Understanding and Addressing Hypermobility

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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