Updated: Sep 17, 2021
What is hyper-mobility and how is it measured?
Hyper-mobility is for the most part an inherited trait and refers to an individual being able to move a joint beyond a normal range of motion. This can account for one joint or be wide spread throughout the whole body. There is a scoring system known as the Beighten Hyper-mobility Score which is a 9 point system analysing the thumb, little finger, elbows, knees and trunk. The higher the score, the higher the amount of laxity. In an individual with hyper-mobility, the connective tissue proteins that provide the internal structures with resilience are affected which allows for increased laxity within the soft tissues that connect joints. Having an abnormal amount of range at a joint generally doesn't change with age, however it is possible to train the strength and proprioceptive systems to allow for increased control of movement which protects potentially vulnerable joints.
What is flexibility?
Flexibility is similar to hyper-mobility in that it refers to an available range of movement in the body, however it is different in that flexibility generally relates to the amount of give in a muscle as oppose to hyper-mobility which relates to the laxity in a ligament. The other vital difference between the two is that flexibility is usually more prominent in children and tends to reduce as we age. It is also possible to change muscle length with effective stretch based activities, whereas joint laxity generally doesn't change as these structures are non contractile.
How common is hypermobility?
Approximately 27% of females and 10% of men are hypermobile.
Can you be hypermobile but not flexible?
Yes, in fact many individuals who are hypermobile are not flexible. Hypermobility affects ligaments which join bone to bone- hence why joints are affected, but flexibility refers to muscle length which isn't increased due to hypermobility.
The two can be confused quite easily but as an example my hips can externally rotate to 180 degrees, yet my box splits is now very limited due to limited stretching and shortened hamstring and adductor length.
Main differences between muscles and ligaments?
Muscles are contractile which means that if they are over stretched then they generally spring back to their original length because they are elastic, whereas ligaments are not contractile and therefore if they are over stretched then they don't spring back and instead remain lax predisposing the individual to injuries such as sprains and dislocations.
Problems with hypermobility
Some individuals have no problems associated with being hypermobile but this usually is dependent on the severity of hypermobility and the activities that one is exposed to. Incidence of dislocation and sprains is significantly higher and individuals that are hypermobile usually find it harder to gain muscle strength as they have a much larger amount of mobility to control. But strength work and proprioception are the only way to help mange hypermobility- note it can be managed but can't be cured. Risk of experiencing injuries such as sprains and dislocations is significantly higher.
Can physio help with hypermobility?
Yes it absolutely can. As already discussed, therapy is used as an intervention to help manage hypermobility. It cannot cure it- nothing can! Physio aims to identify which aspects of your hypermobile joints are causing your symptoms or contributing to your occurrence of injury and thereafter endeavors to address this by putting a progressive exercise plan in place to allow to optimal strength, control and proprioception.