Hypermobility Spectrum Disorder
Hypermobility and Your Health
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.
Please note that there is a very broad hypermobility spectrum along which the issues I describe in this post occur. The majority of people with hypermobility experience functional issues that they can manage through a combination of nutritional therapy, physical therapy and emotional therapy, while people experiencing severe symptoms require appropriate medical diagnosis and management in addition to complementary approaches. Moreover, none of the information covered in this post implies any sort of diagnosis.
When Hypermobility is 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 musculoskeletal problems that 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.
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.
I find that most hypermobile people with health issues thrive on a customized combination of physical therapy, nutritional therapy and emotional therapy (in whatever combination is right for them, and adjusted over time to adjust for changing needs). Each of the three areas are cross-pollinating with the other two, so the work we do in each of these areas gives leverage to the other areas as well!