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Hypermobility Joint Syndrome: A Flexibility Discomfort

Hypermobility joint syndrome is a condition associated with the joints of your body. It is a syndrome in which people are more flexible in moving their hands, legs, etc. it is also known as a double joint syndrome. Mostly, children and young adults are affected by it. 

Here we talk about its treatments, diagnosis, exercises, etc. 

Hypermobility Joint Syndrome: An Overview

Joint hypermobility syndrome is a disorder of the connective tissues in your body. Ligaments are thick bands of tissue that help hold your joints together and prevent them from shifting too far out of range. These ligaments are loose or weak in persons with joint hypermobility syndrome. More flexible joints than usual characterise joint hypermobility syndrome, and it causes pain. 

You must have heard about joint hypermobility and joint hypermobility syndrome and thought them to be the same. However, these two are vastly different from one another. In addition, there is another syndrome called Ehlers- danlos syndrome. These three conditions are often mistaken to be synonymous but are distinct from each other. The following section will focus on these differences to clear all the confusion. 

Difference Between Joint Hypermobility Syndrome and Joint Hypermobility

Hypermobility of the joints is quite frequent. Your joints can move beyond their normal range of motion if you have hypermobility. It is also known as “double-jointed” alternatively. It indicates that your joints are pretty adaptable. Elbows, wrists, fingers, and knees are the most typically affected joints.

Joint hypermobility rarely causes discomfort or medical problems in most people. On the other hand, hypermobility joint syndrome can cause discomfort, ligament injuries, weariness, gastrointestinal issues, and other symptoms in some persons. The main point of difference is pain which is generated only during the joint hypermobility syndrome. There is no pain associated with joint hypermobility. 

The most prevalent age group for joint hypermobility syndrome is children and teenagers. Children recognised as female at birth, and those of Asian and Afro-Caribbean origin are more likely to be affected and it usually improves with age.

Other Medical Conditions Associated with Joint Hypermobility Syndrome

Joint hypermobility syndrome could indicate a more hereditary severe issue. Heritable Disorders of Connective Tissue are the name for these disorders (HDCT). In addition, joint hypermobility syndrome has linkages with the following rare medical conditions:

Ehlers-Danlos syndrome is a collection of disorders that impact your cartilage, bone, fat, and blood. A deficiency causes this disease in collagen, the protein that gives your connective tissue its flexibility and strength.Marfan syndrome is a connective tissue disorder that affects people. This disease happens due to a mutation in the gene that produces fibrillin and elastic fibres, essential connective tissue components.Down syndrome is a genetic condition affecting brain and body development. Down syndrome is a condition in which a person is born with an extra chromosome.

Symptoms Of Hypermobility Syndrome 

Hypermobility can result in various symptoms affecting various regions of the body. These symptoms can be mild to severe, and they can have a significant influence on a person’s life:

Joint and muscular discomfort and stiffness, especially at the end of the day and after vigorous activityJoints that clickBack and neck discomfortFatigue Insufficient coordinationSome people struggle with proprioception, which is the ability to sense the location of a joint without seeing it.Partial or total dislocations of the joints Ligament tears, sprains, and sports injuries are common soft tissue injuries.BruisingStomach ache Bowel and bladder issuesDizzinessSkin that stretches easilyAbnormal scarring

Causes 

Genetics is the primary cause of joint hypermobility syndrome. Hypermobility is typically inherited, and so one cannot prevent it. One in every two children usually has hypermobility if one parent has it.

Collagen, which is defective or weak, is common in people with joint hypermobility syndrome. Understand collagen as the glue that keeps your entire body together. When this glue does not work correctly, the ligaments become weak or strained, making them less effective at holding your joints together.

The shape of your bones is another reason you might suffer from hypermobility syndrome. For example, the range of motion in your hip or shoulder joint will be more extensive than usual if the socket section of the joint is shallow. 

Hypermobility is also Influenced By:

Muscle Tones

Your range of motion will be higher if your muscles are weak or relaxed.

Gender

This syndrome is more common in women than in men.

Age

As you age, the collagen fibres in your ligaments bind together more, which is one reason many become stiffer. When people are younger, they may be incredibly flexible and pain-free. Still, as they age, they may become less flexible, and stretching activities become more uncomfortable.

Ethnicity

The physical characteristics of people from various ethnic backgrounds vary. Indians, for example, have far more flexible hands than Europeans.

According to research, people with autism, ADHD, or Tourette’s syndrome are more prone to experience hypermobility symptoms.

Pathophysiology: Changes in the Body  

Although the leading cause of joint hypermobility syndrome is unknown, it appears to be caused by a systemic collagen defect. Collagen ratio abnormalities lead to this syndrome and other tissue conditions. In simple words, if there is an alteration in collagen, it could lead to joint hypermobility syndrome. 

Risk Factors

The most common kind of joint hypermobility is in youngsters, and it improves with age. However, while joint mobility is most prominent at birth, it begins to decline between the ages of nine and twelve.

