Double jointedness – loose joints – joint hypermobility: what is it and how can physio help?

Do you or your children suffer different joint aches or seem to be constantly injuring different joints?  If so, you may have Joint Hypermobility. In this blog we describe this condition and give some useful tips to help you manage the symptoms and show how Physiotherapy can help.

20-30% of individuals worldwide have some level of hypermobility and it affects both children and adults.  In the past this condition was largely overlooked and management was often ineffective or even aggravating.  There is a real difference between being flexible,  having Joint Hypermobility and having  Joint Hypermobility Syndrome. There is a spectrum of flexibility seen within the population with some people seemingly stiff as a board and others super bendy and there is yet another group who have additional symptoms. Read on to learn more about the differences.

So what is joint hypermobility?

If you were to google it right now the differences in definitions can be quite alarming.  This can also cause inaccurate self diagnosis.

In summary:

Joint Hypermobility

double jointed thumb

People with joint hypermobility are particularly supple and able to move their limbs into positions that other people find impossible. Joint hypermobility is what some people refer to as having “loose joints” or being “double-jointed”.  Some people have just one or two joints involved and others have more – and this is measured on a scale called the Beighton scale.

It is often hereditary. Some people outgrow symptoms as they get older and their joints naturally stiffen up a little.

Many people with hypermobile joints don’t have any problems, and some people – such as ballet dancers, gymnasts and musicians – may actually benefit from the increased flexibility. This is because it allows them to perform at a higher level – but unfortunately it also makes them much more susceptible to injury.

Joint Hypermobility Syndrome 

However some people with joint hypermobility can have a number of unpleasant symptoms as well, such as:

  • pain and stiffness of the joints
  • Clicking joints
  • easy bruising
  • joints that dislocate (come out of the correct position) easily
  • fatigue (extreme tiredness)
  • recurrent injuries – such as sprains
  • digestive problems such as constipation and irritable bowel syndrome (IBS)
  • dizziness and fainting
  • thin or very stretchy skin

    Ankle Sprainpain and stiffness in the joints and muscles

(www.nhs.uk, 2017)

If hypermobility occurs alongside symptoms such as these, it is known as Joint Hypermobility Syndrom. This syndrome is widely thought to be a feature of an underlying condition affecting connective tissue called Ehlers-Danlos syndrome (EDS).  The Brighton Scale, Beighton scale and other clinical tests are often used to diagnose the syndrome.

How can Physiotherapy help?

Joint hypermobility is a long-term condition therefore it is important to know how to manage it.

  • Gentle, low-impact exercise such as swimming and cycling are advised because it is gentle on the joints – as opposed to high-impact exercise that involves running, jumping and hopping.
  • Maintaining a healthy weight is important to keep the loads placed through the joints to a minimum.
  • Not exercising can make the symptoms worse – it’s just a matter of finding the right sort of low-impact exercise.
  • It is also important to normalise hypermobility in children early because for them it is their norm and we need to encourage them to exercise to help manage their symptoms. We don’t want them to be afraid to move and become over protective of their joints.
  • Physiotherapy can help identify which areas of the body are affected. We can help you pitch the level of exercise and tailor an exercise programme according to your particular symptoms.
  • We can point you in the right direction to confirm full diagnosis if required.
  • Pilates is often very good for hypermobility because it is gently strengthening without putting pressure through the joints. It can help increase energy, reduce pain levels and allow movement without fear of dislocation. The benefit of training with a physiotherapist is the improvement of muscle strength, fitness, posture and balance. The level of exercise is targeted specifically to the individual and we take care to go at the individual’s pace.

Our Physiotherapist Katherine Ashmore has a special interest in Hypermobility and has trained especially in Pilates for Hypermobility.   If you suspect that you or your child may have Joint Hypermobility please do book an appointment with Katherine to be assessed and to attend her one-to-one Pilates sessions. Or see any one of our experienced team of Physiotherapists.

To book an appointment, simply:

Call 020 8876 5690

Email us here

Book a Physiotherapy appointment online here

Or just pop in for a chat!

Do you have a gymnast in the family complaining of aches and pains?

Do you have a gymnast in the family? And are they frequently complaining of aches and pains?

As a parent it’s often hard to know how much to worry about your child’s injuries.

We are used to children getting cuts and bruises in the normal course of play and they usually bounce back very quickly.

We have asked Katherine Ashmore, one of our team of musculo-skeletal Physiotherapists, to explain a little more about why children and teenagers are different from adults and what you should look out for if your child gets injured.

Katherine is an ex-gymnast herself so she knows all about the demands of the sport. She has a special interest in helping children and adults recover from gymnastic injuries. She can also help with screening to identify areas of weakness and potential injury risk.

How are children’s skeletons different from adult’s?

