Joint hypermobility and what you can do about it
Hypermobility is a common condition that is thought to affect at least 10-15% of the population. Hypermobility can affect people very differently. To have hypermobility means to have an excess of movement. For most people, this normally refers to an excess of movement in the joints and for these people, they are said to be ‘double-jointed’ or ‘extra bendy’. In reality, they are not double jointed at all. However, the ligaments that hold the joints together are slightly stretchier which allows the joint to move past its ‘normal’ range of movement. But it’s not just joints that can be extra mobile. In some kinds of hypermobility conditions, the extra stretch can also occur in the organs or blood vessels. This is a particularly dangerous type of hypermobility syndrome and leaves the sufferer vulnerable to dangers such as organ or blood vessel damage. However today’s blog focuses on the type of hypermobility that affects the joints. As an osteopath, I see it quite frequently in my patients and suffer with it myself. Having joint hypermobility can cause a wide range of symptoms and unfortunately cannot be ‘cured’ but like so many incurable conditions, it doesn’t have to affect the quality of life. As sufferers are affected differently, management should be tailored for the individual but I’ll explain some common starting points for where management can begin.
Hypermobility and joints
Joint hypermobility can be found:
· Locally – in one or two joints
· Peripherally – in the small joints of the fingers or toes
· Generalised – throughout the body
Ligaments are a type of connective tissue and are like little elastic bands that hold joints together. They have to be elastic enough to allow the joint to move. Too taut and the joint experiences stiffness, too loose (as is the case in hypermobility syndrome), and the joint can move too much. When a joint is too mobile, the ligaments require assistance from other surrounding structures to help support the joint. A lot of the time, this comes from the surrounding muscles. However, muscles already do a pretty demanding job. They are designed to contract, and in contracting, they allow us to move about. When they also start doing the work of a ligament in addition to their own, they can tire fairly quickly and this can lead to aches, pains and fatigue. Pain is an almost universal experience for patients with joint hypermobility syndrome. Over time, hypermobility can cause repeated micro-trauma to the joints leading to joint injury, instability and in some cases joint dislocation. In an effort to correct the imbalance at the joint, the body can subconsciously take on altered holding or movement patterns which can manifest as a leg length discrepancy, scoliosis or pelvis asymmetry.
Other conditions associated with hypermobility
Sufferers of joint hypermobility may show other signs of connective tissue weakness in the body. These can manifest as:
· Low blood pressure
· Irregular heart beat
· IBS – constipation, diarrhoea, sluggish bowel movements
· Pelvic floor weakness
· Recurrent bladder inflammation
· Bruising easily
· Food intolerances and/or allergies
· Painful periods in women/gynae problems
· Headaches and migraines
· Jaw pain/dysfunction – clicking, locking etc.
Children and hypermobility
Children who have a parent with hypermobility syndrome have a 50% chance of being affected although it is quite difficult to diagnose at a young age as children are more flexible by nature. Symptoms to watch out for in children include recurrent abdominal or bladder symptoms and ‘growing pains’.
As the problem in joint hypermobility lies within the ligaments, it is important to try not to stretch them any further than they already are. If you have joint hypermobility syndrome and do activities such as pilates and yoga, these should be adapted so any poses are not held at an end range. For example, in a yoga class, if you are asked to lean into warrior pose, rather than lunge as far as you can, lean into the pose gently and only until you can feel a slight stretch, not a strong stretch. This will activate the leg and core muscles, which helps to strengthen them as well as take pressure off of the ligaments of the hips and pelvis so they don’t overstretch.
The key to managing hypermobility and avoid pain related to hypermobility is to maintain good muscle strength. If the hypermobility is severe enough to cause regular dislocations, splints and braces are sometimes recommended.
As the key relies on maintaining good muscle strength, it is important to make strength training an important part of your weekly routine. This doesn’t mean you have to head into your local gym and start lifting weights, although of course you can do if you wanted. There are plenty of body weight exercises which are just as good at training muscle strength that you can do at home.
Good body weight exercises to start include:
· Box press ups
If your hypermobility causes problems in other parts of your body such as bowel problems, blood pressure issues, period pain, etc, it is important to discuss this with your GP so that you can maintain a good quality of life whilst remaining active. Although more studies need to be done to understand the complexity of hypermobility, we know enough for most people to live with it and still live happy, pain free lives. I’ve worked with patients with hypermobility for years and as a sufferer myself, I know the frustrations of what I call the ‘hypermobility flare ups’. But there are lots of things that can be done. This blog just scratches the surface of a very individual, complex condition. If you suffer with hypermobility or you’d like to know anything more about it, don’t hesitate to get in contact.