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Joint hypermobility is a condition that features joints that easily move beyond the normal range expected for a particular joint. It is estimated that 10%-15% of normal children have hypermobile joints.
Hypermobility is often called “loose or floppy joints, ligamentous laxity or double-jointed.”
Joint hypermobility is diagnosed by testing the range of motion of multiple joints within the body to see if they have more range/movement than the ideal range. A score is allocated (Beighton Score), if it is greater than 4 out of 9 than the child has joint hypermobility.
Often joint hypermobility causes no symptoms and requires no treatment. If a child does have joint hypermobility and does develop pain then they most likely have joint hypermobility syndrome. Joint hypermobility syndrome is considered a benign condition and is very hereditary in nature (passed on from parents to their children).
Joint hypermobility is also a feature seen in some more rare, significant medical conditions such as Ehlers-Danlos syndrome, Marfan’s syndrome and Down Syndrome.
Symptoms of Joint Hypermobility Syndrome
- Joint pain, more common in lower extremities than upper extremities
- Muscle fatigue and pain as muscles have to over-work to provide support to the joints that the loose ligaments cannot do properly
- Pain can be experienced during the day and at night time, is often worse with increased activity
- Often confused with ‘growing pains’
- Increased risk of injury, sprains, strains and dislocations as joints can easily get out of alignment
- Poor co-ordination and balance
- Dis-interest in sport as child may not be as agile, co-ordinated and fast. Hypermobile children often find sport and lots of walking uncomfortable and tiring.
When should I be concerned if my child has joint hypermobility?
- Flat feet (collapsing arches) – due to the ligaments that support the arch being too ‘floppy and stretchy’ allowing the arch to collapse upon weight-bearing.
- Increased risk of widespread joint pain, leading to early degeneration and arthritis in adulthood
- Increased risk of soft tissue injuries, sprains, dislocations etc
- Less willing to participate in sport and exercise
Treatment for Joint Hypermobility in Children
As mentioned earlier, often joint hypermobility causes no symptoms and requires no treatment. Many individuals with joint hypermobility syndrome improve in adulthood as joints become slightly less flexible. That being said, the biggest cause of painful adult flat foot seen in my clinic is due to joint hypermobility allowing the foot to completely collapse upon weight bearing.
If your child’s arch height and foot posture is normal for their age, and they do not have any symptoms, treatment may not be necessary. However if your child does have ‘flat feet’ or collapsing arches and they are having pain that is inhibiting them from participating in sport, then treatment is recommended. It is very important that their pain is not passed off as ‘just growing pains’, as keeping children involved with physical activity is extremely important for many reasons.
If your child does have flat feet, it is recommended that their poor foot posture is addressed early. Exercises to improve foot strength and balance is very important. Customised Foot Orthoses and supportive footwear may also be indicated as they can assist in reducing the likelihood of developing foot, knee, hip and lower back pain as your child gets older.