Hypermobility (Part 1)

What is hypermobility?

This is the first in a series of articles discussing non-pathologic, or normal hypermobility. Physical therapists define “hypermobility” as excessive joint motion. Hypermobility can be generalized, meaning that all (or most) joints of the body are affected, or localized, with only one or a few joints affected.

What causes joint hypermobility?

First let’s talk about the structure of joints. Joints can look like hinges (knee/elbow), ball-and-sockets (hip/shoulder), or a variety of other shapes. Our joints are surrounded by connective tissues, including ligaments, muscles, tendons, joint capsules, and fascia, which provide stability. All of these are made up collagen fibers, with a little bit of elastin included for stretchiness. Think of the joint capsule and ligaments as layers and layers of tough plastic wrap that surround and support your joints. Different brands of plastic wrap have different properties – some are more stretchy or more durable than others. Similarly, some people’s connective tissues are more stretchy than others. People with stretchy connective tissues tend to have hypermobile joints. People with stiff connective tissues tend to have hypomobile joints.

Who tends to have joint hypermobility?

Hypermobility that is not caused by any particular disease occurs in 4% to 13% of the population (Biro 1983). Different people have different amounts of joint motion…some more, some less…but one would only be considered to have a pathology, disease, or syndrome when extremely stiff (hypomobile) or extremely mobile (hypermobile).

In general, women, young people, and people who stretch a lot tend to have more joint mobility than men, older people, and people who don’t stretch. Dancers, yoga practitioners, and gymnasts tend to have a lot of joint hypermobility – sometimes so much that they start to have joint pain or instability. For these populations, it is important to understand how to bend or move, putting the least amount of stress on the joint, and potentially avoiding pain. Many people with joint pain who have underlying hypermobility find that they can relieve their pain partially or completely just by avoiding certain movements or positions, or by strengthening weak areas.

If you have been told by a medical professional that you have hypermobile joints, understanding your body and what it “wants” and “doesn’t like” can be a powerful tool for self-treatment.

This can potentially reduce the need for medical intervention (and reduce the financial burden on you)! Hypermobility that is caused by or associated with a disease process must be treated by a medical professional. Check this space again soon for the next episode in this series.

Written by Dr. Lizzie Bellinger, PT,DPT