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 .

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