#295 - Hypermobile Joints- What Are They and How Can You Provide Support?

What are hypermobile joints? Who can they affect? What are the functional implications?

We dive into these questions, the research, and some information that will be helpful if your child or your clients have hypermobile joints. We also talk about some of the challenges that can be associated with hypermobility.

Things like strength training, swimming, nutrition, and finding the right footwear are just a few of the strategies we talk about.

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Links
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Muscle Tone vs. Muscle Strength
About Joint Hypermobility
Prevalence of Joint Hypermobility in Children
DCD and Joint Hypermobility
Mind Pump Fitness
HyperVibe

Transcript

Jessica: 0:00

What does it mean to have hypermobile joints?

Rachel: 0:04

So really, it just means that you have extreme flexibility, kind of like laxity of your joints and it doesn't necessarily have to be all of the joints from what I've found. Sometimes it can just be your lower body joint. Sometimes it's your upper body joints. We're not necessarily talking about, like a diagnosis here of like EDS or any like specific diagnoses, we're just talking in general hypermobile joints. I'm Rachel.

Jessica: 0:34

And I'm Jessica. And this is All Things Sensory by Harkla.

Rachel: 0:37

We are both certified occupational therapy assistants and together with Harkla, we are on a mission to empower parents, therapists and educators to help raise confident and strong children of all abilities.

Jessica: 0:49

On this podcast, we chat about all things sensory diving into special needs, occupational therapy, parenting, self care, overall health and wellness and so much more.

Rachel: 0:59

We're here to provide raw, honest and fun strategies, ideas and information for parents, therapists and educators as well as other professionals to implement into daily life.

Jessica: 1:10

Thank you so much for joining us.

Rachel: 1:16

Hey, everyone, welcome back to All Things Sensory by harkla. We're happy to have you back today. It is a new year. I don't know when this episode is going to launch, but it's a new year for us. It is the first time recording podcasts in 2024.

Jessica: 1:29

Is it really?

Rachel: 1:30

Yeah.

Jessica: 1:31

I think you're right.

Rachel: 1:32

Yeah.

Jessica: 1:33

Wild.

Rachel: 1:34

So welcome to year six.

Jessica: 1:38

Yeah, happy 2024. I'm starting the new year off with a nice cold. So if you can tell it, my voice is different. You're welcome for that experience.

Rachel: 1:49

We were just laughing because we're both friends fans. We were laughing about how she sounds like Phoebe and Monica. Both of them get sick.

Jessica: 1:56

Probably more Monica in that one episode. I'm fine-d. It's a hard word.

Rachel: 2:03

Yes, so we are diffusing essential oils. We are hydrating. We are ready to share some, hopefully, helpful information. Today we're talking about hypermobile joints. What it means, what it looks like and how to support it.

Jessica: 2:21

This topic actually came up from within the Harkla team. One of our customer service ladies.

Rachel: 2:30

What do you call that?

Jessica: 2:31

I don't know. One of the members of our customer service team has some kiddos and she was asking us some questions about one of her children and she mentioned that she and a couple of her children actually have hypermobile joints. And we realized we had not talked about that on the podcast. But it is something that we see very frequently in the clinic when we're working with children. So we're going to talk about it. What does it mean to have hypermobile joints?

Rachel: 3:03

Before we explain that, I just want to say we do have an episode on low muscle tone. We will link in the show notes, if you want to listen to that. But hypermobile joints, a little bit different, a little bit connected at the same time.

Jessica: 3:18

But yeah, we often see them go together.

Rachel: 3:20

Yes, yes. So really, it just means that you have extreme flexibility, kind of like laxity of your joints, and it doesn't necessarily have to be all of the joints from what I've found. Sometimes it can just be your lower body joints. Sometimes it's your upper body joints. We're not necessarily talking about like a diagnosis here of like EDS or any like specific diagnoses. We're just talking in general, hypermobile joints. Yeah.

Jessica: 3:48

We found a couple of research articles, some That would be an interesting study. different scientific explanations, and one of them, That would be interesting. All I could think about was the kids will link all of them in the show notes so you can also read through them. One of the links or articles we found says that joint hypermobility is often hereditary, so it runs in in elementary school who were like "look what I can do with my families. One of the main causes is thought to be genetically determined changes to a type of protein called collagen. Collagen is found throughout your body. For example, in skin and ligaments. If collagen is weaker than it should be, the tissues in the body will be fragile, which can make ligaments and joints loose and stretchy. As a result the joints fingers and look what I can do. I can put my arms and my elbows can extend further than usual. I feel like that would be an interesting study to take maybe adults with hypermobile joints and adults with non-hypermobile joints, and have them take collagen supplements and see if after a certain amount of time they notice any changes. behind my back." And they thought it was like a big flex. Super double jointed and stuff. Yeah. Well one of the things that I read to said that the double jointedness is often actually just hypermobile joints.

