Understanding and Addressing Hypermobility
Understanding and Addressing Hypermobility: A Whole-Patient Approach
Hypermobility, characterized by an excessive range of motion in the joints, presents unique challenges and potential health issues. At BreatheWorks, we adopt a whole-patient approach, combining various disciplines to manage hypermobility as it relates to TMJ disorders, myofascial pain, and sleep-disordered breathing.
Defining Hypermobility
Hypermobility refers to joints that stretch further than normal. For some individuals it is a benign condition, but for others, it may be associated with chronic pain, frequent dislocations, and long-term joint dysfunction. This condition often requires ongoing management as it can affect various aspects of life, from daily activities to more intense physical endeavors.
Types of Hypermobility
Hypermobility is observed as a symptom in a number of disorders:
- Benign Hypermobility: A common type, characterized by increased range of motion without other health issues.
- Hypermobility Spectrum Disorders (HSD): Accompanied by a wide range of symptoms but not meeting the criteria of a systemic condition.
- Ehlers-Danlos Syndromes (EDS): A group of disorders with systemic implications characterized by hypermobility, skin hyperextensibility, and tissue fragility.
Prevalence and Clinical Implications
Hypermobility is fairly common, especially in children and adolescents. The prevalence varies, with benign hypermobility being more common and conditions like EDS being relatively rare. Awareness and understanding of hypermobility in the general population and among healthcare professionals is growing, leading to more frequent diagnoses and better management strategies.
Symptoms of Hypermobility
- Joint Pain and Discomfort: Especially after physical activity or prolonged periods in one position, pain can range from mild to debilitating and may require both medical and therapeutic interventions.
- Frequent Joint Dislocations or Sprains: Due to the instability of the hypermobile joints, individuals may experience these issues repeatedly, which can lead to further joint damage and pain.
- Fatigue: Often a result of the extra effort needed to stabilize joints, which can be draining both physically and mentally.
- Muscle Stiffness: Particularly in the mornings or after physical activity. This stiffness can be a protective response of the body to unstable joints.
- Skin Elasticity and Fragility: In cases associated with conditions like EDS, the skin may be unusually stretchy and fragile, leading to easy bruising and wound healing difficulties.
Contributing Factors
The causes of hypermobility and related disorders are influenced by a variety of factors:
- Genetic Factors: Many hypermobility cases have a hereditary component, passed down from parents to children.
- Collagen Deficiency: Collagen is essential for maintaining strong and stable joints. A deficiency or defect in collagen can lead to increased elasticity in the joints and other connective tissues.
- Muscle Weakness: Lack of muscle strength can contribute to joint instability.
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Diagnosis and Treatment - A Whole-Patient Approach to Care
Diagnosis often involves a clinical assessment of joint mobility using criteria like the Beighton Score. It may also include a review of medical history, physical examination, and genetic testing when a connective tissue disorder is suspected. A thorough diagnosis is essential to differentiate between benign hypermobility and more serious conditions like EDS. A multidisciplinary approach is crucial for managing hypermobility disorders:
- Physical Therapy: Strengthening exercises to stabilize joints and reduce the risk of dislocations.
- Pain Management: Including medication, heat, or cold therapy tailored to the individual’s needs.
- Lifestyle Modifications: Avoidance of activities that may exacerbate symptoms, tailoring daily routines to optimize physical health while maintaining good quality of life.
- Joint Protection Techniques: Exercises used to protect and support hypermobile joints, such as using braces or supports and learning safe movement techniques.
Prevention and Management Strategies
- Regular Exercise: Focused on strengthening and stabilizing muscles surrounding the joints. A regular exercise routine, ideally developed in consultation with a physical therapist, can be pivotal in managing hypermobility.
- Posture Awareness: Maintaining proper posture to reduce joint strain. This includes ergonomic assessments of professional and living spaces.
- Joint-Friendly Activities: Choosing low-impact exercises to maintain fitness without overstressing the joints. Activities like swimming, cycling, or yoga can be beneficial.
- Nutritional Support: A balanced diet to support overall health and joint function. Nutrition plays a key role in maintaining joint health, particularly in ensuring adequate intake of vitamins and minerals essential for bone and joint health.
