Hypermobility Syndrome

Joint hypermobility is the ability to perform movement in a larger than normal range of motion. It is measured by the Beighton scale, which includes range of motion measurements with a maximum grade of nine points.

Hypermobility syndrome is defined as excessive movement accompanied by muskuloskeletal symptoms and the absence of any known rheumatological syndrome. The frequency in the population is 0.6% - 31.5%. It includes symptoms of the muskuloskeletal system (such as greater tendency to injury, tendon inflammation, instability, osteoarthritis, patellofemoral injuries, scoliosis, etc.), the internal systems and affective symptoms. The damage is caused by structural changes in the collagen fiber that leads to increased passive mobility and damage to the supporting structures that leads to proprioceptive deficits. This causes decreased neuromuscular control.

The internal system includes signs like hernia, asthma, mitral valve collapse, urinary leakage and anal insufficiency, and among the affective symptoms the following can be present: depression, chronic fatigue syndrome, anxiety and sleep disturbances.

Pathophysiology: An anomaly in the relationship among the kinds of collagen with an increase in collagen type 3 in relation to collagen type 1.

The diagnosis is determined by the Brighton criteria (1998) and will be discussed in detail during the lecture.

Treatment: The treatment includes instruction, joint protection (taping), lifestyle adjustments, cognitive behavioral therapy, medication and exercise.

The treatment regime emphasizes the development of neuromuscular control and stability, and proprioceptive exercises that have been shown to contribute to pain reduction and the improvement of function.