Hypermobility and Your Health
By Sara Russell, Ph.D., NTP
A lot of my clients with “hard to pin down” health issues or with multiple diagnoses that keep increasing in number over the years have hypermobile joints. Not all of these clients have a diagnosis that relates to their joint hypermobility, and in many cases I’m the first practitioner who asks them whether they are hypermobile. For this reason, I decided to write this concise introduction to health issues that some people with hypermobility may experience.
Make sure you subscribe to my newsletter to stay up to date on new content relating to hypermobility, as well as other wellness topics that may interest you!
Hypermobility May be Asymptomatic
Some people with hypermobile joints are asymptomatic and perfectly healthy all their lives. If this is your case, you are by no means doomed to developing problems down the line, and may enjoy perfect health your whole life. However, it’s wise to take measures to prevent hypermobile joints from becoming unstable over time. The health problems many hypermobile people experience don’t stem for hypermobile joints per se, but from joints that have become unstable over time via injury, micro-trauma and repetitive motion.
If you have asymptomatic hypermobility, maintain good conditioning through regular exercise. This promotes good muscle tone and structural stability, thus reducing the likelihood of over-extension and injury. If you are very hypermobile, you may want to avoid forms of exercise likely to increase your risk of injury, such as contact sports. If you are hypermobile, you may be a little clumsy due to poor proprioception and balance. If this is your case, you can work with a good physical therapist who can suggest specific ways for you to address these issues.
When Hypermobility is Symptomatic
When hyperextensible joints come alongside symptoms across different body systems, there may be a deeper problem with the connective tissue. Nonetheless, few physicians are aware that hypermobility can be correlated with health problems and few to this day ask their patients about hypermobility.
My focus here is on symptomatic hypermobility associated with Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorder (HSD). These conditions affect the integrity of connective tissue throughout the body, with a variable symptom picture that may include joint hypermobility, ligament laxity, tight muscles, easy injury, bleeding and bruising, slow healing, fragile skin and blood vessels, digestive difficulties, cardiovascular problems, scoliosis, and more.
HSD and hEDS often occur alongside comorbidities including POTS, dysautonomia, dyspraxia, migraines, Chiari malformation and mast cell activation disorders. You can read a fairly comprehensive overview of hypermobility in this 2012 review article. The updated diagnostic criteria were published in March of 2017 and can be viewed at https://ehlers-danlos.com/2017-eds-international-classification/. You can also read a couple of synopses of the new criteria (and some of the associated controversy) at scienceoveracuppa.com and ohtwist.com.
Both Hypermobility Spectrum Disorder and hEDS Run in Families
According to the current hypothesis, HSD and hEDS are autosomal dominant, meaning that in theory that a person with either condition has a 50% chance of transmitting it to their offspring. Because of the overlap in symptoms according to the current diagnostic criteria, the same family may include individuals with both HSD and hEDS, and the same person may fit the criteria for HSD at some points in life and hEDS at other points.
Clinicians note that more females than males present with signs and symptoms. One reasonable explanation for this is that males may have fewer complaints than females due to the fact that while testosterone tones muscles and increases structural stability, female hormones, especially progesterone, relax muscles and loosen up ligaments.
How I Work with Clients with hEDS and HSD
Just like everyone else, hypermobile clients are unique. There isn’t a one-size-fits-all solution for the complex constellation of symptoms these clients experience. In fact, the best support is individual and client-centered. Learn more about how I work with chronic illness in this post. If you’d like to learn how we can work together, make sure you reach out for your complimentary 30-minute discovery call!
Learn more about hEDS and HSD
Castori M. Ehlers-Danlos Syndrome, hypermobility type: An underdiagnosed hereditary connective tissue disorder with mucocutaneous, articular and systemic manifestations. ISRN Dermatology Vol 2012. Article ID 751768, 22 pp. Link
Castori M, Voermans NC. Neurological manifestations of Ehlers-Danlos Syndrome(s): A review. Iran J Neurol 2014; 13(2):190-208.
Castori M, Tinkle B, Levy H Grahame R, Malfait F, Hakim A. 2017. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet Part C Semin Med Genet 175C:148-157.
Celletti C, Camerota F, Castori M, Censi F, Gioffrè L, Calcagnini G, Strano S. Orthostatic intolerance and postural orthostatic tachycardia syndrome in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type: neurovegetative dysregulation or autonomic failure? 2017. Biomed research international. Link
Chopra P, Tinkle B, Hamonet C, Gompel A, Bulbena A, Francomano C. 2017. Pain management in the Ehlers-Danlos syndromes. Am J Med Genet Part C Semin Med Genet 175C:212-219.
Collins, Heidi. “If You Can’t Connect the Issues, Think Connective Tissues.” Video link
Fikree A, Chelimsky G, Collins H, Kovacic K, Aziz Q. 2017. Gastrointestinal involvement in the Ehlers-Danlos syndromes. Am J Med Genet Part C Semin Med Genet 175C:181-187.
Hakim A, De Wandele, I, O’Callaghan C, Pocinki A, Rowe P. 2017. Chronic fatigue in Ehlers-Danlos syndrome–hypermobile type. Am J Med Genet Part C Semin Med Genet 175C:175–180.
Hakim A, De Wandele, I, O’Callaghan C, Pocinki A, Rowe P. 2017. Cardiovascular autonomic dysfunction in the Ehlers-Danlos syndromes. Am J Med Genet Part C Semin Med Genet 175C:168-174.
Hamonet, C. Maladie ou syndrome d’Ehlers-Danlos: une entité clinique, d’origine génétique, malconnue, dont la rareté doit être remise en question. Link
Henderson Sr. FC, Austin C, Benzel E, Bolognese P, Ellenbogen R, Francomano CA, Ireton C, Klinge P, Koby M, Long D, Patel S, Singman EL, Voermans NC. 2017. Neurological and spinal manifestations of the Ehlers-Danlos syndromes. Am J Med Genet Part C Semin Med Genet 175C:195-211.
Lyons J, Yu X et al. Elevated basal serum tryptase identifies a multisystem disorder associated with increased TPSAB1 copy number. Nature Genetics 48(12) Dec. 2016:1564-71. Link
Malfait F, Francomano C, Byers P, Belmont J, Berglund B, Black J, Bloom L, Bowen JM, Brady AF, Burrows NP, Castori M, Cohen H, Colombi M, Demirdas S, De Backer J, De Paepe A, Fournel-Gigleux S, Frank M, Ghali N, Giunta C, Grahame R, Hakim A, Jeunemaitre X, Johnson D, Juul-Kristensen B,Kapferer-Seebacher I, Kazkaz H, Kosho T, Lavallee ME, Levi H, Mendoza-Londono R, Pepin R, Pope FM, Reinstein E, Robert L, Rohrbach M, Sanders L, Sobey GJ, Van Damme T, Vandersteen A, van Mourik C, Voermans M, Wheeldon N, Zschocke J, Tinkle B. 2017. The 2017 international classification of the Ehlers-Danlos Syndromes. Am J Med Genet part C Semin Med Genet 175C:8-26.
Seneviratne SI, Maitland A, Afrin L.2017. Mast cell disorders in Ehlers-Danlos syndrome. Am J Med Genet Part C Semin Med Genet 175C:226–236.
Smith, C. Understanding Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder. Redcliff-House Publications (UK), 2017.