What is it and why do we PT’s care?

Hypermobility can be thought of as extra laxity in the joints, aka the joints are more flexible than is typical. In the clinic, we measure joints in degrees, and usually joints like elbows and knees are supposed to straighten to make the arm one line and the leg one line, which would measure to be 180 degrees. Hypermobility is really easy to see in the elbows and the knees especially because the angle will be visibly past straight, or past 180 degrees.  It is definitely harder to see in the spine, the hips, shoulders, ankles, wrists, feet, and hands but they can be hypermobile too! A couple of extra degrees is completely fine and is within what we call normal. But, when 10 or more extra degrees can be seen and measured, we start to consider this within our treatment planning in the clinic.

You might be thinking, so what, my child’s knee can bend a little backward, why does this matter? That is a great question! We will use the knee as an example. It really matters if you see them standing and “hanging out” on a hyperextended knee (a knee that is over straight) for prolonged periods of time. There are plenty of kids and adults who have hypermobility throughout their whole bodies who have learned through athletics, or just through life, to control their mobility and stand with “neutral joints”. But, at baseline it is harder for those with hypermobility to control their joints. Because of this, they have to train their muscles and ligaments to sense when they are in the right place.

There are many systems that come into play to learn how to control hypermobile joints, but simply put, the muscles and ligaments need to learn how to sense when the joints are aligned versus when they are hyperextended. Then the muscles need to be trained to hold the joints in the “good place”, gaining control and strength through frequent practice. When this is practiced A LOT, it will become a skill that the child doesn’t need to think about, and will happen automatically.

We PT’s care about hypermobility because it can make it harder for children to sense what their bodies are doing as they move and harder to control their bodies. Part of our awareness of what our bodies are doing as we move comes from signals the joints send to our brain. Sometimes with hypermobile joints, these signals are decreased unless the joint is at its “end range” aka when it is fully extended. This causes children with hypermobility to lock out their joints while completing movements, which can lead to abnormal movement patterns in early life. Constantly moving with abnormal patterns on joints that are over extended can also cause joint injury in later life. 

The other big factor that can be tied to hypermobility we also look for and treat is decreased coordination. When there is less control over the joints, it is hard to put movements together. This is especially so for movements that require standing on one leg, pushing through the arms, and moving the limbs, head, and/or trunk in different ways at the same time.

If your child shows signs of joint hypermobility and you believe it is affecting their ability to move easily and with control, call and inquire about our free Discovery Visits, where we can screen your child to see if physical therapy would be an appropriate option for him or her. If you have any questions about this article, feel free to contact us at info@kidpt.com .

Setting attainable goals & letting kids bask in their own successes!

If you’ve ever watched a pediatric physical therapy session, you will often see us putting a toy or desired object just out of a child’s grasp so they are inspired to roll, crawl, walk, scoot, or reach for it. Setting up the environment this way helps us to encourage kids to utilize emerging motor skills and strengthen those skills while building confidence. When we set our environment up, we are always thinking about where the “goalpost” is and whether or not the goal we are setting is attainable for the child at that time. If it seems too hard, we have to adjust the height, distance, or surface where the toy is located so that the child we are working with is working hard but can still be successful!

Setting attainable goals is so important when kids are learning new skills because we want them to build confidence as they are building skill and we want them to enjoy practicing and learning. One way we see kids get really frustrated or discouraged when learning a new skill is when the goalpost is frequently changing as they are working to reach it. An example of the “changing goalpost” that often causes our kiddos to get upset is when they are a new walker, taking unsteady steps to reach mom, dad, or a toy, and who or what they are trying to get to keeps moving backward. We TOTALLY understand the desire to do this, it gets them to walk more, which is good right? While the easy answer would be “Yes, they are walking more”, it is more complex than this. While they are chasing the desired person or object, they are thinking “Gee, I only had to walk that short distance to mom when I started, and I definitely thought I could do this, but now she is getting farther and farther away, and I am getting tired. I don’t know if I can do this anymore.” Even though they definitely CAN do the skill for short distances, their confidence is then starting to decrease, and they may not want to try again because it takes SO MUCH effort to be successful. 

Don’t worry, this is a very easy fix! Say they are a new walker, have them start with a short distance first. Let them reach the object or person they are walking to and then let them play with the toy, hug mom or dad, and revel in the joy of their success with that mobility. Let them feel that joy for a few minutes while playing with the toy or hugging a parent. Then, once they have played for a short time, move the toy and redirect their attention to have them practice the skill again. Maybe even try to place the goalpost a little further next time, building on their ability as their confidence grows. Now they are learning that they can be successful with that motor skill, they are building confidence in it, while also learning that it is a new way of mobility they can use to reach things they want (a win, win, win)! Learning new motor skills takes a lot of patience, but overall the success your child will experience when moving and reaching each goal is worth the wait!

Happy Valentine’s Day! Today, we are going to keep it short and sweet! We know you are all probably having a blast sharing sweet messages with friends and family and eating chocolate, but you know what else is fun?! Valentine’s Day themed exercises, that’s what!! So become the best Cupid you can be today and share the love with these five sweet moves:

  1. Big Hug Jumps- start with your feet next to each other, arms by your sides. Then jump your feet and arms out at the same time! Next, jump back in so that your feet are together and your arms are wrapped around you, aka you are giving yourself a BIG HUG! Repeat this move for 20 seconds!
  2. Open valentines messages- Stand with arms and legs squished together while you squat. Then, open one leg and same side arm until your arms make two right angles and your knees make two right angles, as in the picture below. Now close the box by bringing your arms and legs together in front of you again. Do this with the same leg and arm 3 more times. Repeat to the other side.
  3. Unwrap the chocolate – Start with your back on the ground, with your legs and arms curled into a little ball. Slowly open up your legs and arms, lowering your body slowly to the ground to “unwrap” all the chocolate you want to eat! Unwrap chocolates 10 times!
  4. Give out flowers – Give all of your loved ones pretty flowers on Valentine’s day with a lunge and sway. To do this move, stand with your feet wide and lean onto your right leg, bending your right knee. Then keep your weight on your right leg and straighten your knee while raising your arms to the sky. Pretend you are holding one beautiful flower in your hands as they move to the sky! Repeat this to the left side, then do the move 7 more times to each side!
  5. Cupid’s Bow – Last but not least, be the best Valentine’s Day Cupid you can be by stepping into a lunge with your right foot forward, hips facing sideways (Aka warrior II if you know Yoga – in the picture below). Put your hands, with two fists, next to each other with arms straight in front of your nose. Then pull your left arm back like you are trying to shoot an arrow from your Cupid’s Bow while bending your right knee. Repeat this move 5 more times on this side then 6 times with the left foot forward.  

Need a better visual for what these moves should look like? Go visit our KidPT TikTok @kidpt_nj , our instagram @kidpt , or our facebook page @kidptnj to see Dr. Ali’s demonstrations for each of these lovely moves! We hope you have a happy Valentine’s Day with lots of chocolate to make the heart smile!