Double jointedness is a common term used to describe what medicine refers to as Joint Hypermobility. It is defined as the ability to move the joints beyond what is considered a normal range of motion. It is a hereditary disorder of connective tissues (ligaments) that results in joints becoming loose throughout the body. This may be advantageous in some activities or sports where high flexibility is required. However, individuals with persistent laxity may be prone to injury or pain throughout their lifetime. 

How does joint hypermobility present regarding injury?

Having a few hypermobile joints isn’t unusual. In most people, joint hypermobility causes no problems and requires no treatment. A person with joint hypermobility may notice that flexibility and movement come easy, and they can move further into positions of a stretch than their peers. However, some may experience a variety of symptoms associated with the increased movement, such as: 

  • Joint pain
  • “Looseness” in joints causing sprains, dislocations, painful clicking
  • Recurrent injuries and being “injury prone”
  • Difficulty with balance and stability
  • Back pain related to static positions

How to assess joint hypermobility

The Beighton Score is an easy test to determine an individual’s level of involvement. We test a variety of positions. Each test result is given a score of 0 or 1. A score of 0 if the position cannot be completed and a score of 1 if it can. Where applicable, the positions are tested for both the left and right sides. You can view the test here.

To test yourself, you’ll need to know if you can:

  1. Pull your pinky back beyond 90 degrees 
  2. Pull your thumbs back to touch the forearm 
  3. Extend your elbows beyond 10 degrees 
  4. Extend your knee beyond 10 degrees
  5. Bend forward at the waist, keeping knees straight, and lie hands flat on the floor

A total of 9 points is possible. A positive Beighton score is 5/9 for adults and 6/9 for children. 

Does stretching help hypermobility?

Although stretching may feel good at the time, it is not always indicated for people with hypermobility and may cause tissue or joint discomfort. An easy indication of when to not push stretching is if you consistently hurt or aggravate a joint during or after stretching.  As an alternative to stretching, performing mid-range motion movements before the activity or warming up over the first 5-10 can be helpful. 

Can Physical Therapy help joint hypermobility?

Joint hypermobility can be a primary diagnosis in the clinic or can show up as a secondary area of concern when there is a separate injury. While we cannot prevent hypermobility, we use many strategies to improve joint stability. They include: 

Muscle Strengthening: muscles provide stability to your joints and movement. For individuals with increased laxity, proper strength and control are of utmost importance in injury healing and long-term prevention. Clinical research continues to highly support higher load and intensity strength training when assisted and performed under appropriate medical guidance. 

Balance and Proprioceptive Training: This training improves the ability to balance and sense joint positioning improving stability of the movement and lessening impact forces through your body. Both static and dynamic movements are treated. 

Orthotics/Taping/Bracing: These strategies can provide sensory feedback, which assists your body’s ability to feel the joint and improve strength and motion. It can also provide an external source of stability while you are working on getting stronger. Bracing is often used when an individual is experiencing difficulty with joint subluxations or frequent sprains/strains. 

Manual Therapy: Increased pain is often associated with joint hypermobility. Hands-on, soft tissue joint mobilization helps address the discomfort by gently stimulating the nerves in the joints and muscles. 

You can live a very normal and healthy life with joint hypermobility. However, if you have found that you are more prone to injury or experience pain due to this condition, we would love to help. Our Bend OR physical therapists are experts at helping people with joint instability find stability so they can enjoy the activities they love without the added risk of injury.