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Writer's pictureJames Tomlinson

Ligament Hyperlaxity (Hypermobility) Management: Physiotherapeutic Strategies and Orthotic Interventions

Delving into the intricacies of ligament hyperlaxity unveils a fascinating phenomenon wherein joints assert their exceptional flexibility, surpassing the norm.
Gymnast
Ligament Hyperlaxity

HYPERMOBILITY SYNDROME - WHAT IS IT?

This occurrence results from a heightened elasticity in the collagen fibres comprising ligaments, the structural components responsible for joint cohesion.

Approximately 20% of individuals find themselves endowed with the genetic predisposition for hyperlaxity, manifesting in varying degrees across different joints. While, for some, this attribute proves inconsequential or even advantageous—particularly for those engaged in pursuits demanding extensive bending and twisting, such as gymnastics or dance—it is not without its challenges.


PHYSIOTHERAPY MANAGEMENT OF JOINT HYPERMOBILITY

The manifestation of issues, ranging from persistent pain to post-exertional fatigue akin to completing a marathon after a brief jog, is not uncommon. In extreme instances, hyperlaxity culminates in conditions such as Ehlers-Danlos and Marfan syndrome, transcending mere joint flexibility to interfere with organ function and disrupt connective tissue integrity.

The symptomatic landscape encompasses muscle discomfort and fatigue, particularly pronounced when ligaments fail to provide requisite support. Frequently dismissed as mere "growing pains" in the case of younger individuals, the reality of such discomfort remains tangible.

Marfan syndrome
Ehlers-Danlos or Marfan syndrome,

HYPERMOBILITY - DIAGNOSIS - PHYSIO ASSESSMENT

Diagnostic confirmation of inclusion within the hyperlaxity spectrum often involves the Beighton 9-point assessment. This evaluative tool awards points for hyperflexibility in elbow and knee joints, the pinky finger's ability to achieve a full 180-degree rotation, and the thumb's capacity to gracefully align with the forearm. Additional commendation is granted if one can effortlessly place palms upon the floor with fully extended knees—an exemplary demonstration of flexibility.

In instances where a more nuanced diagnosis, such as Ehlers-Danlos or Marfan syndrome, is under consideration, sophisticated diagnostic examinations may be employed. Once consigned to the realm of hyperlaxity, proactive measures come to the fore. Strategies encompass fortifying muscular structures, harmonising equilibrium through proprioceptive interventions, and bidding farewell to the instability characterising lax joints.


Orthotics
Custom Orthotics for Hyperlaxity

Addressing the peripheral intricacies of ligament hyperlaxity, particularly concerning the involvement of the feet, reveals a comprehensive plan. This includes the integration of sophisticated footwear solutions, bespoke orthotics, and targeted exercises designed to invigorate foot musculature and refine spatial orientation. Far from an arduous journey, the pursuit of optimal flexibility is a harmonious balance—a testament to transforming joints into the paragons of flexibility.




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