Rachel: 5:16

Yeah.

Jessica: 5:17

So it's just like that, like, oh, I have a double jointed thumb. When in reality is like, No, you just have hypermobile joints.

Rachel: 5:24

Yeah, I just had like flashbacks to elementary school of kids like showing off like all the things they can do.

Jessica: 5:30

And their elbows.

Rachel: 5:31

Yes. Yeah, their arms like behind their heads and stuff.

Jessica: 5:35

Mm hmm.

Rachel: 5:37

Yeah. So anyways, that was nostalgic for me. I could never do it. But no, I thought it was cool that people could.

Jessica: 5:43

Super interesting. Yeah.

Rachel: 5:44

So the hypermobility refers to excessive joint movement, and it can be symptomatic, it can be asymptomatic. Another article we found says that hypermobility refers to the excessive joint movements and can be symptomatic or asymptomatic. So that's talking about symptoms being things like pain and instability. And the studies conducted on children, especially kids in the school age, showed that hypermobility range from 30% to 50%.

Jessica: 6:17

Which, if you think about it goes along with your example of remembering in elementary school so many kids who had hypermobility. It's fairly common at younger ages and in my brain, that makes sense, because it's like their bodies are still growing and developing. So their joints almost need to be more mobile to allow for all of that growth. When into adulthood, we stopped growing, ideally, and our joints don't need to be as mobile so we get that more like they don't need Yeah, they just don't need to be as mobile. That that was really hard thought to process. I'm so sorry. It's my brain is not working today, you guys. Anyway.

Rachel: 7:01

That makes sense to me as well. Yeah.

Jessica: 7:03

Yeah. All right. One more article that we found that we are going to add in here talks about joint hypermobility is considered a clinical phenomenon that is relatively common during childhood. Oh, see, I was right. I read this already, so it was already in my brain I think and is usually not related to symptoms requiring medical attention. However, different studies have underlined a possible association with chronic health complaints in a small proportion of children, such as pain, musculoskeletal disorders, and motor delay. And if I'm remembering correctly, this article specifically talked about Developmental Coordination Disorder, and its connection to joint hypermobility. So that would be an interesting one to go read more about. We'll link it in the show notes.

Rachel: 7:51

I think just like anything we talked about on this podcast, everything's connected. It's all connected in some way or another. So we always want to find the underlying why like, is there a reason why a child's joints are continuing to be hypermobile as they grow? Is there an underlying like this article said musculoskeletal disorder? Is there a Developmental Coordination Disorder?

Jessica: 8:14

Is it hereditary? Do their parents also have hypermobile joints? Meaning that the child is more likely to continue to have those hypermobile joints into adulthood.

Rachel: 8:24

And then looking at maybe the adult the parents history like Did they have reoccurring injuries? Did they have any challenges growing up that was maybe a result of their hypermobile joints? Do they have like headaches, joint pain? Like what do you notice? Find that underlying why. I think it's important to know that when we do have these joints that are more lax, it increases the person's risk of injury, sprains, dislocations. Because if you think about let's say you're playing soccer, and you're running and you know a soccer you have to like stop and go and kick and stop and turn.

Jessica: 9:00

High impact.

Rachel: 9:01

Yeah, and your joints have to like move around and stay like firm worked when you're turning on a dime and stopping and going. And if your joints are like a little wobbly in there, and your tendons aren't really as secure as they should be, It makes sense that we would have more injuries, more dislocations, more tears, more sprains because things aren't really as steady as they should be.

Jessica: 9:29

There are a few other things that might also be associated with hypermobile joints. We might have pain in the joints, like Rachel just talked about. Increased risk of injury, fatigue, low endurance, poor coordination, which that one article talked about Developmental Coordination Disorder, digestive and incontinence issues, IBS, constipation, headaches or migraines, and then low muscle tone, flopping muscle tone. We often see these in coordination together.

Rachel: 10:05

So, of course, we're not going to just leave you with some information on these hypermobile joints and maybe you're like, yes, this is what we're struggling with. Yes, this is us. Maybe you're a therapist, you're like, yes, so many of my clients are struggling with this. We're not going to just leave it at that. We're going to give you some tips, we're going to give you some strategies, some things that you can do to possibly help and improve some of the symptoms. I haven't found that you can necessarily like, cure, quote, unquote, cure hypermobile joints, but there are some strategies that we can do as therapists to support and to help build like the underlying skills.

