Are you wondering if you have hypermobility syndrome? Hypermobility syndrome, also known as joint hypermobility syndrome (JHS), is a condition characterised by the ability of joints to move beyond the normal range of motion. If you suspect you may have hypermobility syndrome, there are several signs and symptoms to consider. First, a basic assessment is to evaluate your joint flexibility by performing the Beighton score, a simple test that measures hypermobility in various joints. Points are assigned based on specific criteria, such as bending your pinkie back beyond 90 degrees or placing your palms flat on the floor with straight legs. A higher score may indicate increased joint flexibility.

In addition to the Beighton score, pay attention to symptoms commonly associated with hypermobility syndrome. These may include joint pain, fatigue, and a tendency to develop injuries such as sprains and dislocations more quickly than others. Chronic pain is a crucial indicator, especially in the knees, shoulders, and other joints. If you experience recurrent joint problems, it's essential to consult with a healthcare professional. A rheumatologist or a specialist in connective tissue disorders can provide a comprehensive evaluation, considering your medical history, symptoms, and physical examination to determine if hypermobility syndrome is present.

Remember that hypermobility is a spectrum, and not everyone with joint hypermobility experiences symptoms or requires medical intervention. However, if you are concerned about your joint health or experiencing discomfort, seeking professional medical advice is crucial for an accurate diagnosis and appropriate management.

Hypermobility is defined by a person having a ‘greater than average range of motion’ in either one or more joints. However, this is solely a description, it’s insufficient to form a precise diagnosis. Hypermobility has been a topic of much confusion for a long time within the healthcare setting, however, excitingly, more research has begun to emerge to understand the causes, symptoms, and appropriate physiotherapy management for Hypermobility syndrome. 

Probably the more critical question surrounding Hypermobility is to understand why a person is hypermobile in the first place. This is important to know because it will help identify whether specific symptoms (such as pain and function) are related and even informs health professionals to whether Hypermobility is more of an asset versus a liability. This leads us first to a brief understanding of the different types of Hypermobility.

What are the four types of Hypermobility Syndrome?

1. Firstly general hypermobility syndrome. This is by far the most common and is hereditary, meaning that you are born with it. It is still unknown whether there are specific genetic markers that contribute to Hypermobility. However, regardless of an actual diagnosis, treatment should be based on symptoms. For example, pain or instability, which I’ll get into a little further on.

2. Secondly Peripheral and Localised Hypermobility syndrome. Either of these types can be acquired through stretching. To a large extent, those who are naturally predisposed to being on the ‘bendier’ side are often attracted to sports such as dance, gymnastics, and contortion – sports that require flexibility to access unique movement patterns or shapes, as well as for the aesthetic value. You can also increase joint mobility through continual exposure to specific training methods.

3. Lastly Historical hypermobility syndrome. As we age, our tissues lose elasticity. This can mean that someone may have presented in the past with hypermobility syndrome. Still, it progresses to being within the average range – one reason why it is so essential as a Physio to understand one’s history and symptomology which may linger or emerge later in life. Within this type, it’s easy for a missed diagnosis and thus, mismanagement to occur.

If I have Hypermobility Syndrome, does that mean I have Ehler’s Danlos Syndrome (EDS)?

The short answer is no. This topic has become a bit more confusing in recent years, given that we are now aware different classifications fall under the umbrella of EDS. A simple explanation is that Hypermobility lies along a spectrum, so it isn’t surprising to see individuals fluctuate towards either end as factors in their life change (things like training, age, etc., as listed above). Now I won’t go into too much detail in this blog, but this is something you can gain a lot more clarity in when you go through a thorough screening process with your Physio.

Can you have Hypermoblity Syndrome and be stiff in joints?

Absolutely. Not always, but this can be the case if there is associated weakness and muscular tension. Stiffness is a warning sign that our clever human body gives and is ‘protective’ of a joint that isn’t functioning well. If left unmanaged, it can predispose either that or surrounding tissues to a greater risk of injury or development of short-term injury (e.g. impingement, nerve strains, sub/dislocations) as well as long-term complications (e.g. osteoarthritis).

Do I need to see an experienced Hypermobility Physio?

Firstly, an experienced hypermobility physio needs to understand why a person is hypermobile, as this will determine how they are likely to respond to treatment. Generally, this will involve filling out a questionnaire to hone in on aspects like family and personal history, what it is you are experiencing (symptoms), etc. From here, other tests specific to your primary concerns are carried out, and the starting point for an ongoing plan is determined from there. Depending on the type of Hypermobility and if there are other associated conditions, this may include linking in other healthcare professionals who can further add value and help you reach that next level in your health and well-being or training goals.

