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Double Jointed (Hypermobility)

What does double jointed mean?

When someone is double jointed, it means that person has joints that stretch beyond the regular range of motion. There are a lot of people out there who can bend their thumb a lot farther than it is normal, not to mention many people who are able to perform all sorts of strange movements due to their hypermobility. It is important to remember that these hypermobility can be encountered in one or more joints, being related to the excess range of motion and not to an anatomical difference in the respective joints.

Causes

These are the most common causes believed to be responsible for hypermobility:

  • A misalignment in the respective joints
  • The bones that take part in the affected joints have epiphyses that are characterized by an abnormal shape
  • Connective tissue disease
    • Ehlers-Danlos syndrome
    • Loeys-Dietz syndrome
    • Marfan syndrome
  • Impaired proprioception at the level of the joints
  • Stickler syndrome
  • Rheumatoid arthritis
  • Osteogenesis imperfecta
  • Lupus
  • Poliomyelitis
  • Down syndrome
  • Morquio syndrome
  • Cleidocranial dysostosis
  • Myotonia congenita.

Joint hypermobility syndrome

The joint hypermobility syndrome is a medical condition in which the persons who are double jointed, present a wide range of other symptoms, including myalgia or arthralgia. This condition is often encountered in children and, in adults, it is believed to be more common in the female population.

Symptoms

These are the most common symptoms those diagnosed with joint hypermobility syndrome experience:

  • Instability at the level of the affected joints
    • Increased risk for sprains
    • Can lead to the inflammation of the tendons (tendinitis) or the bursa (bursitis) in the area
  • Pain in the respective joints (arthralgia)
    • Most common – pain at the level of the knee joint
    • Back pain is also frequently encountered, with patients suffering from prolapsed intervertebral discs or spondylolisthesis
  • Osteoarthritis
    • Characteristic – early onset
    • Appears during the teenage years (puberty)
    • Another symptom of this condition – the movement of the affected joints leads to the production of certain noises (clicking sound)
    • In children – growing pains (these appear especially during the night)
  • Increased risk for subluxation/dislocation
    • Most commonly occur at the level of the shoulder (due to the multiple planes in which this joint is able to move)
  • Higher susceptibility to conditions such as whiplash
  • TMJ (temporomandibular joint syndrome)
  • Increased risk for nerve compression
    • At the level of the vertebral spine
    • Or at the wrist – carpal tunnel syndrome
  • Finger locking
  • Reduced response to the administration of analgesics or anesthetics.

Causes

These are the most common causes that lead to the appearance of the joint hypermobility syndrome:

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  • Abnormally-shaped epiphyses of the bones
  • Protein deficiencies – elastin, collagen proteins
  • Hormonal imbalances
  • Pregnancy – relaxin (hormone) allows for the increased range of movement in the joints of the body (so that the baby can pass through the pelvis)
  • Muscle tone
  • Yoga
  • Intense physical exercise
  • Different athletic sports – this syndrome is often encountered in gymnasts
  • Impaired proprioception at the level of the respective joints – the body cannot detect the exact position in space, with the eyes closed
  • Disorders of the connective tissue
    • Ehlers-Danlos syndrome
    • Marfan syndrome.

These are the most common measures of treatment taken for the joint hypermobility syndrome:

  • Physical therapy
  • Occupational therapy
  • Podiatry
  • Anti-inflammatory medication
  • Cognitive behavioral therapy

Treatment

In general, you can consider the following measures of treatment for the double jointed condition:

  • Physical therapy
    • It can help to reduce the risk for recurrent injury
    • Water physical therapy is especially recommended, as the movements are easier performed in water
    • Different exercises are recommended with the purpose of strengthening the muscles (the stronger your muscles are, the better stability you will experience in the joints)
    • The physical therapist can help you stretch muscles that are tight or over-stretched
    • The exercises are also meant to teach the person to use the regular range of motion in the affected joints
  • Low impact physical exercise
    • Recommended choices – Pilates, Tai Chi
    • Reduced risk of injury (as opposed to the exercises with high-impact or the contact sports)
  • Moist hot packs
    • Purpose – pain relief at the level of the joints or muscles
  • Ice packs
    • Purpose – pain relief
  • Alternation between cold and warm applications
    • Recommended in some patients with the purpose of pain relief
  • Medication
    • Recommended choices
      • Analgesics
      • Anti-inflammatory medication
      • Tricyclic antidepressants
      • Steroid injections
      • Gabapentin
      • Tramadol (opioid pain reliever)
      • Benzodiazepines
    • Purpose – reduction of inflammation and pain relief
  • Other
    • Braces
      • Recommended in case of joints that are painful and injured (not indicated for prolonged periods of time, as they can reduce the muscle strength)
    • Prolotherapy injections
      • Strengthen tendons and ligaments (especially those affected by degenerative processes).

Living with Joint hypermobility

Living with joint hypermobility is possible but you will have to learn how to protect your joints from further damage. For example, instead of writing, you can consider typing (less pressure on the joints). If you have to type quite a lot, you can choose to use a professional software that recognizes your voice or you can purchase an ergonomic keyboard (reduce the risk of developing carpal tunnel syndrome).

You might also have to pay attention to the postures you adopt – for example, you should consider sitting instead of standing, so as to protect your joints. If you do have to stand, try to bend your knees from time to time. Discover the benefits of yoga – this ancient practice is going to provide a lot of advantages, for both your mind and your body. Try to spend as much time in the water as possible, as this is the best exercise for your joints. Avoid going over the normal range of movement, as this can do a lot of damage to the joints. Maintain an excellent posture, regardless of your activity and make sure to avoid sedentary activities – these are just as harmful, causing the joints to stiffen and the muscles to shorten. You need to take good care of your body and protect the joints that have been affected by the hypermobility.


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