what is hypermobility?

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what is hypermobility?

http://en.wikipedia.org/wiki/Hypermobility


It is when a joint moves more than is normal. It does not always have to affect all joints (my knees, elbows, wrist and fingers are hyper-mobile but my ankles aren't)

Hmmm, this article doesn't mention the stuff the OT told us. I wonder if it is the right term? The issue I am thinking of is loose joints, which can appear as extended mobility, but may not. It mostly means the joints don't function as tightly as they should, which means that a good grip can be difficult to achieve, and that nerve signals have a difficult time getting through to the brain. As our OT said, because of the lost nerve signals, it is difficult for our son to know where his body is in the air.

The problem is that there is a lot of blurring between definitions, so it is hard to describe it. For example:

Proprioception: knowing where your body is in space. This is often associated with hand eye coordination, and proper muscle control. When your proprioception is messed up, you are likely to run into things, such as doors, fall of ledges, or have difficulty with tactile feedback as needed with things like writing.

Dysgraphia: Difficulty writing or performing other fine motor tasks due to difficulties with fine motor control

Ataxia: Same thing as dysgraphia, but with gross motor control. Generally evident by a lack of physical control, and inability to do things like walk in a straight line, or run without falling over. Often times referred to as being clumsy

Hypotonia: Underdeveloped muscles which result in the person having less stamina, less strength, and so forth. Often times referred to as loose joints because the muscles carry far less tension then usual, resulting in the ability for joints to flex further then usual.

Hypermobility: This is just the name given to joints that bend farther then usual. It could have multiple causes such as loose muscles (as in the case of hypotonia), loose tendons, or unusually aligned joints.

The problem is that all of these tend to happen together often times. If the brain's cerebellum does not develop normally (as is common in the case of autism, asperger's syndrome, or other similar conditions), then it will cause problems with coordination, muscle development, and tactile feedback. As such, these terms tend to get blurred together, because if you have one of these issues, you likely have the others to some extent.

For example, I have hypotonia pretty bad, as in having the physical strength/stamina of somebody who is perhaps 8-9 years old, despite being 24. As such, I get tired easily (heart doesn't have much in it), and I can't carry much of a load. I also have very flexible joints, such that I can easily bend my thumbs back to my forearms; not just the tip of the thumb, but I can actually get my thumb's knuckle's flat against my arm. I also routinely run into door frames, and can't run in a straight line. And I also can't write for more then a paragraph without my hand hurting, and my writing is very sloppy. Technically, those are several different problems with different medical terms, but it is caused by the same thing.

As for your concern about your daughter, I am afraid I can't such much other than stock up on ice packs, and ankle braces. I rolled or sprained my ankles about once a month when I was in 8-10th grade because I had to carry around a 20+ lb backpack full of stuff. A heavy load up high combined with weak ankles muscles and poor balance doesn't work out well. Also, beware of door frames. Those things are vicious and tend to lunge at you when you are trying to walk through doors. Ive gotten more then my fair share of bruises from them.

Tracker, I think you just explained a whole bunch of the concepts OT's have been trying to tell me for years but that went in one ear and out the other. You tied it up quite nicely for me, thank you.

So I hope it makes sense for the OP, too!

I have mild hypermobility and hypotonia. I think the two usually go together, that hypotonia causes hypermobility because your muscles aren't tense enough to hold your joints in place.

Basically for me it means that I can twist myself up in knots and such, for example chewing my toenails like many people chew fingernails. But walking or standing a long time causes joint pain, and sometimes I just get random joint pain for no apparent reason. Usually my joint pain can be helped by popping the joint (eg cracking my knuckles) but not always.

One sign of hypotonia/hypermobility is 'W-sitting'. Basically kneeling, but with the bottom half of your legs out to the side instead of underneath, so your legs make a W shape. I gather for non-hypermobile people this can be painful, but for hypermobile people it's comfortable and easier to balance.

I also tend to sit with my legs up next to my chest, like fetal position. I find I feel unstable if my legs are down. I also take my shoes off at any reasonable opportunity, but I think that's tactile defensiveness.

Ettina, I agree that the two terms probably should usually go together. I think what happened for me was that hypotonia always sounded like something exercise could fix, which really isn't true, while hypermobility was the term chosen by someone who was describing issues exactly like my son's. I latched onto the later because it finally added up. But hypotonia probably is the right primary diagnosis, even though I find the term and the way the OT's usually talk about it to be deceiving. It just doesn't sound like it should cause the issues it does cause.

My son is a monkey in how he likes to sit, too. Hope you don't mind it being described that way. But almost always bended knees drawn in to the body in some way. Although, now that he is a teen, he's taken to the lounge position ... seals on a rock, is how someone I know describes teens

Just wondering my daughter seems to have lots of traits that fit many labels, I realise that some are separate conditions and others are on a spectrum. My daughter seems to nearly meet the criteria but never ticks enough boxes. I am just trying to work out is all these other conditions, co morbid's connected/common with ASD.

I believe hypotonia and hypermobility ARE recognized comorbids of ASD. But that doesn't mean she is ASD. comorbid only means these things were likely caused by the same set of circumstances, and came together.

My daughter has issues with all of the areas on that list. Her proprioceptive issues were really bad but have improved with OT. She can also pop some of her joints in/out of socket without pain and can make weird popping noises with her joints as well. She has a co-morbid of DCD/Dyspraxia.

I have a number of hypermobile joints but I also have very tense muscles, in order for a consultant to gauge the true extent of hyper mobility I ended up needing an epidural to relax my legs because my muscles won't even when relax when I'm asleep.

The 'tightness' of a joint is down to the bones being correctly formed, the ligaments being the right size for the joint and also the 'tightness' of the muscles that work the joint. The tight muscles can compensate to a certain degree for a hypermobile joint but in order to diagnose hypermobility in a joint you discount the influence of the muscles.

If you watch this video, the guy's knee is normal and not moving

http://www.youtube.com/watch?v=yQdBrr3Mmj0

But if you watch this video of the same test on someone with a ligament injury, the knee moves a lot further.

http://www.youtube.com/watch?v=lVaZ710s804

http://www.youtube.com/watch?v=4u6DK3BlNtc

An uninjured but hypermobile knee would show more movement than the first video but not as much as the other two videos.





This is spatial awareness, your brain holds a model inside itself of the 'physical you', a map of where are legs and fingers are and how they related to each other in space. It is also a 3D model of where your body is in relation to objects in the environment.

If you place three cups on a table, close your eyes and then try and put your hand above either the left, middle or right cup, you are relying on your spatial awareness model to position your hand relative to the cup.