Does your child….
- Tire very quickly from walking?
- Seem unsteady or unbalanced when walking or standing?
- Trip over a lot?
- Have flat feet?
- Fall asleep in school?
- Struggle with their handwriting?
- Have very poor, slumped posture/unable to maintain upright posture?
- Have Joint ‘clicking’?
- Have “Double jointed limbs?”
- “W” sit?
Other less common features could also include constipation, stretch marks, stretchy skin, joint pain, late developmental milestones/not crawling, tip toe walking, restless legs, co-ordination problems, easy bruising, subluxations (partial dislocations), dislocations, unresolved injuries, dizziness, fainting, reflux, low confidence/self-esteem, and migraines.
Joint hypermobility (JHM) is where most of an individual’s joints move beyond the normal range taking into consideration age, gender and ethnicity (Hakim & Grahame 2004). When hypermobility is associated with signs and symptoms, it is termed “Hypermobility Syndrome” (Morris et al, 2016).
How common is it?
- Incidence of generalized joint hypermobility is approx. 30%
- More common in females
- More common in Asian and African populations
- Over represented in professional sports… 95% of ballerinas, 63% of elite netballers, 42% of cricket players, 44% soccer players.
Pacey et al, 2010 carried out a systematic review and found that Joint hypermobility is a risk factor for knee injuries in contact sports. In my 11 years of clinical experience, I come across a high incidence of patients which suffer recurrent ankle sprains, shoulder dislocations, back and knee pain, that also have JHM. These patients tend to take longer to rehab back to sports (Collinge & Simmonds 2009)…
- Some are weaker to start with/ or some loose strength quicker after an injury
- Poor recruitment/activation of muscles
- Muscles fatigue faster
- Poor proprioception
BUT… JHM is not a problem if you are fit and strong! As stated above, it is more common in sports people because it can actually help! BUT… it is only an asset if you have the strength and control in your joints through proper training and rehab.
If the above signs and symptoms are familiar to you or your child then an Orthopaedic assessment is advised. The doctor may then suggest Physiotherapy/Occupational Therapy treatment. This will include a thorough assessment, and agreed treatment goals. Treatment will be individualised to each patient’s needs. Physiotherapy may consist of a graduated exercise program that could include strength training, cardiovascular training, balance, proprioception, stability and control exercises (into full range of the joint (Pacey et al 2013)), core stability and posture work. Other treatments may include taping, manual techniques, pacing and strategies. General beneficial activities include swimming, Pilates and rock climbing. Orthotics management may also be recommended.
Why is treatment important for JHM/Hypermobility Syndrome?
- Improve sports performance
- Reduce fatigue
- Reduce symptoms including pain
- Improve posture
- Improve confidence and self –esteem
- Reduce risk of injuries
- Improve fitness
- Improve balance and core stability
- Improve control of the joints
I am happy to discuss further if you have any questions!
Useful website for more information: http://hypermobility.org/