There is a peak in joint mobility in teenage girls at the age of fifteen. After that age, joint mobility diminishes in both boys and girls. In addition, in adolescent girls, joint mobility gets affected by hormonal changes throughout puberty. 

The HealthifyMe Note

Hypermobility is more common in childhood, is more prevalent in girls than boys, and is more prevalent among Asian, African, and Middle Eastern populations.

Tests and Diagnosis

Your healthcare professional may perform a physical exam to assess your joint range of motion. Also, the doctor may prescribe blood testing to rule out any hereditary disorders.

Your healthcare practitioner may use a test or a questionnaire to assess your joint flexibility. The Beighton score assesses joint flexibility on a scale of one to nine. In each of the following, you’ll get one point:

Without bending your knees, you should be able to stretch and lean forward and put your hands flat on the ground.Backward elbow bend (one point each)Ability to bend your knees backwards (one point each)You can touch your wrists with your thumbs bent backwards (one point each).You can stretch your little fingers beyond 90 degrees backward (one point each).You may have joint hypermobility syndrome if you scored four or more points and have had discomfort in four or more joints for at least three months.

Your doctor may also ask you to fill out a five-point hypermobility questionnaire. The following are the five questions posed:

Can you put your hands flat on the ground without bending your knees now (or ever)?Can you bend your thumb to touch your wrist now (or ever)?Did you ever amuse your peers by twisting your body into weird shapes or doing the splits as a kid?Did your kneecap or shoulder dislocate more than once in childhood or adolescence? Do you believe you have two joints?

You may have joint hypermobility syndrome if your answer is “yes” to two or more questions from the above questionnaire. 

Treatments

Joint hypermobility syndrome currently has no cure. Safeguarding your joints and managing your discomfort are two essential aspects of treatment. You can protect your joints by exercising and strengthening your muscles.

 Additional suggestions include:

Maintain a healthy posture.Avoid severe ranges of motion by standing with your knees slightly bent.Wear shoes that provide adequate arch support.To help fix flat feet, use orthotics.See a physical therapist to seek help in alleviating the pain, building muscle strength, and improving posture and balance.

Best Exercise for Hypermobility Syndrome

Yoga and Joint Hypermobility Syndrome  

Yoga’s reputation for flexibility is well-deserved: 

Most styles feature poses that utilise the whole range of motion of the shoulders and hips.

Our connective tissue is born with a specific tone. Some people are inherently stiffer, while others are loose. For example, people with hypermobility have loose connective tissue, which means that connective tissue-based structures, including ligaments, tendons, and joint capsules, are more movable.

The innate tightness of the body protects the stiffer practitioner from overstretching in a highly dynamic activity like yoga. You may think this makes it easier for flexible yoga poses like a foot behind your head. But, on the contrary, joints must be stable to be effective. 

Does this imply that hypermobile individuals should avoid yoga? Certainly not! However, they must resist leveraging their natural mobility to reap the advantages of their yoga practice fully and instead try to create stability in their practice.

Safety Measures for Yoga During Joint Hypermobility Syndrome

Here are five pieces of safety and strength advice for hypermobile practitioners:

Keep your Joints Slightly Bent

Pay special attention to stances like plank, where you support your weight with straight arms. It will keep your joints stable if you micro-bend your elbow here so that you don’t rest on your ligament and instead force your muscle to make an effort. 

Straight-legged standing positions like a triangle (trikonasana) and pyramid pose should also be considered (Parsvottanasana). To maintain a micro bend in the knee, press against the ball of the foot while straightening the leg. Although the slight bend makes the posture feel more complex, you will be developing the strength that your joints require to stay functional.

Make Wise Choices when it Comes to Yoga Techniques

If you’re hypermobile, look for strengthening exercises rather than just stretching. For example, you are unlikely to stretch your connective tissue in class! Instead, Hatha and power courses may be a better fit for balancing your natural mobility and allowing you to strengthen it.

Protect your Knees with your Feet

When doing bent-knee standing poses, put your weight in your heels, and when doing straight-legged standing poses, put your weight in the balls of your feet. Maintaining your weight in the front leg’s heel during poses like extended side angle (Parsvakonasana) and warrior II (virabhadrasana II) will help take pressure off the front of the knee by working the glutes and reducing quadriceps drag. 

In poses with straight legs like pyramid and half-moon (Ardha Chandrasana), one puts pressure on the ball of the foot. It will urge the hamstrings to engage, resulting in a modest bending in the knee joint, preventing hyperextension.

Stabilise your Body

Keep the stretching tissues engaged in maintaining balanced muscle engagement. For example, pull your hands slightly towards each other in straight-arm exercises like a plank to stimulate the biceps. Therefore, prevent the full-range stretch of your hamstrings by drawing your heels in seated postures. For example, head to knees (Janu Sirsasana) or sitting forward fold (Paschimottanasana). While your muscle does not need to be fully recruited during these stretches, keeping them engaged will keep your joints balanced and prevent hypermobility. 