Jessica: 10:47

And as parents too.

Rachel: 10:48

Yep.

Jessica: 10:49

The first one is to build muscle to help support the joints and think this is very important for adults who have hypermobile joints. Pick up a muscle building routine a couple times a week, lift some weights. It's actually my favorite way to exercise.

Rachel: 11:05

But here's the thing, if you are going to lift weights, you need to make sure that you do it with good form accuracy. There's no point there's no benefit, if you're going to be lifting weights and your knees are like internally rotated and they're not aligned and your arms, you're doing push ups and they're externally rotated. I was at the gym the other day, and we were doing like side to side weighted kettlebell lunges.

Jessica: 11:28

Oh, those side lunges are so hard.

Rachel: 11:30

But you're just like staying low and moving back and forth side to side and I was watching a guy do it, who was in like a different rotation as me, his back was completely arched, his head was down. Yes, it was such poor form. His legs weren't even bent and the trainer was like, you need to, like squat down and his form was just so bad. I'm like, this isn't benefiting you at all, you know. So that's what we want to make sure like work it out in front of a mirror. Hire a trainer.

Jessica: 12:00

Hire a trainer. I think most gyms if you sign up at the gym, most gyms will give you a certain amount of like free training sessions to get started. So just ask. Like, go to a gym and ask, Hey, can I get some help? I've never lifted weights before it's been a really long time, I want to make sure I'm doing it correct, with good form, and more often than not, you could get one or two free training sessions . And just have a personal trainer come over and make sure you're lifting with good form because yeah, like Rachel said, if you are lifting weights with poor form, it will do more harm than good. The other thing I want to mention is one of my favorite podcasts is actually a health and fitness podcast and they were talking about lifting weights when you have hypermobile joints. So when you have hypermobile joints, your end range of motion is farther than someone else's. So you think about a squat and a really good squat, you go down so that your thighs are parallel, right? You're like at that 90 degree position is a good squat. If you can go lower, that's good as long as you keep good form. Someone with hypermobile joints is going to be able to go like almost sitting on the floor.

Rachel: 13:10

And their heels will stay flat on the floor. Yoga.

Jessica: 13:12

Yes, but that's not necessarily a good thing. So what the guys were talking about, and they're all personal trainers, what they were talking about was if you have hypermobile joints, don't go to your end range of motion. Go less than you think you can in order to maintain that good form. Now for children, bodyweight exercises are usually the best place to start. So you think about squats without any weights, just bodyweight squats, push ups, pull ups, that kind of thing. Yoga. Oh my gosh, yoga is a great way to build muscle because you're in all of these different weight bearing positions. And if you go to a class, they're going to help you with your form. See if you can find like a kid's gym or a gym that does kids classes. We have a couple here in the Treasure Valley that the gyms have classes specifically for kids, where they have trainers helping these kids learn these different muscle building exercises. So when you build muscle, you help support your joints when you do it with good form.

Rachel: 14:17

BRB, we're gonna go start a fitness podcast.

Jessica: 14:21

No, you know what I really want to do? I really want to be on my favorite podcast because they're all dads.

Rachel: 14:26

Yeah.

Jessica: 14:27

And so they talked about their kids all the time. And it was like they should have us on the podcast to talk about parenting and kids with sensory challenges and stuff.

Rachel: 14:34

Yes. Write em in.

Jessica: 14:37

Yeah, we'll leave them in the show notes. So you guys can all reach out to and be like, Hey, you should have Rachel and Jessica on your show.

Rachel: 14:42

That would be so funny.

Jessica: 14:43

Let me just remind myself to do that.

Rachel: 14:45

Okay, I want to move on to the next one. We talked about our low impact exercises. Now we want to focus on nutrition. Like we mentioned collagen. We're not nutritionists. We are not specialists in that area, but is something to look into. Work with a nutritionist. Talk to them about what your challenges are what your child struggling with, and focus on whole foods. Focus on just like clean foods, reduce toxins, if possible, and just try to fuel your body from the inside out. And, you know, the building blocks that we want to work on the building blocks, like the amino acids, and good amounts of protein and I mean, this is all stuff that you know, fruits, vegetables, like the whole nine yards. Good carbs, eat organic, if possible, just like maybe 2024. That's what you focus on.

Jessica: 15:43

Yeah, there you go. Nutrition.

Rachel: 15:47

BRB, gonna get started on a nutrition podcast.

