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Of Special interest to me is a little-known genetic, connective tissue disorder known as Ehlers-Danlos Syndrome. Hypermobility (also called "double jointedness" or hypermobility syndrome, benign joint hypermobility syndrome, or hyperlaxity) describes joints that stretch farther than is normal. These abnormalities cause abnormal distribution of wear and tear on joints, meaning that the joints wear out and can lead to osteoarthritis.
The condition tends to run in families, suggesting that there may be a genetic basis for at least some forms of hypermobility.
Hypermobility may also be symptomatic of a serious medical condition, such as Ehlers-Danlos syndrome, Marfan syndrome, rheumatoid arthritis, osteogenesis imperfecta, lupus, polio, Down syndrome, morquio syndrome, cleidocranial dysostosis or myotonia congenita. In addition, hypermobility has been associated with chronic fatigue syndrome and fibromyalgia.
Symptoms of hypermobility include a dull but intense pain around the knee and ankle joints and the soles of the feet.
In 1998, a study was done concerning the link between panic disorder with joint hypermobility. Hypermobility syndrome is generally considered to comprise hypermobility together with other symptoms, such as myalgia and arthralgia. Current thinking suggests that there are four factors: These four factors affect different people to varying degrees. The shape of the ends of the bones: Some joints normally have a large range of movement, like the shoulder and hip. Weak or stretched ligaments caused by protein or hormone problems: ligaments are made up of several types of protein fibre. The tone of the muscles: The tone (or stiffness) of the muscles is controlled by your nervous system, and influences the range of movement in the joints. People with hypermobility syndrome may develop other conditions caused by their unstable joints. Joint hypermobility syndrome needs to be distinguished from other disorders that share many common features, such as Marfan syndrome, Ehlers-Danlos Syndrome, and osteogenesis imperfecta.
The Beighton score is an edited version of the Carter & Wilkinson scoring system which has been used for many years as an indicator of widespread hyper-mobility. It is important that the individual with hypermobility remain extremely fit - even more so than the average individual - to prevent recurrent injuries.
Medications frequently used to reduce pain and inflammation caused by hypermobility include analgesics, anti-inflammatory drugs (though these have been linked with an increase in pain and joint instability for some sufferers), and tricyclic antidepressants. If typing is painful, they may try voice control software for their computer or a more ergonomic keyboard.


A decrease in heavy exercise, such as lifting heavy weights or running with wrist weights, which can be jarring to many joints, can be replaced with a more gentle run on an elliptical machine.
Remember to ask for help when needed, as to not risk excessive strain when extra assistance can be acquired.
Bracing to support weak joints may be helpful when joints are injured or painful, but caution must be used not to weaken the joints further. Hypermobility syndrome — A common benign childhood condition involving hypermobile joints (that can move beyond the normal range of motion). Joint hypermobility syndrome — A common benign childhood condition involving hypermobile joints (that can move beyond the normal range of motion). Ehlers–Danlos syndrome — Classification and external resources The collagen fibril and EDS. Male patient with EDS demonstrating ligamentous hyperlaxity of the hand, one of the symptoms of the syndrome.
For example, some hypermobile people can bend their thumbs backwards to their wrists, bend their knee joints backwards, put their leg behind the head or other contortionist performances.
The term double jointed is often used to describe hypermobility; however, the name is a misnomer and should not to be taken literally, as an individual with hypermobility in a joint does not actually have two separate joints where others would have just one.
During pregnancy certain hormones alter the physiology of ligaments making them able to stretch to accommodate the birthing process.
The condition affecting these parts can be alleviated by using insoles in the footwear that have been specially made for the individual after assessment by an orthopaedic surgeon and orthotist.
These proteins include elastin, which gives elasticity, which may be altered in some people.
Some people use special techniques to change their muscle tone and increase their flexibility. In the last couple of years collaborations of experts in connective tissue disorders formally agreed that there was little distinction between Hypermobility Syndrome and Ehlers Danlos Syndrome and that they are in fact the same disorder.
The Brighton criteria will not replace the Beighton score but instead will use the previous criteria in conjunction with other symptoms. Regular exercise and physical therapy or hydrotherapy can reduce symptoms of hypermobility, because strong muscles help to stabilise joints.
Some people with hypermobility may benefit from other medications such as steroid injections or gabapentin, a drug originally used for treating epilepsy. These include standing, stretching the joints (such as in some forms of yoga), and lifting heavy objects or weights.
Weakened ligaments and muscles contribute to poor posture, which may result in numerous other medical conditions.
The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS).


For example, their joints may be easily injured, be more prone to complete dislocation due to the weakly stabilized joint and they may develop problems from muscle fatigue (as muscles must work harder to compensate for the excessive weakness in the ligaments that support the joints). For some women with hypermobility pregnancy-related pelvic girdle pain can be debilitating due to these two converging factors, and prohibits her from standing up or walking. Women and subjects who were younger were found to be over 20 times more likely to have the hypermobile joints than their counterparts in the control group. If a shallow rather than a deep socket is inherited, a relatively large range of movement will be possible at the affected joints. HMS will be diagnosed in the presence of either two major criteria, one major and two minor criteria, or four minor criteria.
These treatments can also help by stretching tight, overused muscles and ensuring the person uses joints within the ideal ranges of motion, avoiding hyperextension or hyperflexion. Isometric exercises and attention to where joints are (avoid crossing legs for example if you have hip problems) are helpful to keep posture from leading to more pain.
This leads to an increase in elasticity of the skin, joints, muscles, ligaments and blood vessels.
Use of a bedpan and wheelchair may be necessary, or even permanent in some cases due to hip stretching.
Women are generally more supple just before a period, and even more so in the latter stages of pregnancy, because of the effect of a hormone called relaxin. Gymnasts and athletes can sometimes acquire hypermobility in at least some of their joints through the exercises they do in training.
Low-impact exercise such as Pilates or T'ai chi is usually recommended for hypermobile people as it is less likely to cause injury than high-impact exercise or contact sports.
Tramadol, a non-narcotic yet opioid pain reliever that is nearly as effective as narcotics, has been used in England to treat HMS joint pain, and it is available either by prescription from a doctor in the United States or from Mexico. The study does not determine whether hypermobility is associated in any way with psychiatric dysfunction or dysautonomia; many factors could explain the relation, and hypermobility's unwelcome gift of chronic pain may very well cause many people anxiety or depression.
Benzodiazapines are also used in HMS sufferers who experience painful muscles spasms around loose joints. Different races have differences in their joint mobility, which may reflect differences in the structure of the collagen proteins.
People from the Indian sub-continent, for example, often have much more supple hands than Europeans.




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