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W
hen we see nimble
acrobats and gymnasts,
we often marvel at their
extreme flexibility. Some
of them will have hypermobility, where
several joints in the body are more
flexible than usual, affording a wider
range of movement.
Children who are hypermobile can
hyperextend their knee or elbow joints,
touch their wrists with their thumbs,
and place the palm of their hands
flat on the ground with the knees fully
extended – movements that are part of
the Beighton’s score, a test for measuring
the mobility of joints. A high score means
you are hypermobile. Also, “this flexibility
can be a huge advantage for musicians
playing string or keyboard instruments,”
says Professor Rodney Grahame, a
consultant rheumatologist at University
College London Hospital.
Symptoms
But along with the advantages of greater
flexibility, hypermobility can sometimes
have painful consequences. It can be
accompanied with joint and muscle
pain, most particularly in the knees,
elbows, and calf and thigh muscles,
with a susceptibility to dislocations,
sprains and injuries of affected joints. In
those cases, it is known as hypermobility
syndrome. The condition is believed to be
hereditary, caused by genetic changes
in the structure of collagen, a protein
found in ligaments that hold and support
the joints. The ligaments are stretchy,
giving the joints greater flexibility and
making them prone to injury.
For sufferers of hypermobility
syndrome, pain usually builds up during
the latter part of the day and worsens
with physical activity. Rest often brings
relief. These symptoms are often confused
with growing pains. A child suffering
from chronic pain might refuse to walk or
engage in physical activities and is often
misunderstood to be lazy or fussy.
Children suffering from hypermobile
syndrome tend to have flat feet and are
likely to be clumsy and accident-prone.
Professor Grahame says, “Their co-
ordination is very poor and they appear
gangly. This is because they don’t have
enough control over their limbs and often
fall as a result.”
An invisible illness
The condition often escapes diagnosis,
and is described by some as an “invisible
illness”. “It’s horrifying that over 56 per
cent of people take longer than 10
years for a diagnosis,” says Donna Wicks,
senior medical liaison officer at the
Hypermobility Syndrome Association, UK.
Isobel Knight, who suffers with
hypermobility syndrome, agrees that the
condition often goes undiagnosed. “It’s
a cruelly deceptive illness,” she explains.
“When doctors examine you and ask you
to do stretches, hypermobility means you
look really good – even better than non-
hypermobile people. As a result, patients
are often dismissed. In the beginning,
friends don’t understand. Even your
family struggles to work out why you are
in pain all the time.”
Managing the condition
The condition can be managed with
pain medication, physiotherapy and low
impact exercises that help build muscle
strength and avoid over-extending
the joints. Inactivity and weight gain
exacerbate the problem, so physical
activity and a healthy diet are a must.
Children suffering from hypermobility
syndrome need a lot of support, as they
tend to get isolated. Being trapped in
a body racked with pain is debilitating
enough, but it is especially disheartening
when no one understands why they
are in pain. More awareness about the
condition is key for the timely diagnosis of
a disease that puzzles many.
Some children have particularly flexible joints, but this can
sometimes have painful consequences, writes
Shikha Bansal
.
What is hypermobility syndrome?
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