Jessica: 15:51

Who are we?

Rachel: 15:52

Ah, yeah.

Jessica: 15:53

Okay. The next tip is to use heat to soothe painful joints. So if you or your child, clients, are experiencing pain because of hypermobility, get a rice pack, get a heating pad, and use the heat to help soothe those painful joints.

Rachel: 16:14

Do want to hear a funny story?

Jessica: 16:15

Always.

Rachel: 16:16

I have a rice pack or heat pack. My mom made it for me years ago. I use it every single night even in the summer.

Jessica: 16:24

Does it stay warm? Even summer summer?

Rachel: 16:25

I use it every single night. I have for years, like we're talking probably like, six years.

Jessica: 16:32

It's part of your sensory diet.

Rachel: 16:34

Oh, I have the whole bedtime thing of all the sensory things I need. But yeah, it's weighted. It you know, just as warm is just like what I need.

Jessica: 16:42

Totally.

Rachel: 16:43

Put on my back.

Jessica: 16:44

That's great.

Rachel: 16:44

Okay, there you go.

Jessica: 16:45

Next one. Oftentimes, if someone has hypermobile joints, they are going to have flat feet, which means that they don't have that natural, they don't have that arch in the middle of their foot and the reason for this is because their lax joints have caused the feet to not develop that arch in order to have more support on the ground. So if you or your child has flat feet, and hypermobile joints, seek out a podiatrist, this is a foot specialist to help find the right footwear to support the lower body joints. This can help decrease any pain that's occurring. This can help provide support when walking and running. I never actually thought about this but podiatry is like a profession that maybe we need to look into more.

Rachel: 17:46

Yeah.

Jessica: 17:46

I never thought about this until we did the research for this episode.

Rachel: 17:50

Yeah.

Jessica: 17:50

So if you or someone you know, has a good podiatrist. If you work if you're a podiatrist.

Rachel: 17:56

If you've got him on speed dial.

Jessica: 17:57

Let us know send us a message on Instagram and let us know and maybe we need to get a podiatrist like a pediatric podiatrist on the podcast.

Rachel: 18:07

Okay, let's do it. Going along with that and focusing on joint health. I was thinking, sleeping with a knee pillow at night. Keep your joints in neutral. Honestly, it's been a game changer for me.

Jessica: 18:21

This is more towards the adults because I feel like a child. Children flail around so much when they sleep. But for adults, if you're an adult with hypermobile joints.

Rachel: 18:31

Yeah. I mean, if you have a kiddo who wants to try to like by all means, let them try it. But yeah, something to add to the list and see if it benefits.

Jessica: 18:40

Maybe you try a heated, weighted race pack in between your knees?

Rachel: 18:46

No, because it's too heavy. Because the knee pillow was really ligh so you can like turn back and forth.

Jessica: 18:51

But you don't want it to be weighted.

Rachel: 18:53

Yeah.

Jessica: 18:53

Gotcha.

Rachel: 18:54

Yeah.

Jessica: 18:54

I was just thinking the heat and the support would be helpful. It would be nice. So heating pad with the pillow.

Rachel: 19:00

Yes.

Jessica: 19:01

Okay, there we go.

Rachel: 19:02

Yep.

Jessica: 19:03

Our next suggestion is to seek out a professional podiatrist, OT, physical therapist, PT, physiotherapy was something that came up in the research as being very helpful. Any of these professional professions can help with pain management, injury prevention, building stability, and strength. So these are all very important for just overall lifelong health.

Rachel: 19:33

I was also thinking using a full body vibration plate. Something like the...

Jessica: 19:37

Hyper vibe!

Rachel: 19:39

Somethings like the hyper vibe to increase proprioceptive awareness and going along with that, improving like full body proprioceptive and proprioceptive processing, not just like heavy work and things like that. I'm thinking more of like, standing on one foot on one of those foam pads or just even standing on your foot on the floor, and balancing and letting your joints support you and balance and you can add challenges as needed. But this is something like an OT or PT or physiotherapist would help you with. But focusing on your alignment, making sure that you are, you know, your knees aren't like internally rotated if you're balancing on one foot, making sure they're not completely externally rotated. Again, that we focus on getting out of positions like w-sitting. Oftentimes, kids with hypermobile joints will sit in those positions. W-sitting they'll sit on one knee with like one leg bent up and like rest their head on their knee. If they're laying on their tummy, they'll probably rest their head on the floor. They'll probably be slouched when they're sitting. You know, we are going to recommend primitive reflex integration as well looking at that.

