The term hypermobility is used to describe a higher than normal range of movement through joints. Sometimes referred to as being “double jointed”, hypermobility occurs when the collagen fibres making up a person’s ligaments are more stretchy than normal (think of them like a particularly stretchy rubber band). It is estimated that around 20% of individuals are hypermobile in some or all of their joints though the exact reason why hypermobility occurs is poorly understood. While hypermobility itself is not always symptomatic, it can act as an underlying factor in various joint and muscle issues, potentially worsening if left untreated.
In some sports such as gymnastics or dancing, hypermobility can be advantageous. However in many other cases, it can lead to issues such as pain, lower limb injuries and excessive fatigue after even short amounts of activity. Conditions such as Hypermobile Ehlers Danlos Syndrome and Hypermobile Spectrum Disorder may present with flexible joints however can have other more serious concerns such as digestive, bladder or circulatory issues due to the stretchiness of the collagen fibres throughout the body.
What Symptoms Are Associated With Hypermobility?
There are a number of symptoms which can be associated with hypermobility depending on the degree of laxity in the ligaments. The most common symptoms we see presenting at My Family Podiatry are:
Muscle pain and fatigue: As the ligaments are stretchier, the muscles have to work harder to stabilise the joints. This can lead to increased fatigue after even a short amount of activity with pain typically increasing with activity load. This can commonly be misdiagnosed as “growing pains”.
Joint pain: this is typically seen more in the lower limb due to the loads placed on these joints. Patients may experience frequent ankle sprains, flat feet or overpronation that can affect gait and stability.
Increased tripping, falling and clumsiness: The increased flexibility and muscle fatigue can lead to tripping and falling, more often seen in children however this can continue through to adulthood.
Lack of interest in sports and activities: The increased pain after activity can lead to children not wanting to participate in sports. This can even extend to children asking to be carried instead of walking.
How Do We Test For Hypermobility?
The standard test for hypermobility is the Beighton’s 9 point Hypermobility Assessment. This test involves a series of maneuvers to assess the flexibility of various joints, including the knees, elbows, and spine, as shown in the image below.
For conditions with genetic markers such as some variants of Ehlers Danlos Syndrome or Marfans, genetic tests can be ordered by a rheumatologist. However it is important to note, not all variants have genetic markers and a clinical diagnosis may be required in those situations.
How Can We Help?
In treating hypermobility disorders, our primary goal is to stabilise the foot, which in turn enhances the muscle efficiency in the foot, ankle, and legs. This effective stabilisation reduces muscle pain, fatigue, and the risk of injury. Here's how we achieve it:
1. Appropriate Footwear: Wearing the right kind of shoes is the first step in foot stabilisation. Footwear with adequate support and cushioning can significantly improve joint alignment and relieve pain. Proper shoes distribute weight evenly across the foot, reducing strain on specific areas and enhancing overall comfort and function.
2. Custom Foot Orthotics: These are specially designed insoles tailored to your unique foot structure and biomechanics. They will provide additional support to your arch and heel, improve alignment, and redistribute through the foot. This allows the other muscles throughout the lower limb to function more efficiently and may work to reduce pain.
3. Strengthening Exercises: Targeted exercises aim to strengthen the muscles in the foot and lower limb. A strong musculature helps support lax joints, reducing the stress and load on them. This ultimately lessens fatigue and improves stability and functionality during activities like walking, running, or standing.
4. Manual Therapies:
- Massage: This involves kneading and manipulating muscles to improve blood flow and release muscle tension. This decreased muscular tension may help to reduce pain.
- Dry Needling: This technique uses very thin needles to stimulate trigger points in the muscle, which can relieve tension and pain. Dry needling can be particularly effective for addressing muscle spasms and improving muscle function.
5. Shockwave Therapy: This non-invasive treatment modality uses acoustic waves to target areas of pain and stimulate the body's own healing processes. Shockwave therapy can be effective in breaking down fibrous tissue that often builds up in chronic conditions, thus reducing pain and improving function.
The team at My Family Podiatry are experienced in the management of pain and injury associated with Hypermobile Spectrum Disorder, Hypermobile Ehlers Danlos Syndrome and general joint hypermobility. If you have been struggling with foot and leg pain or fatigue, give the team a call on 3088 6116 to book an appointment today.