Hypermobility describes joints that simply move more than we would expect. It’s not necessarily problematic, but can be associated with tight muscles and achey joints. Ultimately, it’s the result of having lax ligaments, which could be something you’re born with or the result of injury.

Identifying Hypermobility

The image above shows 9 joints tested to give a Beighton Score:

• both knees
• the lower back
• both elbows
• both thumbs/wrists
• the middle fingers

If any of these go further into a given movement than expected, they would give one point each. It’s a very primitive way of quickly rating someone’s degree of mobility. It doesn’t account for the hips or ankles, which could be very different to the rest of the body. But it does give a rough idea that we can use clinically.

We can also look at your movements in a standard joint exam to determine your level of mobility.

Effects of Hypermobility

If a joint is hypermobile, the surrounding muscles have to support it where the ligaments normally would. As a result, tension and achiness in those muscles is a common side effect. If the joint has not been supported well enough, it may have suffered more damage to the cartilage. So a hypermobile joint is also more predisposed to developing osteoarthritis and experiencing the associated joint pain.

With extra mobility becomes less stability, so a hypermobile joint is more vulnerable to dislocation. The shoulder and kneecap are two commonly affected joints as they are both shallow and depend on support from surrounding soft tissues. We can offer preventative advice here as well as rehabilitation if dislocation has already occurred. Fortunately, joints become less lax over time. For a hypermobile person, that brings them towards a potentially more comfortable range.

Osteopathic Management

Whether you have symptoms or not, some of our management strategies would be much the same. Your osteopath’s aim is to support the mobile joints better, by helping you to strengthen the muscles in those areas. Simultaneously, we would work to relieve those hypermobile joints of excessive demand. For example, a stiff nearby joint would need to be compensated for by the more mobile one. Treatment to ease tension there, both through joint mobilisation and massage might be a starting point.

Strengthening is mostly homework for you! We can prescribe exercises based on what we find during the appointment. These might need doing a couple of times a day, and we will check in on them at subsequent sessions, changing them as needed. If a muscle is not working at maximum capacity all day, it’ll be able to function more comfortably. So combining that with the mobilising of other areas mentioned above, we aim to support the affected areas through at least two prongs.

Very mobile joints, especially when associated with stretchy skin, can be indicators of Ehlers Danlos Syndrome. This is a genetic condition with wide reaching effects that can go undiagnosed for years. Although we can’t diagnose it, we can support you in speaking to your GP about the appropriate referral pathway if we suspect you may have it.

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