What is Hypermobility?
Hypermobility is the term used to describe the ability to move joints beyond the normal range of movement.
Is it a problem?
Hypermobility shouldn’t automatically be classed as a problem. It is a spectrum, of which at one end the flexibility can be beneficial. Take gymnasts, swimmers, dancers and musicians for example, whose flexibility allows them to function at a very high level.
For a small percent of the population however, whose flexibility lies at the other end of the spectrum, may experience unpleasant symptoms such as joint instability, pain, fatigue and a range or less easily recognised symptoms including gut, heart and even mental health problems. If hypermobility occurs alongside symptoms such as these, it is known as joint hypermobility syndrome (JHS).
In extreme cases, JHS can be very difficult to live with as it can cause such a wide range of symptoms. The nature of JHS means that you are at increased risk of injuries, such as dislocations and sprains.
Diagnosing joint Hypermobility:
If your doctor or physio thinks that you may have joint hypermobility, the Brighton score is often used as a quick test to assess the range of movement in some of your joints. The Brighton Score is out of a total of 9 points. If you score 4 or more, it is likely that you have some degree of hypermobility. As mentioned, being hypermobile does not necessarily mean you will have any pain or difficulty.
The Brighton Criteria takes into account your Brighton scale but also considers other symptoms, such as joint pain and dislocations, and how long you have had them, in order to diagnose joint hypermobility syndrome. Your GP may also carry out blood tests and further assessment if you have other symptoms to help determine if you have joint hypermobility syndrome.
What causes joint hypermobility?
Joint hypermobility is often hereditary. Studies have found that one of the main causes is related to genetically determined changes to a type of protein called collagen. Collagen is found throughout the body, in our skin and ligaments. If collagen is weaker than it should be, it can make ligaments and joints loose and stretchy, which as a result the joints can extend further than usual.
Hypermobility in Children?
Joint hypermobility is particularly common in children and young people. One recent study found that 20% of 14-year olds qualified as hypermobile. This study suggested that they were twice as likely to develop problems in the knee, shoulder, ankle or foot 4 years later. If they were obese then the risk dramatically increased, with 11 times more likelihood of having pain at the age of 18 years old than who were not hypermobile or obese.
Hypermobility in Pregnancy?
Women are naturally more flexible than men, with a study suggesting that about 20% of women meet the Brighton score for hypermobility, with most of them being symptom free.
Hypermobility can be more problematic in pregnancy, when changes in hormones and weight can put increased stress on supportive ligaments and joints, resulting in an increased risk of developing pelvic organ prolapse after birth.
Treating Joint Hypermobility:
People with JHS often benefit from a combination of controlled exercise and physiotherapy, as well as additional help to manage pain and make everyday tasks easier. Individuals can be reassured that the pain will ease, but only when the muscles are strong and fit and are protecting the joints more fully. The main areas of treatment include:
- Improving the endurance and strength capacity of the postural support and joint-stabilising muscles.
- Improving balance and coordination.
- Improving stamina and general fitness.
- Re-educating posture and walking patterns
- Pain management with relaxation techniques, mindfulness and breathing
Which exercises is best?
Pilates is a fantastic form of exercise to help manage JHS, as it targets all these main principals in retaining posture, challenging your trunk stability and motor skill, as well as focusing on balance, muscle strength and breathing in a pain free, safe environment.
Swimming and deep-water running are great methods of exercises, as well as cycling, for good aerobic work which does not over stretch the joints. Nordic Pole walking can also be very effective. The aim is to encourage a lifelong commitment to exercise and maintenance of good general fitness, through normal activities and a return to sport.
Which classes shall I come to?
Here at FSL all our Pilates classes as physio lead so we will make sure that you’re working correctly, with a focus on quality movement, at a level that is specific for you to ensure the most out of your practice. We ask all our clients to attend an initial 1:1 intro session where we can assess your main areas of focus and then direct you to the most suitable class for your level, for example:
Kids and Teen Pilates – Mondays 5am
Mat Class – Monday 6.30pm
Pilates Circuit – Wed 9.15am
Reformer Foundations – Friday 12pm