Joint Hypermobility
Syndrome

If you have ever entertained your friends with bodily contortions, excelled at ballet, yoga or gymnastics, or been called “double-jointed,” you probably have hypermobile joints. Hypermobile joints are able to extend beyond what is considered “normal” range of motion.
Joint hypermobility is fairly common, affecting up to 15% of the population, with women affected three times more often than men. Most people with hypermobility experience no problems whatsoever with their lax joints, but others suffer chronic pain and other symptoms. When joint hypermobility is symptomatic, the condition is called joint hypermobility syndrome, or JHS.
While hypermobility can be advantageous in certain sports and activities, hypermobile joints can also be highly unstable, making you vulnerable to injury. As you age, joint hypermobility can contribute to balance issues that set you up for a fall. Hypermobile joints are more vulnerable to premature osteoarthritis caused from wear-and-tear.

Causes of Joint Hypermobility

The primary cause of joint hypermobility is loose or elongated ligaments within the joint capsule. The condition is thought to be hereditary, and can occur as a result of longer than normal ligaments that attach bone to bone at a joint, or to weakened or excessively elastic connective tissue. Weak and overstretched muscles and tendons can increase and contribute to hypermobility.
Hypermobility is most commonly observed in the joints of the extremities, including:
  • ankles
  • knees
  • shoulders
  • elbows
  • wrists
  • fingers
However, joint hypermobility can also affect the head, neck, trunk and low back, and may contribute to spinal issues like neck strain and low back pain.
Activities like dance, gymnastics and yoga can contribute to joint hypermobility as muscles and connective tissue are deliberately stretched to meet performance demands.

JHS Symptoms

While many hypermobile people never report health problems associated with loose joints, others may experience symptoms ranging from nagging to severe.
Common symptoms associated with JHS include:
  • pain and stiffness in joints and muscles
  • clicking or popping joints
  • joints that are easily dislocated
  • chronic fatigue
  • recurrent injuries such as sprains
  • digestive issues like constipation and IBS
  • thin or stretchy skin
When occurring in conjunction with hypermobility, these symptoms indicate JHS.

Ehlers-Danlos Syndromes (EDS)

One unique subset of JHS are Ehlers-Danlos Syndromes, a group of connective tissue disorders characterized by hypermobile joints, hyperelastic skin and fragile tissues. To date, 13 subcategories of Ehlers-Danlos Syndrome have been identified, each with its own peculiar characteristics. The syndromes are thought to be hereditary, and many symptoms overlap from one category to the next.
Most symptoms of Ehlers-Danlos Syndromes affect the joints and skin, which are often fragile and painful:
  • Joints: Joints are loose and unstable, and often painful and prone to dislocation.
  • Skin: Skin is velvety-soft and tears and bruises easily; wounds heal slowly.
  • Less common: Fragile arteries, intestines and uterus; scoliosis, poor muscle tone, mitral valve prolapse and gum disease.

JHS Diagnosis

In addition to reviewing your health history and reported symptoms, your therapist may ask you to complete a brief questionnaire to confirm JHS.
Questions may include:
  • Are you able to bend forward and place your hands flat on the floor without bending your knees?
  • Can you bend your thumb far enough to touch your forearm?
  • Can you now or have you ever been able to perform a full split?
  • Have you in the past experienced frequent dislocations of your shoulders, elbows or knees?
  • Have you often been called “double-jointed?”
A physical exam may ensue, and an instrument called a goniometer may be used to measure your joint angles. Diagnostic real-time ultrasonography may be incorporated to view joints and muscles in motion.

Treatment for JHS

While there is no cure for JHS, the condition can be managed through physical therapy and exercises geared to balancing muscle tension at the joints and strengthening the muscles and tendons that contribute to joint integrity.
Real Time Ultrasound Imaging may be used to help you retrain deep muscles to build protective support around your joints. Good postural control is critical, and therapy sessions may incorporate corrective exercises. Computerized gait analysis may help identify deficiencies in movement that put you at greater risk for injury and dislocation of joints while walking or running.
If you are athletic or physically active, treatment may involve additional coaching for your sport or activity to improve safety and promote joint stability. Additional joint support like elastic bandages, athletic taping or padding may be recommended during physical activity to reduce your risk of injury.
If you have a family history of JHS, or if you have experienced past injuries associated with hypermobility, taking a proactive approach can spare you undue pain and expense. A physical therapist can help improve the integrity of your joints, and can prescribe an exercise regimen to help maintain optimal joint function and mobility.

Treatment for JHS in NYC

If you are experiencing symptoms of JHS, or if your hypermobile joints are limiting your ability to remain physically active, the sports medicine team at NYDNRehab can help. We combine state-of-the-art technology with world-class expertise to give our patients the very best care and treatment. Make an appointment with the professionals NYDNRehab today, and see why we are the very best clinic for rehabilitation in NYC.
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