Introduction
Hypermobility means that a joint has more movement than usual. 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.
People who are hypermobile will be very flexible and so may have found it easy to do sports like gymnastics or dance; or they might find that they can ‘party tricks’ with their joints by moving like a contortionist. 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.
Diagnosis
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.
| 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 90degrees towards the back of the hand | 1 |
Treatment & Management
If you have hypermobility, it is important that you look after your joints. You can do this by avoiding stretching the joints beyond normal limits or doing ‘party tricks’ with your joints. 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.
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.
If the pain levels are high then you will be advised initially on 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. 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.
Hypermobility is a condition that needs managing in the long term. The primary form of management is to avoid moving the joints through excessive ranges and to strengthen the muscles around the affected joints.