Don’t be a Thrill Seeker

It’s tempting to push the stance as far as possible when you’re flexible. After all, if you quit before completing a stretch, you might not “feel anything”. On the other hand, if you’re hypermobile, you generally don’t need to be more flexible; instead, you need to be more steady. Rather than aiming for your movement’s maximum range, aim for 80% of it. People often believe that to “get it”. you must be “feeling it”. Backing off (and not feeling a stretching sensation) can be ideal for hypermobile yogis in the long term. Make sure your ego isn’t driving the bus by checking in.

Asanas should be steady and easy according to the Yoga Sutra. Every practitioner, rigid or flexible, is encouraged to strike a balance between these attributes to build a sustainable and functional practice. The hypermobile has a lot of flexibility and needs to work more on the steady portion of the equation.

The HealthifyMe Note

Exercise is one way of treatment for joint hypermobility syndrome. It helps in strengthening the muscles around the joints. The strong muscles and tissues prevent extra flexibility of the muscle. 

Consult a Physiotherapist

In hypermobility syndrome, physical therapy addresses muscle inhibition, atrophy, and poor joint control caused by joint discomfort. Education is a crucial part of treating hypermobility syndrome. Patients who do not receive this education will continue to exceed the normal joint range, resulting in a more unstable joint. 

Joint hypermobility syndrome leads to fatigue, anxiety, and depression. Therefore, you should take steps to improve your quality of life. You can follow an active lifestyle by consulting a physiotherapist. Research shows that physiotherapy is an effective treatment for hypermobility joint syndrome. 

The Conclusion

“Don’t train to tiredness” is the golden guideline you should follow if you suffer from joint hypermobility syndrome. The muscles’ ability to stabilise decreases as they become weak due to tiredness. Instead of focusing on the number of reps to expand your boundaries, prioritise quality above quantity. 

Frequently Asked Questions (FAQs)

Q. How serious is hypermobility?

A. Hypermobility joint syndrome usually decreases with age. You should consult a doctor to remove all doubts. Since this condition may be genetic, it’s better to be cautious. You should try to improve muscle strengthening by yoga or consult a physiotherapist for the same. 

Q. Is hypermobility syndrome a disability?

A. No, it is not a disability. It is a condition when the joints are more flexible than usual. It would help if you did not put much body weight on a very flexible joint to avoid injuries. You should consult a doctor to remove all doubts.  

Q. Can joint hypermobility be cured?

A. Hypermobility generally goes away with age. In case it doesn’t there is, unfortunately, no cure. Precautions are the only remedy for it. You should try to improve muscle strengthening by yoga or consult a physiotherapist for the same. Alternatively, you can talk to a doctor to understand your condition better.  

Q. What causes joint hypermobility syndrome?

A. Genetics is the primary cause of joint hypermobility syndrome. Hypermobility is typically inherited, and so you cannot prevent it. One in every two children has hypermobility if one parent has it.

Q. How do you know if you have hypermobility?

A. A physical exam may be performed by a healthcare professional to assess your joint range of motion. The doctor may suggest blood testing to rule out any hereditary disorders. Your healthcare practitioner may use a test or a questionnaire to assess your joint flexibility. The Beighton score assesses joint flexibility on a scale of one to nine. Suppose the score comes to more than 4. It means you may be suffering from joint hypermobility. 

Q. How do you test for hypermobility in joints?

A. Your healthcare practitioner may use a test or a questionnaire to assess your joint flexibility. The Beighton score assesses joint flexibility on a scale of one to nine. In each of the following, you’ll get one point:

Without bending your knees, you should be able to stretch and lean forward and put your hands flat on the ground.Backward elbow bend (one point each)The ability to bend your knees backwards (one point each)You can touch your wrists with your thumbs bent backwards (one point each)You can stretch your small fingers beyond 90 degrees backward (one point each)

You may have joint hypermobility syndrome if you scored four or more points and have had discomfort in four or more joints for at least three months.

Q. Will I end up in a wheelchair with EDS?

A. Ending up in a wheelchair will be an extreme condition. This extreme condition will only happen if you do not adequately care for the joints. If you consult a doctor and a physiotherapist and do yoga, you might not end up in a wheelchair. You might almost control the condition to a negligible level. So be cautious and follow the guidelines as your doctor says. 

Q. Is hypermobility syndrome an autoimmune disease?

A. No, it is not an autoimmune disease. Joint hypermobility syndrome is a genetic disorder. 

Q. What exercise is good for hypermobility?

A. Yoga is a good option for hypermobility. Strength training exercises like physiotherapy and other activities are also helpful. Please note that when you are starting with any exercise, start slowly and progress gradually. For example, stability should be your mantra in yoga poses rather than flexibility. 

Q. Is hypermobility linked to autism?

A. In a way, yes. Autism correlates with hypermobility. People who have autism have higher chances of joint hypermobility disorder. But it’s not the other way around.

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