Following on from the previous blog about the relationship between tight hips and lower back pain I thought I’d take a quick look at why so many people who are hypermobile experience pain also. It seems unfair –being stiff can cause pain but being very flexible can also cause pain.
Joint hypermobility is when some or all the joints have a greater range of motion than is optimal. This makes it difficult to stabilise these joints and often leads to the individual being clumsier with poor balance. Often spraining joints frequently and even dislocating joints like the kneecap(patella) and shoulders. Sometimes people who have hypermobile joints have been told that they are double jointed.
There is a series of tests that a chiropractor or physiotherapist can run through with you to score how hypermobile your joints are. This score is called Beighton’s scale and a score of greater than 4 is considered hypermobile.
As you can imagine, having joints that are super bendy is not optimal for creating stability in a joint. This lack of stability is often interpreted by the nervous system as unsafe. When our body feels unsafe it may give you pain. This is a protection mechanism to prevent you from injuring yourself – after all, if you feel pain in a joint you are less likely to put a lot of stress through that joint and less likely to injure it.
Very bendy joints caused by stretchy ligaments and connective tissue can make balance and proprioception (the body’s ability to sense its location, movements, and actions) more difficult which is why people with hypermobility are often considered clumsy and prone to injury. This can also result in your nervous system being hypervigilant to risk leading to more pain.
It’s important to remember that this pain is a protection mechanism not an indicator of damage. In fact, there is very little evidence that joint hypermobility results in greater levels of osteoarthritis or abnormal wear and tear of joints (an indicator of joint injuries in the past) in older age.
There is no cure for joint hypermobility, its not really a disease. Its just the way your body is made up, like having blue eyes or curly hair. However if you feel that it is causing you problems you should talk to a medical professional about it as there are some conditions such as Ehlers-Danlos syndromes - NHS (www.nhs.uk) that have joint hypermobility associated with them but also have a few other symptoms and signs that could be more serious and need monitoring.
Managing benign joint hypermobility is relatively straightforward but does require some commitment.
1. Balance training – start by simply standing on one leg with your eyes open for 90 seconds. Progress to closing your eyes. If this is really challenging lightly put one hand on the back of a chair to help your proprioception to start with. You can progress this exercise to standing on a cushion on one leg then try a wobble board. Stand up paddle boarding is a fun way to improve balance.
2. Sports – you may find that you are awesome at yoga and gymnastics but these aren’t necessarily the best exercise for very flexible individuals. Look for sport that trains balance, control and strength -Tai Chi, Pilates, and even weight training (with careful supervision to ensure good form) are great options.
3. Diet – the old adage “you are what you eat” holds true. A balanced diet including good sources of collagen is essential as this will provide your body with the essential ingredients it needs to maintain itself. Many people with joint hypermobility also experience digestive problems such as Irritable bowel syndrome (IBS) - Symptoms - NHS (www.nhs.uk). Consider taking a food intolerance test Shop the Full Range of York Test Tests | York Test Products as eating food that doesn’t agree with you may exacerbate your pain symptoms.
4. Chiropractic treatment – of course! A physical assessment for posture, strength, proprioception and alignment with a case history will help to inform a treatment and exercise plan bespoke to individual needs. This is always going to be better that self-diagnosis from internet blogs.
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