What do we mean by being double jointed ?
Around 10% of the population are generally hypermobile and have multiple joints with a larger than normal flexibility. these individuals are able to bend joints back beyond a range of motion that is perceived as being normal.
It has been documented that up to 55% of children could be classified as being hypermobile. As we get older hypermobility gets less common, falling to around 34% in those aged 20–30 years and 18% in those aged 60 years or older.
Girls tend to be more susceptible to hypermobility than boys and he increased connective tissue flexibility in GJH is considered to be mainly a genetic trait
Commonly children will demonstrate this to you as having more bend at the elbows, knees and fingers. Those with hypermobility can also have more flexibility in spinal , shoulder and hip joints.
Why are some people double jointed / hypermobile ?
The tissue that makes up the capsule and ligaments is more elastic and results in it being stretchier. This allowing the joints to move further than the average person.
These individuals may find themselves gravitating to sports and activities that require larger degrees of flexibility e.g gymnastics or dance.
They may also at a younger age may be more predisposed to injuries that involve joints sub-luxing due to a lack of stability at the joint. They rely more on the muscular stabilizers so if they lack strength and control they are at risk of injury.
Typical sites for this type of injury are the patella and shoulder joints. It is not uncommon to see issues or history of patella subluxation, ( knee cap dislocation), in hypermobility syndrome.
Risk of injury and hypermobility
Quick screening tests for hypermobility syndrome:
Beighton score for hypermobility.
A Beighton score is a useful research tool to indicate generalised hypermobility. It is straightforward to perform clinically, but a high Beighton score does not mean an individual has hypermobility syndrome. Signs and symptoms also need to be present before hypermobility syndrome can be diagnosed.
Usually a score of 4 or more using this test is considered to indicate hypermobility.
Quick screening test for hypermobility.
(Hakim and Grahame, 2003)
- Can you now (or could you ever) place your hands flat on the floor without bending your knees?
- Can you now (or could you ever) bend your thumb to touch your forearm?
- As a child did you amuse your friends by contorting your body into strange shapes or could you do the splits?
- As a child or teenager did your shoulder or kneecap dislocate on more than 1 occasion?
- Do you consider yourself double-jointed?
If you answered ‘Yes’ to 2 or more of these questions there is a high likelihood that you have joint hypermobility.
Is there medical significance of being double jointed / hypermobile ?
Apart from musculoskeletal injuries in children and adolescents there are also conditions that have joint hypermobility as a feature of their presentation. Just because you are hypermobile DOES NOT MEAN you have one of these conditions.
These conditions are beyond the scope of this blog , but include;
- Hypermobility associated with pain in more than one area can be categorised as a Hypermobility Spectrum Disorder.
- Hypermobility is also known to be associated with types of Ehlers Danlos Syndrome. For more information on this condition check this website
- Marfan’s syndrome.
- Osteogenesis imperfecta.
What you can do to reduce injury risk if you are hypermobile or “double jointed”.
- Get assessed to determine if there is hypermobility and determine how it affects you.
- Posture and functional movement assessment. Addressing how you move and the postures you adopt in common activities through the day can help to take pressure off the joints and get the stabilizing muscles to work better.
- Improve endurance and build muscle strength to help protect the joints and give them better stability.
If you are concerned about hypermobility and how it may impact you book in to see one of our therapists here.