Hypermobility Syndrome

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Hypermobility Syndrome is a condition that features joints that easily move beyond the normal range expected for a particular joint. The joint hypermobility syndrome is considered a benign condition. It is estimated that 10%-15% of normal children have hypermobile joints, or joints that can move beyond the normal range of motion. There is a tendency of the condition to run in families. It is felt that certain genes are inherited that predispose to the development of hypermobile joints. Genes that are responsible for the production of collagen, an important protein that helps to glue tissues together, are suspected of playing a role.

Hypermobility syndrome is also a feature of a rare, but more significant medical condition called Ehlers-Danlos syndrome that is characterized by weakness of the connective tissues of the body. This condition is inherited in specific genes passed on by parents to their children.

If, for one or more of the above reasons, you have hypermobile joints, then you may have the following symptoms. The most frequent symptom is pain. This usually happens after hard physical work or exercise, because your muscles have to work much harder if the joints are supple than if they are stiff. As a result, what doctors call an 'over-use' develops in the muscles around the joint. Athletes often experience this after hard training or after an event. Sometimes fluid collects inside the hypermobile joint, making it feel tense and stiff. This is probably because your body is trying to repair the small amounts of damage that are caused if the joint is over-stretched. Your pain will often get worse as the day goes on and improve at night with rest. Sometimes, however, pain also occurs at night.

If your hypermobile joints are caused by altered collagen protein, then collagen may also be weakened in other parts of your body. This can lead to hernias or varicose veins. You may also have a flat arch to your foot, and this can lead to foot ache particularly after standing for a long period. Backache may affect you if the base of your spine is particularly supple, sometimes as a result of one of the bones in the back (vertebra) slipping on another. This is called a spondylolisthesis.

These problems do not mean that you have a disease – they are just the unfortunate effects of having joints that are more supple than most.

Only some people with hypermobility syndrome develop these symptoms. For unknown reasons, a large proportion of hypermobile people do not have any symptoms or problems.

Hypermobility Syndrome generally results from one or more of the following:

  • Misaligned joints
  • Abnormally-shaped ends of one or more bones at a joint
  • A Type 1 collagen defect results in weakened ligaments, muscles & tendons. This same defective process also results in weakened bones which may result in osteoporosis and fractures
Abnormal joint proprioception

The condition tends to run in families, suggesting that there may be a genetic basis for at least some forms of hypermobility. The term double jointed is often used to describe hypermobility, however the name is a misnomer and is not to be taken literally, as an individual with hypermobility in a joint does not actually have two separate joints where others would have just the one.

Some people have hypermobility with no other symptoms or medical conditions. However, people with hypermobility syndrome may experience many difficulties. For example, their joints may be easily injured, and they may develop problems from muscle overuse.

It is important that the individual with hypermobility remain extremely fit - even more so than the average individual - to prevent recurrent injuries. Regular exercise and physical therapy or hydrotherapy can reduce symptoms of hypermobility, because strong muscles help to stabilise joints. These treatments can also help by stretching tight, overused muscles and ensuring that the person can use their full, hypermobile range of motion. Low-impact exercise such as Pilates is usually recommended for hypermobile people as it is less likely to cause injury than high-impact exercise or contact sports.

Moist hot packs can relieve the pain of aching joints and muscles. For some patients, ice packs also help to relieve pain.

. . . Medications
Medications frequently used to reduce pain and inflammation caused by hypermobility include analgesics, anti-inflammatory drugs, and tricyclic antidepressants. Some people with hypermobility may benefit from other medications such as steroid injections or gabapentin, a drug originally used for treating epilepsy.

. . . Lifestyle modifications
For many people with hypermobility, lifestyle changes decrease the severity of symptoms. For example:

  • If writing is painful, people may be able to reduce the pain by typing.
  • If typing is painful, they may try voice control software for their computer.
  • They should avoid over-stretching the joints - stretching to one's maximum capabilities may result in injuries. Just because they are able to stretch much further, doesn't mean that it is a good idea.
  • They should watch their posture to make sure they are standing or sitting up straight. Weakened ligaments and muscles contribute to poor posture which may result in numerous other medical conditions.

  • . . . Other treatments
  • Bracing to support weak joints may be helpful, but caution must be used not to weaken the joints further.
  • Those who are overweight should lose weight. The extra weight puts additional stress on the already weakened ligaments, making them more susceptible to injury.

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