Have you ever been able to bend your thumb back to touch your wrist? Or can you place your hands on the ground without bending your knees? Have you always been told that you’re flexible?
You may have what’s known as joint hypermobility. Most people live life without any impact from hypermobile joints. It might actually be something you show off to people. However, others may have significant symptoms from having hypermobile joints.
What Is Hypermobility?
A joint is where two bones come together. Ligaments are connective tissue that hold the bones together. Ligaments are normally tough fibrous tissue. Hypermobility in the joints means that you have more range of motion, or movement, in your joints than the average person. Having hypermobile joints can also mean that the tissues in your body are fragile and more prone to injury. People with this condition may also have decreased proprioception, or knowing how your joints move in space without looking at your limbs.
Hypermobility can be the result of a genetic mutation in the production of collagen in your body, the tissue that holds everything together. This condition is usually hereditary, but it can also spontaneously occur during development. Joint hypermobility can also be caused by:
The shape of the bones not fitting properly in the joints.
Decreased muscle tone
Joint hypermobility can fall under Ehler ’s-Danlos Syndrome (EDS), a connective tissue disorder. There are 13 types of Ehler’s Danlos Syndromes with joint hypermobility being the most common form of this condition. EDS is thought to affect 1 in 5,000 people and is more common in women than men. It is mostly diagnosed in someone’s later 20s or early 30s. If EDS is suspected based on family history and symptoms, your doctor will run a genetic test for confirmation.
What Are The Signs of Hypermobility?
Several symptoms indicate you may have joint hypermobility. They are:
Dislocation of joints, particularly at the shoulder
Pain and stiffness in the joints and muscles
Clicking joints
Fatigue
Back and neck pain
Recurrent sprains and soft tissue injuries
Some symptoms aren’t related to the joints and muscles. These can be:
Acid reflux
Gastroparesis- slow digestion and emptying of the stomach causing bloating
Constipation
IBS
POTS - Postural Orthostatic Tachycardia Syndrome.
POTS occurs when abnormalities in the connective tissue around the nervous system are affected. This impacts the body’s ability to regulate heart rate and blood pressure. As a result, sitting or standing for prolonged periods or changing positions can cause a drop in blood pressure, resulting in fainting.
How is Joint Hypermobility Diagnosed?
Diagnosing of this condition is done through 2 main tests.
The Beighton Score.
The Beighton score looks at 5 criteria and gives a point for each positive result for 9 points. A score of 4 or more indicates a positive result.
placing your palms on the ground while standing with your legs straight
elbows that bend backward
knees that bend backward
thumbs that touch the forearm when bent backward
little fingers that bend backward beyond 90 degrees
This test requires a Beighton score, but also looks at other systems for identification.
A recent study looked at the diagnostic tests for joint hypermobility and found that there are limitations in their diagnostic criteria since they don’t take into account the systemic effects of connective tissue disorders.
How Does Joint Hypermobility Impact Your Pelvic Health?
Since hypermobility is a connective tissue disorder, it isn’t discriminatory and can affect every part of your body, including your pelvic floor. People who have hypermobility can have pelvic health symptoms such as:
Stress Incontinence
Hernias
Pelvic Organ prolapse
Pelvic pain
Painful sex
Fecal incontinence
Rectal prolapse
Treating Pelvic Health Conditions in Women With Joint Hypermobility
Treating someone who has hypermobility and pelvic health symptoms requires a multidisciplinary approach. Pelvic floor physical therapy can help to balance out the pelvis and strengthen the muscles around it. This helps to stabilize the pelvis by improving the biomechanics of the pelvis.
One study has shown that a 6-week generalized physical therapy program to improve strength and fitness improved pain scores and self-esteem in women with hypermobility and pelvic organ prolapse.
Another study showed that patients with pelvic girdle pain improved with targeted physical therapy that included strength training, proprioceptive exercises, and gentle stretching.
The bottom line is pelvic floor physical therapy is a great way to help improve your hypermobility symptoms. If you know you have joint hypermobility or EDS and are trying to conceive or are already pregnant, consult a pelvic floor PT early on. We can help prepare your body and pelvic floor for pregnancy and delivery.