What is Hypermobility?

Definitions of hypermobility: 

Joint hypermobility (JH):
  • Capability for a joint to move beyond normal physiological limits.
  • A descriptor, not a diagnosis
  • Also known as joint laxity, double-jointedness, or joint hyperlaxity.

“Hypermobility is the term used to describe the ability to move joints beyond the normal range of movement. Joint hypermobility is common in the general population. It may be present in just a few joints or it may be widespread. It is most common in childhood and adolescence, in females, and Asian and Afro-Caribbean races. It tends to lessen with age. In many people, joint hypermobility is of no medical consequence and commonly does not give rise to symptoms. Hypermobility can even be considered an advantage, for example, athletes, gymnasts, dancers, and musicians might specifically be selected because of their extra range of movement.

For a small percentage of the population, instead of being advantageous, hypermobility may be associated with joint and ligament injuries, pain, fatigue, and other symptoms. Hypermobility can also be a sign of a more serious underlying condition, which are often passed down through the generations.”(1/ Hakim A.J.).

Joint Instability (JI):
  • Implies a detrimental effect on the joint, whereas JH has neutral implication
  • Hypermobile joints need not be unstable, and vice versa.
Flexibility vs. Hypermobility:
  • Hypermobility should be confused with flexibility, as people can be hypermobile without being flexible and vice versa.
  • Hypermobile joints are loose or unstable and slip or dislocate easily.
Prevalence:

“Experts estimate that up to 10% of the general population may have some degree of hypermobility, with women affected about three times more often than men. Most hypermobile people do not develop any problems from their loose joints, but some suffer chronic pain and other symptoms.” (2/ Pocinki A.)

Cause(s): 

The exact cause(s) of joint hypermobility is unknown; however, various genetic mutations in one or more of the components that help build our connective tissues may result in loose joints. Research suggests that both genetic and epigenetic factors play a role in the variability of signs and symptoms associated with joint hypermobility. These indicators fall somewhere along a vast spectrum in presentation and include the severity of issues experienced by some people with joint hypermobility.

Development:

Proprioception and Hypermobility

“Those with GJH often have other minor musculoskeletal physical traits, which may be the result of the interactions between “softer” musculoskeletal tissues and mechanical forces during growth. These include flat feet (flexible type), misaligned bones in the elbow and big toes, mild to moderate scoliosis (side to side curvature of the spine), kyphosis (outward curvature) of the upper spine and lordosis (inner curvature) of the lower spine. There may be an indirect association with mild reduced bone mass as a result of many factors—lack of proprioception, muscle weakness, and the resulting reduced activity.”

https://www.ehlers-danlos.com/what-is-hsd/

Importance & Impact: 
Stats & Facts: 

1/500 EDS/JHS combined

Large Gender Difference – 70% Female

8.5y delay to the average age of dx between women & men

Delayed dx in children is linked to trauma, misdiagnosis, abuse and disease progression

Lifestyle:

There’s no cure for hypermobility syndromes. The main treatment is improving muscle strength, joint stability, and proprioception, so your joints are protected and movement is safe and empowering vs. discouraging. Positive lifestyle modifications, such as mind-body strategies facilitate long-term behavior change through helping manage pain, ease anxiety, and decrease symptoms of comorbid conditions

Early Diagnosis is Critical – Prevention, Comorbid Conditions Presentation, & long-term management

Citations/Sources: 

Demmler JC, Atkinson MD, Reinhold EJ, et al
Diagnosed prevalence of Ehlers-Danlos syndrome and hypermobility spectrum disorder in Wales, UK: a national electronic cohort study and case–control comparison
BMJ Open 2019;9:e031365. doi:10.1136/bmjopen-2019-031365

Written by Kendra Neilsen Myles, CHES, BCPA. Edited by Liz Murphy. Medical Review by EDS Wellness’ Board of Directors. View also Our Team


Assessing Generalized Joint Hypermobility Using the Beighton Score (2016 post)

Assessing Hypermobility – Updated (2020 post)

The Beighton Score for Generalized Joint Hypermobility

EDS Wellness’ Generalized Joint Hypermobility Self-Scoring Questionnaire

Understanding Your Beighton Score

Hypermobility, EDS & HSD Medical Information and Educational Resources

Joint Hypermobility Brochure – Coming Soon!

Beighton Score Brochure – Coming Soon!


Reviewed by Page last updated: June 2020. Planned update: July 2020 to validate current estimated prevalence and statistics on hypermobility.

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