Jessica: 20:53

And I think too, aren't just thinking about when a kid is in weight bearing on all fours, on their hands and knees, four different primitive reflex exercises. For crawling, we'll see those lacks joints in the elbows and so I like to bring attention to it, depending on the child and where they are, cognitively and take a picture and show them how their elbows are externally rotated, hyper-extended. Talk about why that is and then talk about how they can focus on doing the motions as I'm talking how they can focus on activating their muscles throughout their arms to get their elbows out of that misalignment, out of that hypermobility, and that can be a good way to support their joints is to move into that better aligned position. And sometimes you just need to bring awareness to it. I was also thinking about our kids with low muscle

Rachel: 21:48

Yeah. tone lacks joints, and they have constipation or IBS or just overall digestive challenges. Getting them into a pelvic floor specialist, usually like a physical therapist, who specializes in pelvic floor exercises is going to be so important. Because if you have a child or you yourself, and you aren't digesting your food, you're constantly constipated. It's so painful and difficult to go to the bathroom that really affects your quality of life and your ability to get through your day successfully. So working with someone who can teach you the pelvic floor exercises to build up the strength in your pelvic floor, in order to be able to go to the bathroom is so important. We're actually interviewing one next week so be on the lookout for that coming soon. Woohoo. Going back to the crawling position, and just being able to observe compensatory strategies and positions. I just wanted to bring up scapular winging because it's not something that we talked about much but when a kiddo is on their hands and their knees, and you can like basically like grab their scapula. So that bone on the like their short right after their Yeah, their shoulder blades, yeah, blade. You can basically like put your fingers under it and grab it like there's it's not like being held strongly in place and so that's another compensatory, not strategy, but just like a compensatory position. Yeah. And you'll see their head is probably hanging down, like it's difficult to look straight ahead in that position. Their knees are probably wider. They're probably trying to get a wide base of support. Probably have some lumbar lordosis so like arching of the lower back. So there's really a lot that you can tell if you just have your child get down into a crawling position and say, hold that for 30 minutes. No, I'm kidding.

Jessica: 23:44

30 minutes?

Rachel: 23:45

Your eyes just shot so wide.

Jessica: 23:47

Well, I thought you were gonna say 30 seconds. I was gonna not.

Rachel: 23:50

So 30 seconds. I just was seeing if anyone was paying attention. Yeah, like, hold it for 30 seconds, take a video, take a picture. And then you can see and you can monitor progress that way as well.

Jessica: 24:01

Yeah. And if you notice these compensatory strategies in your child, seek out some help. So you got a professional who can help give you some strategies like specific for your child and specific for the areas where they're struggling. You know, I was thinking of the scapular winging and I was thinking of the different back and shoulder exercises that could be done that would be helpful with a trained professional.

Rachel: 24:27

With a trained professional. Yes. Our podcast is great. Our YouTube is great, but nothing beats in-person services.

Jessica: 24:35

If possible.

Rachel: 24:36

Yes, you are learning all the things. Thank you for being here. That's all we have for you today. Hopefully it was helpful. Hopefully you learned something and yeah, we appreciate you.

Jessica: 24:46

Yeah, make sure you let us know if you are listening to this episode by taking a screenshot and sharing it on social media, tagging us at All Things Sensory Podcast. If you have things that you want us to talk about, if you have questions, there is a link in the show notes where you can submit your question and we will answer it on the show. Thanks for being here.

Rachel: 25:06

Okay, bye. Thank you so much for listening to All Things Sensory by Harkla.

Jessica: 25:11

If you want more information on anything mentioned in the show, head over to Harkla.co/podcast to get the shownotes.

Rachel: 25:19

If you have any follow up questions, the best place to ask those is in the comments, on the show notes, or message us on our Instagram account, which is at Harkla_family or at all things sensory podcast. If you just search Harkla, you'll find us there.

Jessica: 25:35

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Rachel: 25:54

Head to Harkla.co/sensory to use that discount code right now.

Jessica: 25:59

We are so excited to work together to help create confident kids all over the world. While we make every effort to share correct information we're still learning.

Rachel: 26:08

We will double check all of our facts but realize that medicine is a constantly changing science and art.

Jessica: 26:14

One doctor or therapist may have a different way of doing things from another.

Rachel: 26:18

We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties, and what we have found to be beneficial that will be as evidence based as possible.

Jessica: 26:29

By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your child.

Rachel: 26:38

Consult your child's pediatrician or therapist for any medical issues that he or she may be having.

Jessica: 26:44

This entire disclaimer also applies to any guests or contributors to the podcasts.

Rachel: 26:49

Thanks so much for listening