Hypermobility - How to manage?
By Mary Thornton MCSP
What is hypermobility? Most of us perceive hypermobility as the ability to move joints of the body into an excessive range. However, this condition can present with much more than over bendy joints. In March 2017 a new international term was introduced to describe this condition; Hypermobility spectrum disorder (HSD). The new term encompasses the large spectrum of symptoms this condition can present with. At one end could be someone who has increased joint range but no symptoms and actually finds their symptoms an advantage, such as in a gymnast, at the other end of the spectrum could be someone who has daily pain and needs to use a wheelchair to help them function.
HSD is a spectrum of inherited symptoms affecting the connective tissues of the body. Connective tissue is found extensively throughout the body and helps form a structural supportive webbing. The type of symptoms a person may present with is dependant on the type of collagen that makes up a specific connective tissue.
In people with HSD during embryonic development a faulty gene affects how specific collagen is formed resulting in dysfunction of that tissue. For example it could effect the walls of blood vessels causing them to be thinner and more extendable, this may result in bruising more easily. The symptoms that a person presents with will be based on which type of collagen has been compromised during development. As there are many different types of collagen in the body the array of symptoms can be very broad.
As a result the symptoms that a person with HSD can present with can sometimes be very mixed, leading to poor diagnosis and sometimes mismanagement of their symptoms. Hypermobility is still often misdiagnosed by the medical profession due to lack of knowledge and education of the condition, but slowly things are changing and there are now more specialised units to help give long term multi-disciplined management.
Our knowledge of HSD is relatively new in medical terms and there is new research emerging all the time to help scientists and clinicians determine the type of genes that are at fault, and how best to treat the symptoms that occur.
Some of the many symptoms that people with Hypermobility syndromes may present with :
Recurrent subluxation joint & muscle pain
Skin involvement/ poor healing
Fatigue
Arterial/ heart involvement/ Postural Orthostatic Tachycardia (POTS)
Intestinal problems
Eye problems
Excessive bruising
Bladder involvement / dysfunction
Headaches
Increased spinal curvature - Scoliosis
Anxiety
Fidgeting
Unstable gait
Poor proprioception
Autism
Poor tolerance to medication & general anaesthetic
Uterine prolapse
Prolapse disc
Pelvic girdle pain
As you can see this is a large array of symptoms. There is no cure for HSD, but there are ways of managing many of the muscular skeletal symptoms like chronic pain, joint subluxation and pelvic health that may present. In my practice I combine a holistic approach to hypermobility treatment using movement therapy that combines Physiotherapy, Pilates and Yoga techniques. The best way to find an appropriate treatment programme for you is to have an individual assessment to determine your specific needs are, a group class is not the best option to start with.
It is imperative that if you think you have hypermobility that you find a practitioner who understands the condition and is able to adapt and create a bespoke treatment plan for you. A good movement teacher will encourage small controlled movement patterns, while also paying attention to releasing tension in your body. A balance between developing endurance and strength in movement and not overworking you, as this will cause fatigue and develop compensations. Pacing is the key to your exercise plan.
So remember there are Pilates/ Yoga teachers and clinicians out there who can help you!
As well as treating individuals who have HSD Mary also educates Pilates & Yoga teachers how to approach this condition with her popular “Keeping it in the box!” teacher training programme.