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What is hypermobility?

Hypermobility, often referred to as being "double jointed",  is the term used to describe the ability to move joints beyond the normal range of movement. Hypermobility will make it hard for an individual to control end range of motion. Severe cases of hypermobility can lead to musculoskeletal issues such as ankle sprains and shoulder subluxations.

Hypermobility is presented in 5% of the adult population and is more common in children, up to 10-15%. Hypermobility, can be advantageous for athletes such as dancers and gymnasts but can cause issues for other members of the population.
 


Figure 1: Hypermobile Elbows 

How do you assess hypermobility?

As a coach it is our responsibility to initially screen all clients. Beighton’s Hypermobility Test is a quick assessment that can tell you a lot in a matter of a few minutes.  The test consists of 5 different assessments and is scored out of 9. Depending on your source, classification differs but the higher the score the higher the laxity.

Figure 2: Beighton Hypermobility Test
 

The Beighton score is calculated as follows:

  1. One point if while standing forward bending you can place palms on the ground with legs straight

  2. One point for each elbow that bends backwards

  3. One point for each knee that bends backwards

  4. One point for each thumb that touches the forearm when bent backwards

  5. One point for each little finger that bends backwards beyond 90 degrees.


Taken from  http://hypermobility.org


A few points to note about hypermobility are; its more common in females then in males, it is more common in African & Asian populations than in Caucasians and is more common in children then in adults.
 

How do you manage it?

To understand how to manage hypermobility, you must first understand the concept of protective tension. One of the big issues with hypermobile individuals is that they constantly stretch because they ‘feel tight’. Contrary to what you may think, static stretching isn’t the answer and actually does more harm then good for a hypermobile individual.
 

When a joint doesn’t have sufficient stability, the body lays down trigger points as a safety mechanism. This is what we call “protective tension” and is the reason that people with laxity always feel tight. Stretching doesn’t help this and only makes the matter worse. A better solution to the issue is ditch the static stretching and prioritize soft tissue work and stability drills. Foam rolling and trigger pointing are better alternatives as they will help down regulate the sympathetic nervous system and get out of "fight or flight" mode.
 

Our bodies have two types of stabilizers, static and dynamic. Our dynamic stabilizers are our muscles and our static stabilizes are our bones, ligaments and joint capsules. What happens in the case of a hypermobile individual is our dynamic stabilizers have to work in over drive to cater for the laxity in our static stabilizers.

Summary

If you have laxity, its not a bad thing.  It means that you need to focus on building functional stability. With the correct guidance, you will be able to build strength and control through full range of motion and most importantly, stay injury free.
 

References

  1. "Hypermobile Joints :: Nationwide Children's Hospital". Nationwidechildrens.org. N.p., 2016. Web. 24 Apr. 2016.

  2. "Laxity | Eric Cressey | High Performance Training, Personal Training". Ericcressey.com. N.p., 2016. Web. 25 Apr. 2016.

  3. Reinold, Mike. "Laxity Does Not Mean Instability - Mike Reinold". Mike Reinold. N.p., 2014. Web. 25 Apr. 2016.

  4. Rodriguez, Tori. "Double-Jointed And Anxious". Scientific American Mind 26.4 (2015): 10-10. Web. 25 Apr. 2016.


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