In my practice as a physiotherapist, I often see people presenting with pain that appears for no apparent reason. There is no trauma or noticeable injury, however there is pain particularly in the joints. Sometimes these people have pain because they have hypermobile joints.
Joint Hypermobility Syndrome affects the joints and bones allowing them to go beyond the normal range. This disorder has also been termed double-jointed. It is part of a group of Connective Tissue Disorders which has gained more understanding and attention from the medical fraternity over the past 2 decades.
Joint Hypermobility Syndrome can bring with it an array of symptoms that can cause joint pain, and sprains, joint dislocations, and a predisposition to osteoarthritis in later life.
What are the features of Joint Hypermobility Syndrome?
* Hypermobile joints tend to be inherited
* Joint hypermobility often causes no symptoms and requires no treatment
* Frequent dislocations of the joints or ‘double jointed”
* When there are symptoms, they appear as pain in the knees, fingers, hips, and elbows. Treatments are customized for each person based on their presentation.
* Signs of the syndrome are the ability to place the palms of the hands on the floor with the knees fully extended, and the ability to touch the thumb to the forearm.
Joint hypermobility is also a feature of a rare, inherited, more significant medical condition grouped together as Heritable Connective Tissue Disorders These include Ehlers- Danlos syndrome (EDS), which is characterized by weakness of the connective tissues of the body affecting connective tissue beyond the joints. Joint hypermobility is commonly seen in people with Down Syndrome and in people with Marfan Syndrome.
Why do hypermobile joints become painful?
Hypermobile joints are capable of excessive motion beyond normal range and so they are susceptible to injury. The tissues surrounding the joint become overstretched with poor joint alignment. Consequently, there is a higher incidence of joint dislocation and sprains of involved joints. Scoliosis (curvature of the spine) occurs more frequently in people with hypermobile joints and can lead to back pain. Joint hypermobility tends to decrease with ageing as we become naturally less flexible. However, joint hypermobility can lead to degenerative cartilage and arthritis over time.
What can be done to help?
Often people with hypermobility avoid movement activities because movement will aggravate susceptible joints. They become deconditioned and experience muscle weakness and fatigue which only adds to their problem.
Strong muscles will help support joints and can help reduce pain if approached in the correct manner. It is important to avoid high impact activities that will expose the joints to a greater risk of injury. Work towards strengthening muscles and improving fitness with low impact activities. Swimming is perhaps the most ideal low impact activity. The muscles can improve strength using the natural resistance of the water. Additionally, swimming will improve cardiovascular fitness.
Pilates is also an ideal low – impact land-based form of exercise that will help to strengthen muscles without injuring joints.