Presentation of child’s lower limb skeletal system

The way children’s bodies react to injury can be very different to that of an adult, especially when they are going through a growth spurt.

Sometimes what you think is nothing more than a muscle ache might be something more – especially if your child is specialising early in gymnastics where the demands on the body are high.

The immature skeleton contains growing tissue that is not present in an adult – so they shouldn’t be regarded as a ‘mini-adult’.

Growth spurts

Children go through two growth spurts – one around the age of 6 to 8 years old and the other more major one is during puberty. This can start at about age 10-12 in girls and around age 13-14 in boys.

Their skeletons are not fully formed until they have gone through puberty. This is about 15-16 years for girls and 18-19 for boys (and sometimes as late as 21-22 years) – when they finally stop growing.

How do I tell if it’s just growing pains?

Growing pains are a recognised condition and are typically:

  • felt more in the legs below the knees
  • experienced by boys and girls equally
  • symmetrical although they can be worse in one leg
  • rarely cause the child to limp
  • felt only at night and intermittently
  • not brought on by an injury

Hypermobility

gymnast demonstrating hypermobility

Another factor that makes children who get into gymnastics a bit more susceptible to injury is that they are often hypermobile – or, in plain language, double jointed!

They can have one or two isolated joints that are extra bendy or they may have multiple joints affected which is called hypermobility syndrome.

It is often this increased flexibility that attracts them to the sport in the first instance and makes them excel at it.

The demands of the sport

The nature of the sport involves very repetitive actions and extremes of joint movement.

In the young competitive world of gymnastics children have high training schedules making them susceptible to overuse injuries.

Types of injuries

The most common gymnastic injuries are in the wrist, back, knee and ankle.  This can be due to the explosive force of power put through the arms and legs on push off and landing.

Commonly gymnasts have a higher incidence of soft tissue injuries (muscle and ligament strains, sprains and dislocations) and bone fractures.  Landing awkwardly is often a cause of these injuries – for example affecting shoulder muscles or ligaments when landing on your hands, or causing an ankle sprain when landing awkwardly on your feet.

floor exercises

Certain types of gymnastic disciplines may give more problems than others –  with the vault, uneven bar, balance beam, pommel horse and floor exercises having the highest incidence of injury.

5 good reasons why a young gymnast should consult a Physio

  • Suffering from lower back pain: this tends to be more common in girls and in those with poor core stability. Pain is commonly due to repeated hyperextension (over-arching of the lower back).  In extreme cases this repeated hyperextension can cause a Spondylolithesis (a small bony stress fracture in the spine) which often goes undetected until the child is seen by a physiotherapist.
  • Knee pain felt in children in their early teens can sometimes be due to a condition called Osgood Schlatter’s disease. This is where the quads muscle attaches via a tendon onto a bump of bone under the knee called the tibial tubercle. This bump is a centre of bone growth called an apophysis. When teenagers put on a sudden growth spurt this junction between tendon and growing bone can become stressed and painful.
  • Hypermobility can make children more susceptible to injury but Physio can help by identifying the problem and showing them how to manage this condition by strengthening their supporting muscles. So if your child seems to complain of frequent aches and pains it would be worth having them assessed by one of our Physios.
  • Poor core stability: we don’t really know when children gain good core control (muscular control around their back and stomach) but we often surprisingly observe poor core stability in children doing quite high level sport. This lack of strength around their middle can also raise their risk of injury. Exercises can help them to restore this strength.
  • A simple sprained ankle: spraining your ankle is always seen as a relatively minor injury but we know that unless the ankle is properly rehabilitated recurrent problems can occur. In children instead of simply straining the ligament they can sometimes pull off a small piece of bone from the ankle bone as well

How Physio can help

So in summary, we can help by assessing your child to:

  • rule out hypermobility or teach your child to manage it
  • identify any weaknesses that may lead to injury and set a programme of exercises to work on them
  • by treating any injury that may occur whilst screening for anything more serious.

To book an appointment with Katherine or one of our Physio team:

Call 0208 876 5690

Email us here

Pop in for a chat or book online here!

 

  • Physio on the River
    The Old Ticket Office
    Barnes Bridge
    The Terrace
    Barnes
    London
    SW13 0NP
  • Opening Hours

    Mon: 7am – 9pm
    Tues: 8am – 9pm
    Wed: 7am – 9pm
    Thurs: 8am – 9pm
    Fri: 7.30am – 7pm
    Sat: 8am – 2.30pm
    Sun: Closed

Get our latest offers, updates on services and health tips

This contact form is deactivated because you refused to accept Google reCaptcha service which is necessary to validate any messages sent by the form.

Because of our great transport links and free on-street parking we have regular patients and exercise class participants from:
Barnes, Mortlake, East Sheen, Putney and Roehampton