In this article, you will find out everything you need to know about hypermobility and the most effective ways to treat it, including an advanced treatment called Prolotherapy.

Hypermobility syndrome

Hypermobility syndrome (HMS) is a condition in which your joints move beyond their normal range of motion. As a result, your joints become extremely flexible. Elbows, wrists, fingers, and knees are the most typically affected joints.

HMS is a connective tissue disorder that runs in families. Excessive looseness of several joints is one of the main symptoms. You can characterize this condition by the weakening of your body’s connective tissues. Hypermobility of the joints is common in patients with Down syndrome and Marfan syndrome. Ligaments are the type of connective tissue that holds your joints together and keep them from excessive movement. Looseness of these ligaments in hypermobility syndrome is the main reason for your loose joints.

Hypermobility of the joints is quite common. Your joints move beyond their normal range of motion if you have hypermobility. This indicates that your joints are quite adaptable. The most prevalent form of hypermobility is Ehler-Danlos syndrome (EDS) affecting roughly one out of every 100 to 200 persons.

In this article, you will get a thorough understanding other symptoms of hypermobility syndrome and what you need to do to avoid it.

Causes of Hypermobility

Your genetics is a potent factor that can cause hypermobility syndrome(1). Parents’ genes for hypermobile joints are handed on to their children. As a result, the disorder is developed in young people that this genetic disorder runs in their family. If you have this condition running in your family, chances are great that you will also suffer from this condition later on in life. Faulty genes for collagen produce a dysfunctional protein that will form loose connective tissue in your body resulting in hypermobile joints.

Aging is another factor that can cause hypermobile joints. During aging, your body continues to degrade proteins and this causes your ligaments to lose their strength over time and that results in hypermobility. Your collagen synthesis is also reduced over time and this decreases your bones’ health status.  The overall result of this is the so called joint hypermobility syndrome that is associated with the joint moving beyond its typical range of motion.

Any joint or bone abnormality also triggers joint hypermobility. If you have abnormal joint depth, it is highly likely that you will be suffering from joint hypermobility later. This is because your bones get extra space to move in your joint cavity. In addition, any abnormality of muscle tone in the muscles associated with a joint can lead to hypermobility of that joint.  For that matter, you need to take care of your musculoskeletal health and consult your orthopedic doctor if any anomaly arises. Hypermobile flat feet occur when the arches sag and the feet roll excessively.

Symptoms of hypermobility syndrome

• Pain and stiffness: These are the most common symptoms of hypermobility syndrome. You will feel dull pain from time to time and you will feel your joints difficult to move. Severe joint pain and especially back pain occurs when you try to exercise or do some strenuous activity.
• Clicking joints: This is a potent sign of hypermobility syndrome in which you will feel discomfort and awkward feel to walk. You will notice crackling in your knees, but it can also happen in other joints like the shoulder, elbow, or neck. Crackling with pain is a sign of wear and tear or injury.
• Joint dislocation: This injury can cause severe joint pain and can distort and immobilize your joint for a period of time. Shoulders and little fingers are the most common dislocation sites, but muscle tones, elbows, knees, and hips can also be affected. More severe injuries require surgical treatment to restore the normal function of the foot. Osteoarthritis is a common disease characterized by joint degeneration.

• Fatigue: Fatigue or tiredness is a state of extreme exhaustion. It’s difficult to get out of bed in the morning, go to work, do your typical activities, and get through the day when you’re tired. You may feel a strong need to sleep, but you do not feel fresh after resting or sleeping.

Types of Hypermobility syndrome

Classical type 

This variety of Ehlers-Danlos syndrome is characterized by considerable joint hypermobility, skin hyperextensibility, and vulnerability. Minor damage readily rips stretchy skin, or bruises the smooth skin. Joint dislocations are more common. Joint sprain can occur as a result of joint vulnerability. This classic type is passed down through the generations as an autosomal dominant genetic trait (directly passed on from one parent to child).

Hypermobility type

The most common genetic connective tissue disorder is hypermobile Ehlers-Danlos syndrome (EDS) (2). The main symptom of this type is joint hypermobility. This can affect any of your joint and dislocations can last for a long time. This genetic trait is also inherited as an autosomal dominant trait.

Benign joint hypermobility syndrome (BJHS) is a condition caused by the laxity of the joints joint and muscle strength in supporting your connective tissue. Inguinal hernia is also thought to be caused by weak supporting tissue, which could be a symptom of a larger connective tissue problem. Joint hypermobility (JH) is common in rheumatology (3), and it may indicate worsening of disease in some situations, such as rheumatoid arthritis (RA). For that matter, you should probably make a rheumatologist your first port of call.

Vascular(VEDS) type

Abrupt damage of arteries is a far-reaching sign of this type of Ehlers-Danlos syndrome that is often fatal. Talipes might be present from the moment you are born. This type of genetic anomaly transfers via the dominant pattern of inheritance.

Kyphoscoliosis type

A departure in the sagittal and coronal planes of the spine’s normal curvature, which may include a rotation of the spinal axis. Scoliosis in adults is characterized as a lateral deviation in the coronal plane of more than 10 degrees as evaluated by the Cobb angle. Scoliosis is characterized by a delicate eye globe, substantial movement at joints, and curvature of the spine(4). This disease transmits via the autosomal recessive pattern of inheritance.