Should I See a Hypermobility Physio?

If you suspect that you have hypermobility syndrome or are experiencing symptoms related to joint hypermobility, consulting with a physiotherapist specialising in hypermobility can be beneficial for several reasons. A hypermobility physiotherapist has expertise in understanding the unique challenges of hypermobile joints. They can thoroughly assess your joint mobility, muscle strength, and overall physical function to identify areas of concern or weakness.

A hypermobility physio can then tailor a targeted treatment plan to address your specific needs. This may include exercises to improve muscle strength and joint stability and guidance on proper body mechanics and posture. Physiotherapy aims to enhance your overall physical function, reduce pain, and mitigate the risk of injuries associated with hypermobility. The physiotherapist can also provide education on self-management strategies, empowering you to maintain your joint health actively.

Regular sessions with a hypermobility physiotherapist can help monitor your progress, make necessary adjustments to the treatment plan, and provide ongoing support for managing symptoms. In some cases, physiotherapy may be a key component of a multidisciplinary approach that includes other healthcare professionals, such as rheumatologists or orthopedic specialists. Seeking the expertise of a hypermobility physiotherapist can contribute to improved quality of life by addressing the specific challenges associated with joint hypermobility and promoting long-term joint health.

Should my Child see a Hypermobility Physio?

If you suspect that your child may have hypermobility or if they are experiencing issues related to joint flexibility, it's advisable to consult with a healthcare professional, such as a pediatrician, who can provide an initial assessment. The pediatrician may refer your child to a physiotherapist with expertise in hypermobility if there are concerns about their joint function, muscle strength, or coordination. Physiotherapists specializing in hypermobility can play a crucial role in evaluating your child's specific needs and designing a targeted intervention plan.

Typically, a hypermobility physiotherapist will assess your child's joint range of motion, muscle strength, and overall physical function. If they identify areas of concern, they can develop a personalized exercise program to address muscle weakness, instability, and joint control. Early intervention is essential, as addressing hypermobility-related issues in childhood can help prevent long-term complications and improve overall physical well-being. Regular follow-ups with the physiotherapist can monitor progress and make necessary adjustments to the treatment plan as your child grows and develops.

It's important to note that seeking professional advice is crucial, as hypermobility can vary in its impact on individuals. The physiotherapist can guide activities, exercises, and lifestyle adjustments to support your child's physical development and minimize the risk of complications associated with hypermobility.

What factors influence Hypermobility syndrome?

There are many factors that can influence if someone has hypermobility syndrome. Genetics, age, sex, bone morphology, ethnic background, muscle tone, temperature, nutrition, hormones, injury, or surgery.

While it can be easy to identify Hypermobility syndrome in some people via a hypermobility physio Melbourne, there are also times when it lies under the surface, undetected. This largely depends on which type one has as well as if/when they are/become symptomatic. This new understanding has helped explain the variety of ways in which a Hypermobility disorder might be expressed, including physically, physiologically, and mentally.  

What other symptoms or conditions may I also experience alongside Hypermobility Syndrome?

Common symptoms that are found in Hypermobile individuals include dislocation, functional instability (meaning a joint is unstable as it moves through the range), recurrent sprains or strains, joint clicking, poor co-ordination, changes in bone mass, scoliosis, muscle weakness or difficulty building muscle, ongoing pain, and a fear of movement, and fatigue. Any readers out there relate to these…?

Perhaps some of the least recognised symptoms include poor sleep (quality, quantity, timing), nutrient deficiencies, digestive issues, hypersensitivity to pain, and anxiety.

There are other conditions commonly found in conjunction with Hypermobility - Postural Orthostatic Tachycardia Syndrome (POTS), hypermobile Ehlers-Danlos Syndrome (hEDS), and Mast Cell Activation Syndrome (MCAS) which have both a unique and blended picture of related symptoms as per the image below.

How can I tell if I am hypermobile?

There are various assessment tools, most of which are subjective (in the form of questionnaires). If you’ve already delved a little online, you’ve probably come across the Beighton Score - it is probably still the most common and well-known. If you’re curious, it’s not a bad starting point and there is a simple online form that can be found here . Keep in mind though, that this isn’t as detailed and therefore as informative as you may need. For a more accurate idea of where on the spectrum you sit, it’s best to find an experienced hypermobile Physio who can guide you through the most appropriate screening tool(s), help you interpret them, and provide you with the proper guidance and importantly learn what you can take away and implement into your day or training.