If you have hypermobile joints, you are able to extend them easily and painlessly beyond the normal range of motion. Hypermobility of the joints occurs when the tissues holding a joint together—mainly ligaments—are too loose. Often, weak muscles around the joint also contribute to hypermobility.
The joints most commonly affected are the knees, shoulders, elbows, wrists, and fingers. Hypermobility is a common condition, especially in children, since their connective tissues are not completely developed.
According to the Mayo Clinic, a child with hypermobile joints may lose the ability to hyperextend as he or she ages. (Mayo)
Hypermobility of the joints may also be called:
- joint laxity (or hyperlaxity)
- loose joints
- hypermobility syndrome
What causes joint hypermobility?
Four factors may affect people to varying degrees:
- The shape of your bones – If the socket part of the hip or shoulder joint is particularly shallow, the range of movement in the joint will be greater than usual and you’ll also have a greater risk of dislocation.
- Weak or stretched ligaments – Ligaments are made up of several types of protein fibre, including elastin (which gives stretchiness) and collagen (which gives strength). Small changes in the chemical processes in your body can result in weakened collagen fibres and more elastic ligaments. This in turn causes weakness in the ligaments that help to hold the joints together. This is likely to cause hypermobility in many joints.
- Muscle tone – The tone (or stiffness) of your muscles is controlled by your nervous system. The more relaxed your muscles are, the more movement you’ll have in your joints.
- Sense of joint movement (proprioception) – Some people find it difficult to sense the position of a joint without being able to see it, and they may develop joint hypermobility by over-stretching the joints without realising it.
Relieving Symptoms of Hypermobile Joints
Hypermobility is often the result of weak joints. If you have this condition, you are more likely to dislocate or injure your joints through sprains, strains, etc.
To decrease your risk of complications, you can try the following:
- do exercises, such as yoga, to strengthen the muscles around the joint
- learn what normal range of motion is for each joint in order to avoid hyperextension
- protect your joints during physical activity by using padding or braces
If you have joint hypermobility syndrome, treatment will focus on relieving pain and strengthening the joint. Your doctor may suggest you use prescription or over-the-counter pain relievers, creams, or sprays for your joint pain.
He or she may also recommend certain exercises or physical therapy.
How is joint hypermobility diagnosed?
Your GP will be able to make a diagnosis of generalised joint hypermobility or joint hypermobility syndrome by examining you and asking you a series of questions based on two commonly used scoring systems.
The Beighton’s score measures your flexibility using a standard set of movements. A high Beighton’s score means you’re hypermobile but doesn’t mean you have joint hypermobility syndrome.
Diagnosis of joint hypermobility syndrome depends on having symptoms as well as hypermobile joints and is made using the Brighton criteria – if you have four or more hypermobile joints and you’ve had pains in those joints for three months or more then it’s likely that you have joint hypermobility syndrome.
What treatments are there for joint hypermobility?
If you have symptoms of joint hypermobility then a combination of rest, exercise and physiotherapy will often help, but drug treatments are also available if you need them.
Research funded by Arthritis Research UK has shown the value of exercise. In most cases you can ease your symptoms by doing gentle exercises to strengthen and condition the muscles around the joints that are particularly flexible.
The important thing is to do these strengthening exercises often and regularly but not to overdo them. Use only small weights, if any.
A physiotherapist will be able to advise you on suitable exercises. For some people gentle stretching seems to be as effective as strengthening.
You can use splints or firm elasticated bandages can be used if you need to protect your joints against dislocation. An occupational therapist or physiotherapist can advise on these.
It’s also quite common for hypermobile people to manipulate and click their loose joints, which often makes the joints feel better.
But sometimes you may need professional medical help to manipulate the joint back into place.
Painkillers (analgesics) are the usual treatment if you have symptoms. Paracetamol is normally the first choice. It’s often better to take a dose before activity to keep the pain under control rather than waiting until it’s very bad.
Your doctor can prescribe a stronger painkiller such as co-codamol or co-dydramol if necessary, though these may sometimes cause side-effects such as constipation or dizziness.
Non-steroidal anti-inflammatory drugs (NSAIDs) may be more helpful if your joint often swells up, especially after dislocation.
You can buy ibuprofen from your local chemist or supermarket without a prescription. See your doctor if the regular dose isn’t helping, as they may be able to prescribe a higher dose or a different NSAID.
NSAIDs can cause digestive problems so your doctor may prescribe another drug along with the NSAID to help protect your stomach.
Your doctor will be cautious about prescribing NSAIDs if you may be at increased risk of heart attack or stroke.
Painkillers and NSAIDs are also available as sprays or creams which you can apply directly to the painful joint. These may not be quite so effective but may be an option if tablets aren’t suitable for you.
NSAID sprays or creams
Surgery isn’t generally recommended for hypermobile joints. However, if you tear (rupture) a tendon (which is more likely than usual if you have hypermobile joints) then this should usually be repaired with surgery.
Regular exercise is important as part of a healthy lifestyle, and there’s no reason why people with hypermobile joints shouldn’t exercise or play sports.
However, if you find that certain sports or exercises involve movements that cause pain then you should stop these activities.
What’s important is to avoid overstretching your joints. Swimming can help, where the weight of your body is supported by water, although breaststroke can irritate the knee and hip, so it’s best to paddle your legs.
We also recommend cycling and simple strengthening exercises.
If any of your joints dislocate regularly it may help to wear a splint or elastic bandage while exercising.
You may need to see a physiotherapist or orthotist for supports if this is a significant problem.
Diet and nutrition
There’s no specific diet to help joint hypermobility, but we would recommend a healthy, balanced diet to keep your weight under control and for your general health.
People with hypermobile joints often ask about complementary therapies to help with pain relief.There’s no evidence to support a particular therapy, although acupuncture is now recommended in the National Institute for Health and
Clinical Excellence (NICE) guidelines for low back pain.
Generally speaking complementary and alternative therapies are relatively safe, although you should always discuss their use with your doctor before starting treatment.
There are some risks associated with specific therapies. In many cases the risks associated with complementary and alternative therapies are more to do with the therapist than the therapy.
This is why it’s important to go to a legally registered therapist, or one who has a set ethical code and is fully insured.
If you decide to try therapies or supplements you should be critical of what they’re doing for you, and base your decision to continue on whether you notice any improvement.
There’s a wide variation in the shape of the foot in people who are hypermobile.
Most tend to have flat feet but a few have a high-arched foot. Special insoles in your shoes (orthoses) may help to restore the arch of the foot.