When is hypermobility a stretch too far?
As an Osteopath I often see patients whose hypermobility is contributing to their symptoms.
Joint hypermobility is when you have very flexible joints that move beyond their ‘normal’ range. It is said up to 1 in 4 people in the UK* are hypermobile and this can be anything from asymptomatic and advantageous in the person’s life (for sports, dance, their career) to symptomatic causing daily pain, stiffness and fatigue, in which case it is called a ‘hypermobility syndrome’.
The most common of these syndromes are Hypermobility Spectrum Disorder (HSD) and Hypermobile Ehlers Danlos Syndrome (hEDS) but hypermobility can also be a sign of other conditions.
HSD and hEDS are hereditary connective tissue disorders that result in weaker collagen and therefore weaker or looser ligaments which are the main support for joints.
How to spot the signs
As babies and children are naturally more flexible and most will grow out of it, it can be hard to spot hypermobility issues before teenage. But if your child fatigues easily from exercise or prolonged sitting or standing, often sprains their joints (typically ankles) and/or complains of evening or night pain in the legs, it is important to investigate why, and to consider hypermobility, after more serious potentials have been ruled out.
Paradoxically, adults often present as stiff, achy and easily fatigued (rather than overly flexible) as their postural muscles are working harder to support their under-supported joints.
Whilst you cannot cure hypermobility, there is so much you can do to improve your symptoms from: strengthening exercise, manual therapy and adopting better work and life postures that will reduce strain and improve your quality of life. It is also important to be aware of how generalized hypermobility can affect other parts of your body such as your mental health through an altered neurological system, bowel and bladder function and cardiovascular function.
Other possible symptoms:
- Joint and muscle pain and stiffness.
- Evening and night pain/aches.
- Clicking joints
- Dislocating joints
- Prone to joint sprains and strains
- Fatigue easily from both exercise and rest.
- Bruise easily
- Poor balance and coordination
- Headaches
- Thin stretchy skin
- Dizziness and fainting
- Bowel or bladder problems (such as constipation, heartburn or urinary incontinence)
- Higher risk of anxiety and depression
- Potential associations with Fibromyalgia and Chronic fatigue Syndrome.
Whilst you cannot cure hypermobility, there is much you can do to improved your symptoms:
Strengthening
The most important action you can take. Get advice on the most appropriate joint strengthening exercises for you e.g. isometric and closed chain exercises to ensure joint stability and balance exercises to improve proprioception. Potentially useful equipment: resistance bands; stress balls and wobble boards.
Manual therapy
Osteopathy can greatly help to reduce pain and restore natural mobility. Hard working postural muscles become overly tight in hypermobility becoming inefficient and easily fatigued so massage and gentle stretching are important to improve circulation and reset.
Posture
Ensure your school/work posture is well supported with the right chair and desk set up and that you regularly get up and move about to avoid fatiguing joints.
Potentially useful equipment: pencil/ pen grips, sloping work stations and wrist supports.
Pain management
Counselling, alternative therapies, meditation and/ or medications.
Footwear
Supportive outdoor shoes or boots with arch supports where necessary will protect from plantar fasciitis, fatiguing feet arches and ankles that are prone to spraining. Bare feet/grippy socks rather than slippers at home for strengthening.
Diet/lifestyle
Eat a varied diet including foods rich in protein, Vitamin C, copper and zinc. Avoid smoking, overexposure to UV and excess sugar.
Whatever your level of hypermobility we are here at the Odiham Clinic to help you find out what you can do and how to achieve your best quality of life.
*Figure from Dr Neha Issar-Brown at VersusArthritis.