Being “Double Jointed” is More than Just a Party Trick
What is it?
Joint Hypermobility Syndrome (JHS), commonly referred to as being “double jointed” is a connective tissue disorder characterized by chronic musculoskeletal pain due to joint instability and hyperextensibility (1). Basically, joint hypermobility means that some or all of your joints are more flexible than most people’s, and individuals with JHS have chronic pain related to their joint flexibility. Approximately 3% of the general population is believed to suffer from chronic pain and fatigue caused by JHS, though it often is mis- and under-diagnosed.
What are the causes/risk factors?
Some people are more likely than others to present with joint hypermobility. Given that not all individuals with hypermobile joints develop chronic pain and fatigue, it is likely that genetic and environmental factors contribute to the development of JHS. For example, joint hypermobility due to abnormal collagen (a protein that provides structure to muscles) or from shallow joint sockets is likely to be inherited (2). Contrarily, increased muscle elasticity and therefore, less stable joints, can be developed through the training and exercises an individual participates in such as gymnastics (2).
Women, children, and adolescents are more likely to have hypermobile joints (1,2). JHS is also more common in individuals of Asian and West African ethnicity. The differing degrees of joint flexibility for people of different ethnic backgrounds could be related to structural differences in collagen proteins. (2)
What are the symptoms/indicators?
Not all individuals with hypermobile joints suffer chronic pain related to JHS. While hyper-flexible joints may give individuals such as athletes or musicians an advantage, these individuals may also be more likely to dislocate their joints, experience generalized joint pain, and be more injury-prone than their less flexible peers. Additional symptoms of JHS include:
Joint stiffness – When the muscles surrounding a joint are overstretched, the body may produce excess fluid within the joint in an attempt to repair the damaged tissue. This collection of fluid could cause joints to feel tense (2).
Headaches – As many as 75% of females with JHS suffer from migraines (1).
Fatigue – The muscles of an individual with JHS are forced to work harder to stabilize the joints they surround. As a result, the muscles are overworked and become fatigued. Muscle weakness is believed to be the main cause of generalized fatigue for an individual with JHS (1).
Dysautonomia– an autonomous nervous system condition that could cause fainting, gastrointestinal discomfort, cardiovascular issues, breathing problems (1).
Abdominal and pelvic pain– a 2014 study found that 86% of JHS patients complain of abdominal pain (1).
How can PT help?
For individuals with JHS, building and conditioning the muscles surrounding the joints is imperative. Physical therapists can advise patients with JHS on beneficial exercises and can help develop an exercise regimen to strengthen muscles without the risk of overtraining or injury (1,3). Clinical studies have also shown that physical therapy techniques such as manual therapy and muscular taping are low-cost interventions that may also reduce JHS related pain and fatigue (1,2,3).