the ability to know where and how your body is oriented in your surroundings.
*** Paresthesia is the feeling of tingling, numbness or “pins and needles.”
**** The ability to stretch the skin beyond the normal range. When the skin is stretched, upon release, it recoils back to its original shape as elasticity of the skin is retained.
References
1. Burlington sports, https://burlingtonsportstherapy.com/wp-content/uploads/2020/11/flexible-wrist.jpg
2. Physiopedia: https://www.physio-pedia.com/images/8/82/Beighton_Score.png