Arthrochalsia type

Joint laxity and dislocations are major problems for patients who are small in stature (5). In this type versus arthritis the involvement of the skin varies. It can transmit from parents to offspring by many genetic patterns. A biopsy of the skin tissue is carried out to diagnose this condition. When compared to women with normal mobility, women with joint hypermobility have a much higher rate of vaginal prolapse.

Treatment

You can treat hypermobility syndrome in accordance with particular manifestations present in an individual. If you have EDS type I or type II, genetic testing is usually available through a blood test.

• If you have joint hypermobility syndrome, treatment will focus on chronic pain and strengthening of your joint. Your occupational therapist may advise you to treat your joint discomfort after physical therapy (6) and suggest pain medications. Ibuprofen is a pain reliever and the inflammation reducer is an example of such meditation.
• Physiotherapy is generally used to treat postural hyper-kyphosis. Regular exercises for muscle strength and developing proper posture are among the treatments. Keep your soft tissues in good shape with soft tissue manual therapy.
• Ehlers-Danlos syndrome (hypermobile eds) is a rare genetic disease and treatment is currently symptomatic and focuses on increasing the quality of life of these patients, as there is no curative treatment.

• Surgical procedures are more common to be successful when the treating physician is aware of the diagnosis of VEDS and its associated tissue fragility. Surgery to correct your blood vessels may be required in some cases before any emergency occurs.

• Prolotherapy

  In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat Hypermobility.

  Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.

  Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to repair the damage and help Hypermobility.

  As prolotherapy is helping to treat the root cause of Hypermobility, it is deemed to be a permanent fix, preventing the symptoms from returning.

  

Preventions and exercises

Hypermobility syndrome is inherited, but it doesn’t mean that it is not preventable. Nevertheless, when hypermobility syndrome causes symptoms due to family history, primary-care practitioners play an important role in helping patients to understand and self-manage long-term health conditions.

Avoid weightlifting, contact sports, and other activities which cause tiredness that increase your risk of receiving an injury. Wear sunscreen when you are outside and use mild soap. Skin protection is critical, however simple precautions, such as covering sharp furniture edges and making homes safe to prevent falls, are simple to implement for the protection of your skin. In addition, rheumatology nurses play an important role in identifying when people with hypermobile joints are patients.

It’s a fantastic approach for hypermobile people to get some exercise. The plank posture is probably the most well-known isometric exercise. Isometric exercises increase joint awareness while providing a sense of stability in the shoulder joint and knees. Exercises that reinforce muscle strength, can help to reduce pain and decrease the rate of joint injury. Many patients with EDS can benefit from low-impact exercises which help build core strength.

Conclusion

Musculoskeletal issues are one of the most prevalent reasons people seek basic health care. Many patients with non-inflammatory musculoskeletal difficulties may have joint hypermobility syndrome (JHS).

The aim of the article is to increase understanding of HMS which may be helpful in alleviating symptoms and assisting you in self-managing the disease. Physiotherapists and other health professionals provide medical support to those who are suffering from this illness. For that matter, the Hypermobility Syndrome Association is a support group for people and families who are impacted by this condition. Understanding the various aspects of hypermobility is crucial for those affected, as well as for the healthcare professionals involved in their care. Additionally, awareness of related conditions, such as hyperlordosis, is essential, as hyperlordosis causes and symptoms may overlap with those of HMS. By recognizing these connections, individuals can better advocate for their health needs and seek out tailored treatments that address the unique challenges posed by their symptoms.

References

1. Grahame, R. (1999). Joint hypermobility and genetic collagen disorders: are they related? Archives of Disease in Childhood, 80(2), 188–191. https://doi.org/10.1136/adc.80.2.188
2. Tinkle, B., Castori, M., Berglund, B., Cohen, H., Grahame, R., Kazkaz, H., & Levy, H. (2017). Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 48–69. https://doi.org/10.1002/ajmg.c.31538
3. Fikree, A., Aziz, Q., & Grahame, R. (2013). Joint Hypermobility Syndrome. Rheumatic Disease Clinics of North America, 39(2), 419–430. https://doi.org/10.1016/j.rdc.2013.03.003
4. Colombi, M., Dordoni, C., Chiarelli, N., & Ritelli, M. (2015). Differential diagnosis and diagnostic flow chart of joint hypermobility syndrome/ehlers-danlos syndrome hypermobility type compared to other heritable connective tissue disorders. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 169(1), 6–22. https://doi.org/10.1002/ajmg.c.31429
5. Carter, C., & Wilkinson, J. (1964). PERSISTENT JOINT LAXITY AND CONGENITAL DISLOCATION OF THE HIP. The Journal of Bone and Joint Surgery. British Volume, 46-B(1), 40–45. https://doi.org/10.1302/0301-620x.46b1.40
6. Engelbert, R. H. H., Juul-Kristensen, B., Pacey, V., de Wandele, I., Smeenk, S., Woinarosky, N., Sabo, S., Scheper, M. C., Russek, L., & Simmonds, J. V. (2017). The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 175(1), 158–167. https://doi.org/10.1002/ajmg.c.31545