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Hypermobility - Good thing or bad thing ?

Does being ' double jointed ' cause damage to the body and if so how can we tackle it ?

Thinking back to our school days we can probably all remember those people that were a bit ' double jointed ' and could do a perfect backwards bridge or the box splits in the playground. I certainly remember being told in a disapproving manner that they would be ' crippled with arthritis by the time they were 40.. just like Olga Korbut ' ......... but is this really true or is it just another old wives tale ? Does being flexible lead to more problems with the joints ?

So what is Hypermobility Syndrome ?

Hypermobility is defined as being " an abnormally excessive range of motion in the joints caused by excessive laxity or ' give ' in the surrounding constraining soft tissues " Basically the soft tissues like ligaments and capsule that surround the joints are rather more elastic then they would normally be, more like an elastic band than a rope.

Some conditions like Marfans or Ehler Danos Syndrome are excessive types of hypermobility which often carry additional problems with bladder, bowels and cardiac issues. This kind of goes beyond the scope of what we are dicussing here..... we'll do those another day ! Generalised hypermobility affects around 20% of the population, is more common in females than males and generally decreases as we age naturally as the tissues become a little less ' springy 'as part of the natural aging process.

What causes it and how is it diagnosed?

Very simply it comes down to genetics ! Hypermobility does seem to run in families. Our genes will dictate just how elastic our collagen is and collagen is the building block for all of our soft tissues from bone to ligaments and cartiledge. Diagnosis is often based upon taking a careful history - including family medical health - blood tests to exclude any systemic diseases and your Physio or GP may score your joint motion on the Beighton Scale. A history of kneecaps dislocating, popping shoulders or being a playground cortortionist can all point towards a diagnosis of Hypermobility.

But is Hypermobility a problem ??

Well, in the vast majority of cases .. no. Most gymnasts and dancers would be defined as being ' hypermobile ' yet manage perfectly well, their flexibility is a necessity for the aesthetic of their discipline. Yes, they train and stretch to maintain their excessive flexibility but it's probable that they would always have been at the more ' bendy ' end of the spectrum even with no training. Their body has simply adapted to the demands of their discipline.

BUT in some instances it can cause problems. After all if the usual scaffolding system for the joints isn't providing support then what is ? ! This is where there can sometimes be issues with joints not being protected by their usual support system, structures become overstretched and pain and sometimes damage can occur.

So which joints are at risk !

Any joint potentially can be at risk but specifically ones that we see in clinic

  1. Shoulders - The most commonly dislocated joint in the whole body as the ligmanets and capsule are already very ' baggy ' to allow the huge range of motion needed at the joint

  2. Low Back & pelvis - far more common in females ( yay ! ) and especially during big hormonal shifts such as during periods, pregnancy and menopause. The hormones have a ' loosening ' effect on the soft tissues in order to allow more movement at the pelvis to prepare for birth ( this happens on a mini-scale during a monthly period )

  3. Knees - in particular the little kneecap - similar to the shoulder - it's support system is naturally loose making it more vulnerable.

  4. Ankles - we all know people who can ' go over ' their ankles easily causing an ankle sprain. A history of repeated sprains that occur easily can often be a sign of hypermobility.

What is the best way to tackle hypermobility !

Whilst we can do nothing about our genetic make up of our soft tissues one thing we can have an affect on is our muscles ! Muscles provide a secondary stability system to many of our joints, acting almost as straps or slings, helping to squeeze and compress the joints together. This system is especially true in the shoulder and the low back and pelvis ( you can see why pregnancy is such a challenge for the body - hormones totally haywire, supporting muscles stretched beyond belief and you've got a huge belly to support all of a sudden .... maybe Mother Nature is male ?! )

So the key really is exercise BUT the right kind of exercise ! Strength is going to be your friend rather than stretching and this is where many hypermobile folks have run into problems in the past, understandable otfen gravitating towards sports and activities that make the most of their inhearant flexibility but don't always build on strength. Those professional dancers and gymnasts that we see do a phenomenal amount of work building strength so they can control that huge range of motion they have. Think of including Pilates, weight lifting, core workouts rather than excessive amounts of stretching and impact work.

So back to our original question... does being double jointed cause damage ? Well, in of itself no. But your muscular system may have to work a little harder to control your movement you have than someone who is not hypermobile. And was Olga ' crippled ' as my mum predicted ? Any elite athlete of any discipline will have some damage to their joints, what they do is not normal as they intensively operate at the very extremes of what the body is capable of - It's like an F1 car compared to a Ford Fiesta, one will wear out much quicker as it's being thrashed whilst the otther pootles around with the odd blast down the motorway.

So whilst Olga was no doubt incredibly strong she was also involved in hour upon hour of harsh, impact on her joints at a time when I'm guessing her coaches ( and probably government ) were not prioritising her long term health. For the majority of us mere mortals don't panic - the body is a machine and like most family cars if you look after it you will have a good little runaround for years to come ( one careful owner ! )

We are always here to help and happy to have an informal chat if you are not sure which direction is best for you, feel free to give us a ring to discuss your needs.


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