Why are People with Hypermobility More Likely to get Injured?
Insights from our transition year student
16/11/2022
Interesting topic observed on work experience
This week during my work experience placement I got to see some patients who are hypermobile. In this short written piece I’m going to try to explain why people with hypermobility are more likely to get injured, using the knowledge I received from Niamh, Garett and the, “Too Flexible to Feel Good” book by Celest Pereira and Adell Bridges. As someone who knew very little about the disorder, I found it very interesting to see how differently it presents itself from person to person and I wanted to investigate more.
What is Hypermobility?
But what is hypermobility to begin with? In simple terms, that I can wrap my head around, hypermobility is a spectrum disorder that is caused by a disruption of how collagen is organized in the body. Its official name is joint hypermobility spectrum disorder (JHSD) and it affects around 15 to 20 percent of the population. The severity of the disorder varies, with people on the far end of the spectrum having what’s called Ehlers-Danos Syndrome (hEDS) and those on the other end who are simply very flexible but have no ill health.
Symptoms
Collagen is a protein that makes up most of the fascia and soft tissues, like tendons, ligaments and muscles. It is also the main structure of the gut lining, the walls of arteries and the skin. As there is a difference in collagen in hypermobile people, they can have an excessive range of motion in the joints (basically they have extra flexible joints), which can cause pain and weakness, which can lead to excess injuries. In comparison to a person who is not hypermobile. Hypermobile people are also more likely to suffer from anxiety, digestive problems, fatigue, bone density problems and other health problems.
Reasons for the Injuries
People who have hypermobility are more prone to getting injuries for a number of reasons. First of all, signals from the brain to the rest of the body can get muddled up in people with hypermobility, as the neural pathways between the brain and the soft tissues are affected by the abnormal collagen. People with hypermobility know no different than having these different neural pathways and as a result they often have poor proprioception (body awareness). They can pick up a lot of injuries from everyday life such as bruises from walking into corners and stretching to the anatomical barrier during dance class because it ‘feels good’.
Another reason why hypermobile people are prone to getting injuries is because their collagen can be much more elastic (hence some hypermobile people being able to bend their pinky back more than 90 degrees!). This can cause problems because it allows the joints to move around more which puts strain on surrounding muscles, which then have to compensate for the pain the person is feeling. This causes a vicious cycle because the pain from injuries can cause other parts of the body to become weaker as they compensate, leading to more pain and injuries. One example I learnt was someone had weak hips which caused a pinching pain in the knee, due to a group of four muscles going from the front of the hips to behind the knee cap.
Treatment
The best way to treat hypermobility is through physiotherapy, as you can find proprioceptive exercises that are tailored to your needs. These can help prevent pain and further injuries as you achieve a better understanding of your own body. Reformer pilates is also amazing as it teaches the body to stabilise itself and makes the patient less likely to hyperextend.
Mia’s Reflection
Obviously hypermobility is way more complex than an A4 sheet of information written by a TY student, and I hope that I understood everything I learnt correctly by putting it into simple words. Maybe one day if I study physiotherapy myself I will be able to learn even more about hypermobility and have a deeper understanding about the disorder.
