Introduction
Hypermobility means that a joint has more movement than usual and they might find that they can do ‘party tricks’ with their joints by moving like a contortionist.
Signs & Symptoms
People who are hypermobile will be very flexible and so may have found it easy to do sports like gymnastics or dance. Moving your joints beyond their normal range can cause damage and pain within the joint and soft tissues surrounding it. Sometimes because one area of the body is hypermobile a different area of the body might feel stiff; this is your body’s way of compensating. Your skin may also be thin and stretchy.
Often people only find out that they have hypermobility after they are suffering pain. They may attend an appointment with a GP, First Contact Practitioner or Physiotherapist complaining of joint pain and assessment shows an increase in mobility in the joints and a positive Beighton score.
Causes
A joint can be hypermobile due to a change in a collagen make up in the soft tissues (ligaments and tendons); it can also be due to a change in the shape of the bone. The condition is normally hereditary and is due to a change in the proteins fibres in the collagen causing increased elasticity.
Assessment & Diagnosis
Your Physiotherapist will take a detailed history of your symptoms and will perform a comprehensive physical examination. Hypermobility is diagnosed based on the Beighton score. If you score 4 or more out of 9 from the list below you would be diagnosed as having hypermobility. Having a diagnosis will ensure the most effective treatment and management plan can be put in place. Your Physio will work with you to set goals based on what is important to you – this will also help them design a personalised self-management and exercise strategy for you.
| Movement | Score |
| Can place hands flat on the floor without bending knees | 1 |
| Can bend right knee backwards into hyperextension | 1 |
| Can bend left knee backwards into hyperextension | 1 |
| Can bend right elbow backwards into hyperextension | 1 |
| Can bend left elbow backwards into hyperextension | 1 |
| Can touch right thumb onto the back of the forearm | 1 |
| Can touch left thumb onto the back of the forearm | 1 |
| Can bend right little finger past 90 degrees towards the back of the hand | 1 |
| Can bend left little finger past 90 degrees towards the back of the hand | 1 |
Treatment & Management
If you have hypermobility, it is important that you look after your joints. Your Physiotherapist will most likely advise that you avoid stretching the joints beyond normal limits or doing ‘party tricks’ with your joints. If the pain levels are high then your Physiotherapist can recommend pain reduction techniques such as anti-inflammatory medication, ice and/or heat, rest, and gentle movement. If the pain continues to be difficult to manage it can be helpful to see a Physiotherapist.
Physiotherapy
Hypermobility is a condition that needs managing in the long term. It is essential that you stay strong and fit as there is no cure for hypermobility. If you have greater strength and stability, it will counteract the risks and subsequent issues that can develop as a result. At Pure we would use techniques such as graded exercise, massage, acupuncture or cupping to help your pain settle.
When the pain has settled it is important to establish an exercise programme that allows you to strengthen your muscles within pain free limits. Our Physiotherapists are specialised at grading the exercises for you and will prescribe you an individualised plan that will help you achieve the goals important to you. Regular re-assessment will ensure you are making progress and will make certain that suitable modifications can be made to ensure your programme is optimal. Your Physio will provide ongoing support and advice so that you can continue to self-manage.