BreatheWorks’ Care Plan
Our approach includes:
- Whole-Patient Assessment: Conducted by a Speech-Language Pathologist, we take a detailed case history to get a clear picture of your body’s story and assess the function of the speech, swallowing, and breathing mechanisms. We will observe how the muscles perform tasks like speaking, chewing, swallowing, clearing your teeth, and breathing and identify the contributing factors that may relate to your symptoms.
- Collaboration with Specialists: Working with rheumatologists, geneticists, and physical therapists who have expertise in managing hypermobility and related conditions.
- Individualized Care Plans: Addressing the unique challenges and needs of each patient.
- Education and Support: Empowering patients with the knowledge to understand the nature of hypermobility, strategies to manage symptoms, and how to protect joints from further injury.
Conclusion
Hypermobility, though often overlooked, can have significant implications for individuals’ daily lives and long-term health. At BreatheWorks, we provide comprehensive, patient-centered care, focusing on managing symptoms, strengthening muscles, and supporting joints. Through our multidisciplinary approach, we aim to support our patients in leading active and fulfilling lives while effectively managing the challenges of hypermobility.
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This is specific to each patient, their needs, and how often they are practicing their exercises. We see faster progress with patients who are in weekly sessions and practicing exercises daily. In some cases patients can complete the in person/teletherapy phase of treatment in 4-12 sessions. Our phase 1 of treatment is typically weekly with our in-home program that typically lasts between 3-6 months. Phase 2 treatment which involves remote monitoring and in many cases less need for more in-clinic based treatments takes between 8-12 months depending on individual progress.
Yes, we offer teletherapy services through Breatheworks virtual therapy platform. This option gives our patients the flexibility to receive high-quality, patient-centered care when and where they want it. Our teletherapy ensures our patients receive the same level of care as our in-person services, tailored to fit into any lifestyle. Teletherapy has many benefits like increased scheduling flexibility, easier follow-ups, and in many cases improved outcomes, all while contributing to a healthier environment by reducing travel related emissions. Whether from the comfort of your home or on the go, we’re here to support your health journey every step of the way.
Orofacial Myofunctional Disorders (OMD)
Orofacial Myofunctional Disorders (OMD) refer to a group of conditions characterized by abnormal patterns of muscle function and incorrect habits involving the face, mouth, and throat. These disorders can affect various aspects of oral function, including speech, swallowing, breathing, and facial development. Examples of OMD include tongue thrust (where the tongue pushes against or between the teeth during swallowing or at rest), open mouth posture (habitual mouth breathing with the mouth consistently open), and incorrect tongue resting position. OMD can contribute to dental malocclusions, speech articulation difficulties, temporomandibular joint (TMJ) dysfunction, and other orofacial issues.Orofacial Myofunctional Therapy (OMT or MYO)
Orofacial myofunctional therapy (OMT) is a specialized form of therapy designed to address and correct Orofacial Myofunctional Disorders (OMD). It focuses on retraining the muscles of the face, mouth, and throat to achieve proper resting posture, swallowing patterns, and speech articulation. OMT involves a variety of exercises, techniques, and behavioral modifications tailored to the individual’s specific needs and goals. The goals of OMT include improving orofacial muscle strength and coordination, correcting abnormal swallowing patterns, promoting nasal breathing, and enhancing overall oral function and health. OMT is typically provided by speech-language pathologists or therapists trained in orofacial myofunctional therapy techniques.Benefits of Orofacial Myofunctional Therapy (OMT)
Orofacial myofunctional therapy (OMT) can be highly beneficial for individuals with Orofacial Myofunctional Disorders (OMD). By addressing underlying muscle dysfunction and promoting proper oral habits, OMT can help improve speech clarity, correct swallowing patterns, alleviate breathing difficulties, and optimize facial development. However, the effectiveness of OMT depends on various factors, including the severity of the OMD, the individual’s commitment to therapy, and consistency in practicing exercises and techniques. OMT is often recommended as part of a comprehensive treatment plan in collaboration with other healthcare professionals, such as dentists, orthodontists, and ENT specialists, especially when addressing complex orofacial issues.We hold space in our clinicians’ schedules for new patients because we know that early intervention is the best approach. We like to see new patients in less than 2 weeks and typically schedule phase one treatments during the first visit. We can see you virtually or in person. Get started now.