• Philip J Hehir, Chiropractor D.C, M.R.C.C

Hypermobility

The human frame is bound together by tough pieces of connective tissue called ligaments.

Think of ligaments as bundles of biological Sellotape that wrap around bones and joints to hold them together. Ligaments are an important structure in keeping us upright and moving and subsequently, ligamentous laxity is important and could make the frame more unstable if too loose. Take this: after spraining an ankle or even the joints in your lower back, it is not uncommon for recurrence of injury to happen. One of the main reasons for this is because the ligaments in that area have been stretched and results in localised hypermobility, or excessive joint movement.


In 1973, a team of scientists, Beighton and Co, coined the term “Hypermobility Syndrome” referring to generalised ligament laxity and any professional who deals in treating human skeletons has been interested ever since. Thanks to Beighton and his team, we understand that hypermobility syndrome, now often referred to as Benign Joint Hypermobility Syndrome (BJHS) is a distinct inherited clinical entity that can give rise to symptoms of joint pain; an increased risk of injury; and in some cases, other medical conditions not related to joints.


Beighton and his team developed a scoring system for determining whether someone was classed as hypermobile. You can check this out on yourself now:

  1. Are you able to hyperextend each knee when standing? (Give 1 point per knee.)

  2. Are you able to hyperextend your elbow? (Give 1 point per elbow.)

  3. Are you able to comfortably draw your thumb to the palm side of your wrist, on the same side, whilst your arm is stretched out in front of you? (Give 1 point per thumb.)

  4. Are you able to bend your little finger backwards to at least 90-degrees? (Give 1 point per finger.)

  5. Whilst standing, are you able to bend and touch your toes, knees straight and with flat palms on the floor (Give 1 point).


There’s a total of 9 points and if you score 4 out of 9, you could be classed as having BJHS.


The prevalence of BJHS is around 10-15% within the population; is more common in women than men (2:1); and in non-Caucasian populations (up to 43%). We know it can run in families and is part of a group of disorders called Inherited Connective Tissue Disorders. Other, more problematic conditions in this group are Ehler-Danlos Syndrome, Marfan Syndrome and Osteogenesis Imperfecta which have their own diagnostic criteria (Google these if you want more information).


In 2011, Bulbenna and Co. interestingly discovered that individuals with BJHS were 22 times more likely to suffer with anxiety than control groups. Incidentally, another condition called Fibromyalgia (FM), has a lot of cross over symptoms of BJHS. We know that suffers of FM are 44% more likely to have BJHS, giving rise to theories of potential associations with the two conditions.



As chiropractors, who are interested in the restoration of normal spinal and joint functioning, it is not uncommon for us to see sufferers of BJHS. We have to be particularly careful and as such more traditional chiropractic treatments, such as manipulation, may not be appropriate. Dry needling, soft tissue therapy and strengthening exercises often work better. In fact, we frequently find in these individuals that a lack of exercise makes their pains worse, so encourage more activity if not doing so already. Finally, sufferers with BJHS should be aware that with any treatment, including physiotherapy, recovery time and healing is often slower than in their non-hypermobile counterparts. This is due to the time required to improve joint strength and stability; so should adjust their expectations accordingly.


If you have any questions on the content of this article, please feel to contact the clinic and ask to speak to one of our team.