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What is Joint Hypermobility Syndrome?

Published: 03 May 2016 - Clinical Conditions

Image of a woman doing yoga

We’ve all seen people who are double-jointed and have probably marvelled at their talent or been completely horrified by the way they can contort their bodies.

The technical term for this is hypermobility, meaning this person’s joints can move beyond the normal range of motion we expect. Joints most commonly affected are the elbows, wrists, fingers, and knees.

While there are people for whom this is a neat party trick, some people with hypermobility might suffer with joint or muscle pain and may be prone to injuries and dislocations. If this is you or your child, it could be Joint Hypermobility Syndrome (JHS) often referred to as Benign Joint Hypermobility Syndrome (BJHS) or Ehlers-Danlos Syndrome.

There is much more to JHS than unusual flexibility which means that the condition can easily be undiagnosed or misdiagnosed.

What is Joint Hypermobility Syndrome?

Joint Hypermobility Syndrome is an inherited collagen-related disorder with a large range of symptoms – from having some degree of joint laxity or flexibility to severe, life-impacting symp-toms related to the cardiovascular system and/or the autonomic nervous system.

While only a small proportion of people experience symptoms that impact their quality of life, the severity of a person’s symptoms determine where they sit on the hypermobility spectrum. Some of the conditions included on this spectrum include Ehlers-Danlos Syndrome, Marfan Syndrome, Stickler Syndrome, and Osteogenesis Imperfecta.

Hypermobility is fairly common in the general population – even some high- level athletes, danc-ers and gymnasts develop symptoms from training.

Could I have Joint Hypermobility Syndrome and not realise it?

Often joint hypermobility causes no symptoms and requires no treatment. You may have JHS if you experience these symptoms:

- Joint sprains and pain
- Tendon injuries
- Joint dislocations and subluxations and clicking
- Chronic and acute pain in multiple body areas
- Clumsiness and poor body awareness
- Increased stiffness and tightness in muscles and associated muscular pains

Because JHS is an inherited collagen disorder that impacts all connective tissue in the body, the following symptoms are also very common:

- Elastic and stretchable skin, especially on the back of the hand and at the neckline
- Stretch marks and abnormal skin scars
- Prone to bruising easily and slow healing
- Digestive tract issues, including certain food group intolerance and bloating
- Bowel and bladder symptoms
- Vascular vessels distension and dilatation, blood pressure dysregulation, prone to developing aneurysm when on the severe end of the spectrum
- Respiratory asthma-like symptoms

The Autonomic Nervous System (ANS) - responsible for the regulation of internal organs and their function – can also be impacted. Some ANS symptoms that may become apparent in JHS include:

- Chronic fatigue
- Headaches
- Dizziness and/or blurry vision
- Poor ability to concentrate
- Reduced response to anesthetic agents
- Heart palpitations
- Blood pressure dysregulation
- Nausea, vomiting, feeling faint, especially with changes in position and head and neck move-ments

How is Joint Hypermobility Syndrome treated?

Symptomatic JHS is a condition that would require lifelong management but understanding the nature of the disease and being able to fit all the different pieces of the puzzle together to diag-nose the condition properly is an important first step. The bigger picture can easily be missed, and can unfortunately lead to chronic pain and create other problems, including serious psychological stress and have a real impact on quality of life.

Multidisciplinary management is usually required, most often involving:

- Physiotherapy (most effective form of management)
- Medication
- Dietary adjustment
- Psychological management
- Pain management and coping strategies

More specialised care may be required in some cases.

How does physiotherapy help people with Joint Hypermobility Syndrome?

Physiotherapy is often the most effective form of management because it directly helps:

- Assess the body and screen for symptoms and signs of JHS
- Improve body awareness (proprioception)
- Improve joint stability and strength
- Develop an appropriate exercise regimen to help reduce symptoms and prevent aggravation
- Improve bladder and bowel symptoms by strengthening pelvic floor muscles
- Address ANS symptoms by helping individuals develop adequate coping and symptom-relieving strategies
- Enhance and optimise function, improve participation in activities of daily living and overall im-prove quality of life

If you suffer from JHS or think you may have symptoms of the condition, contact your nearest Back In Motion practice for your free initial assessment.

Author

Adriane Chan - Physiotherapist (Clinical Associate) | Back In Motion Brunswick

Physiotherapist - Bachelor of Science, School of Physiotherapy, Curtin University, Perth;  Pilates instructor; Endorsed in dry needling/acupuncture, APAM.

Adriane is originally from the beautiful island of Mauritius in the Indian Ocean. She migrated to Australia for her studies and graduated from Curtin University (School of Physiotherapy) in Perth. She then worked in the private practice setting and developed experience in treating a wide variety of musculoskeletal disorders.

She is passionate about treating and managing a variety of musculoskeletal and sports injuries, with a special interest in back/spinal injuries. Adriane also has experience in treating complex cases, including chronic pain, and ensures she stays up to date with the latest research and literature to provide the best care for all her patients. She is endorsed in dry needling and acupuncture treatment and has experience in Clinical Exercise, which she particularly likes to use in the rehabilitation of her patients. She has also completed the Level 1 course in Life and Wellness Coaching (WCA) and believes in adopting a holistic approach to managing an injury.

Adriane moved to Melbourne at the start of 2015 to further her career in Musculoskeletal Physiotherapy and has now joined the fantastic Back in Motion Brunswick team.

Outside of work, Adriane can be spotted running in the local park. She also enjoys all kinds of sports, especially beach volleyball and tennis. She is a keen pianist and is now learning guitar.

Resources:

1. hypermobility.org
2. Arthritis Research UK