Hypermobility Services

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Hypermobility

 

Physiotherapists with extensive experience in managing musculoskeletal pain associated with hypermobility.

We are passionate about working to improve the health and wellbeing of people with hypermobility. 

At PhysioTec we assess whether joint hypermobility could be associated with the presentation of your pain/injury. In a single joint, hypermobility is a larger than normal joint range. This can be genetic or acquired through sport (eg dancing, or sports involving sharp changes of direction) or repetitive use.

Around 10% of the population are generally hypermobile and have multiple joints with a larger than normal flexibility. This simply means that they might consider themselves bendy or double jointed (or may have felt this way when they were younger). The collagen in their ligaments is stretchier, allowing the joints to move further than the average person. When this hypermobility is associated with pain in several areas it can be categorised as a Hypermobility Spectrum Disorder (HSD). Hypermobility can also be associated with Hypermobile- Ehlers Danlos Syndrome (hEDS) and some other rarer genetic conditions. In more complex presentations HSD and hEDS are also be associated with fatigue, digestion issues, headaches, dizziness, anxiety and sleep disturbances.

Not Sure if you are Hypermobile? Take this quick screening test.

(Hakim and Grahame, 2003)

  • Can you now (or could you ever) place your hands flat on the floor without bending your knees?
  • Can you now (or could you ever) bend your thumb to touch your forearm?
  • As a child did you amuse your friends by contorting your body into strange shapes or could you do the splits?
  • As a child or teenager did your shoulder or kneecap dislocate on more than 1 occasion?
  • Do you consider yourself double-jointed?

If you answered ‘Yes’ to 2 or more of these questions there is a high likelihood that you have joint hypermobility.

At PhysioTec we are aware that being extra bendy may be of very little daily issue for you or may be a major problem (this is a condition that is as different in each individual as your fingerprint). Those with hypermobility are more likely to develop arthritis and with an earlier onset than others, and may also have a higher risk of tendon conditions, nerve related pain and persistent pain. Remember, this is certainly NOT the case for everyone with hypermobility, but those who are hypermobile often need to be a little more pro-active in looking after their bodies. Understanding how to care for your joints and ensuring you have good muscle support is an important part of your long term management plan. We can provide a detailed physical assessment to accurately assess you and guide you in achieving your goals through advice and education, hands on techniques as required and the use of graduated, individualised exercise program.

At PhysioTec we are also aware that many “hypermobile” individuals actually experience a feeling of joint stiffness. The stiffness often develops as the body tries to find a way to become more secure. The large, superficial muscles will increase their activity all around a joint, in effect splinting it and restricting motion. Unfortunately this often has secondary effects. This excessive muscle activity makes movement and prolonged standing or sitting tiring. Our physiotherapists work to improve specific muscle function and efficiency. Initially we may use Real Time Ultrasound Scanning to train the deepest layer of muscles to better provide a protective ‘corset’ around your joints. We can then train you to maintain good control around your joints during everyday movements. Once you have improved muscle control around your joints, the feeling of 'stiffness' will usually improve.

Those involved in more demanding physical activity and sports will then require higher level training to maintain optimal control, safety and muscle efficiency during these tasks. We have team members who can guide you through training safely in the gym and during sport while working towards your physical goals. Many dancers are also more bendy than the average person and some may have been diagnosed with Ehlers Danlos Syndrome. We have a dance physiotherapy team who can assist you with your hypermobility and your dance performance.

We look forward to assisting you with achieving your goals, despite your hypermobility.

References:
Hakim AJ, Grahame R (2003). A simple questionnaire to detect hypermobility: an adjunct to the assessment of patients with diffuse musculoskeletal pain. Int J Clin Pract ;57(3):163-6.

Tinkle B, Castori M, Berglund B, Cohen H, Grahame R, Kazkaz H, Levy H (2017). Hypermobile Ehlers–Danlos syndrome (a.k.a. Ehlers–Danlos Syndrome Type III and Ehlers–Danlos Syndrome Hypermobility Type): Clinical description and natural history. Am J Med Genet, Part C Semin Med Genet; 175C:48–69.