Joint Hypermobility Syndrome

Joint Hypermobility  

Joint Hypermobility Syndrome (JHS) refers to a condition that features one or more joints in the body that have an unusually large range of movement. Joint hypermobility is what some people refer to as having “loose joints” or being “double-jointed”.  The joint hypermobility syndrome is considered a benign condition. Some people with hypermobile joints don’t have any joint related problems, and some others – such as ballet dancers, gymnasts and musicians – have benefits from the increased flexibility. However, there are many people with joint hypermobility that do have joint related problems such as joint pain, recurring sprains and instability on movement. 

Joint Hypermobility Syndrome Symptoms  

Because the joints are capable of excessive motion in people with the joint hypermobility syndrome, they are susceptible to injury. Symptoms include: 

• pain and stiffness (due to excessive wear) in the joints and muscles (e.g. knees, fingers, hips, elbows, ankles) 
• clicking joints 
• joints that dislocate (come out of the correct position) easily 
• fatigue (extreme tiredness) 
• recurrent injuries – such as sprains 
• digestive problems – such as constipation and irritable bowel syndrome (IBS) 
• dizziness and fainting 
• thin or stretchy skin 

If hypermobility occurs alongside symptoms such as these, it is known as joint hypermobility syndrome (JHS).

What causes Joint Hypermobility Syndrome? 

Joint hypermobility is often hereditary. One of the main causes is thought to be genetically determined changes to a type of protein called collagen. 

Collagen is found throughout the body – for example, in skin and ligaments (the tough bands of connective tissue that link two bones together at a joint). 

If collagen is weaker than it should be, tissues in the body will be fragile, which can make ligaments more stretchy and hence causing joints to be more mobile and less stable. Joint hypermobility is also a feature of a rare, inherited, more significant medical condition called Ehlers-Danlos Syndrome (EDS), which is characterized by weakness of the connective tissues of the body. Joint hypermobility is commonly seen in people with Down’s Syndrome and in people with Marfan Syndrome. 

How do we diagnose Joint Hypermobility Syndrome?  

JHS is diagnosed by examining affected joints and noting that they easily move beyond the normal range expected. For example, the middle of the fingers may bend backward more than usual. There is no blood test for hypermobility syndrome but your GP may carry out blood test and X-rays to rule out other conditions associated with joint pains, such as rheumatoid arthritis.  

The Beighton score is often used as a quick test to assess the range of movement in some of your joints. However, this cannot be used to confirm a diagnosis, because it is important to look at all the joints. 

The Beighton score consists of a series of five tests, the results of which can add up to a total of nine points. The score is worked out as follows: 

• one point if you can place your palms on the ground while standing with your legs straight 

• one point for each elbow that extends backwards  

• one point for each knee that extends backwards  

• one point for each thumb that touches the forearm when bent backwards  

• one point for each little finger that bends backwards beyond 90 degrees 

If your Beighton score is four or more, it is likely that you have joint hypermobility.

How do we manage Joint Hypermobility Syndrome? 

 If you have Joint Hypermobility (one or two joints presents Hypermobility and not a range of symptoms) that doesn’t cause any problems, treatment is not necessary. However, you may need treatment and support if you have joint hypermobility syndrome (JHS), which causes a wide range of symptoms, including joint pain and digestive problems. Treatment such as: 

Self management 

• ensuring you have a generally healthy lifestyle – including having a healthy diet and maintaining a healthy weight; this will help improve the strength of your joints and reduce the strain on them 
• adopting healthy sleeping schedules if you have trouble  
• staying as active as you can, but sticking to “low-impact” exercises, such as swimming or cycling to reduce strain on your joints 
• wearing comfortable and supportive footwear to support your ankles

Podiatry

• For some people with JHS, flat feet can be a problem. If someone has flat feet, that person has no arch in the inner part of their feet, which can put a strain on nearby muscles and ligaments. If you have problems with your feet, a podiatrist (a foot specialist) can recommend treatments such as special insoles to support your feet 

Physiotherapy/ Osteopathy  

Physical therapists use a variety of tools to help with JHS, such as:  

• Education of the expected range of movement  

• Control neutral joint position: identifying the abnormal resting position of symptomatic joints, re-training postural muscles to avoid excessive movements 

• Activity modification- to help you understand the best activities for your case 

• Strengthening exercises aimed to strengthen the affected ligaments to support the joints. A variety of closed chain exercises can be helpful, as they don’t stress the injured ligaments 

• Proprioception exercises- control of the joint position and retrain the dynamic & motion control 

If you are suffering from Joint Hypermobility Syndrome and would like some help, please contact us at Woodside Clinic, Dunstable on 01582 608400 or Leighton Buzzard on 01525 372 447 to book an appointment with one of our podiatrists, physiotherapists or osteopaths or you can book online.