Hypermobility – great for dancers, gymnasts and party tricks but what happens when the party’s over and the pain is with you all day?

KTB Director Katie Ballard has suffered from hypermobility all of her life and draws on her own experiences to talk you through what hypermobility is and how physiotherapy and pilates can help you.
There’s no quick fix but good therapy and an understanding of self-care can go a long way.

Do you remember the kids at school who could do the splits on command (no warm-up required!), click their joints and fold themselves into a variety of contortionist positions?

As much as it was entertaining, some of those may actually have had hypermobility which for children is highly entertaining but as you get older, chronic pain can replace the hilarity and is no laughing matter.

It’s an advantage for sports people sometimes – dancers and gymnasts in particular benefit but if you’re someone who develops chronic pain as a result, the only medal you want is one to acknowledge that you got through the day without crumpling into a contortion-style heap on the floor.

Chronic pain is relentless, stops you doing what you want to do and prevents you from being who you want to be. Simply put, it just goes on and on.
People around you know you have it, but just accept is as one of your ‘things’ and every time they ask how you are, you’re tempted to answer: ‘OK, but everything (still) hurts’…

It affects your life when you can’t do the things you want to do – a long walk, a charity 10km, or something else that requires physical activity that your joints just can’t cope with.

The problem is that even amongst professionals, hypermobility is often overlooked, disregarded, misdiagnosed and inappropriately treated. Doctors can overprescribe pain-relieving medication and physiotherapists can give overzealous manipulation and too many individuals are simply led to manage their own symptoms with little understanding and no reassurance.
But the good news is, that when hypermobility is diagnosed promptly and managed well, pain is reduced dramatically and the negative impact upon life is much less.

What is hypermobility?
Let’s just go back a bit though and take a look at what joint hypermobility syndrome is. It’s a connective tissue disorder caused by a gene defect. The problems it causes are mostly mechanical, with joint and muscle pain but you can also have scarring, prolapse, hernia, and depression. A diagnosis can’t be made from MRI, X-ray or blood tests and this is where the delay in treatment and ultimately, pain relief lies, because any tests you have will come back clear and while you wait for the next, treatment is in limbo.

You may remember or know a child who has the symptoms – clumsy, walking into things, bruises easily, active but misses PE because of the pain, has messy handwriting and fidgets a lot…especially on the science stools that didn’t support their painful backs.
They probably had neck ache from carrying their book bag and not just a quick ‘ouch’ but a lingering ache.

In adulthood, those daily tasks are still affected – a day’s shopping, standing in a pub on a night out, sitting on a bar stool for a meal – hypermobility sufferers are usually putting on a brave face.
The condition progresses as you get older into a sense of early aging – feeling much older than you are, clicking joints, popping and clunking, even dislocation too.
Those poor muscles around the joint are working so hard to keep up with the hypermobile joint – they’ve got a hard life!

If you’ve ever been pregnant, you’ll know that your body releases a hormone called relaxin – which enables the body to go into a temporary mobile state and mums-to-be will usually say their joints ache and they’re in pain…but luckily for them, it’s only short-term.
For people with hypermobility, it’s not over in nine months – it’s there to stay!

Can physiotherapy take the edge off?
Effective physiotherapy is crucial to pain management of hypermobility – but it’s not an overnight fix. It takes time for your body to react to the treatment.
Our therapists will need to understand how the condition impacts on your daily life and when it’s at its best and worst for you.
Perhaps you can’t get on a plane to have a summer holiday or can’t sit in a car for a long tie to visit someone important or go somewhere – we can help to get you doing the things you want to do with reduced pain and more comfort that you have now.
Usually, there are several areas to be treated at the same time and with this, comes the longer healing process for the tissues – and this is where the delay in results comes.

Hands-on treatment will include mobilisation of stiff areas through gentle manual therapy with stretches alongside joint mobility exercises.
Physiotherapy will support in progressing a general exercise programme to build muscle endurance, complimented by stability work to improve control of the hypermobile joints. Core stability exercises and muscle re-education including Pilates-based moves, body awareness work, postural correction and advice on lifestyle changes to reduce strain on muscles and joints must form part of the treatment programme.        

Tips for people with hypermobility:
Avoid repetitive movement – pace yourself
Think about your posture – stand tall, shoulders back
Stretch – give those over-worked muscles a break with a lovely stretch
Exercise – fitness will help your body to cope with the condition
Core strength – your core supports your whole body; strengthen it to ease the muscles
Pilates – this gentle but therapeutic stretching technique will give your body both strength and relaxation
Physiotherapy – regular sessions will focus on weakened areas and build up strength for support around hypermobile joints

Ultimately what is important is that treatment empowers you to believe that you can take control of the pain, make changes to your life and reduce the burden that chronic pain brings. You are believed, you will be listened to, and you will be supported to make the right changes to begin to feel better again.