- With Mayo Clinic physical medicine and rehabilitation specialist
Edward R. Laskowski, M.D.
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Edward R. Laskowski, M.D.
Edward R. Laskowski, M.D.
Dr. Edward Laskowski is certified by the American Board of Physical Medicine and Rehabilitation and is a fellow of the American College of Sports Medicine. He is co-director of the Mayo Clinic Sports Medicine Center and a professor at Mayo Clinic College of Medicine.
He has been on the staff of Mayo Clinic since 1990 and specializes in sports medicine, fitness, strength training and stability training. He works with a multidisciplinary team of physical medicine, rehabilitation and orthopedic specialists, physical therapists and sports psychologists.
Dr. Laskowski is an elite-level skier and approaches sports medicine from the perspective of a physician and an athlete. In addition to skiing, he is an avid hiker, cyclist and climber.
In 2006, President George W. Bush appointed Dr. Laskowski to a two-year term on the President's Council on Physical Fitness and Sports.
Dr. Laskowski was a member of the medical staff of the Olympic Polyclinic at the 2002 Winter Olympics in Salt Lake City and was involved in medical coverage for the Chicago Marathon. He serves as a consulting physician to the National Hockey League Players' Association and is a featured lecturer at the American College of Sports Medicine's Team Physician Course.
Dr. Laskowski, a Cary, Ill., native, has contributed to Mayo Clinic's CD-ROM on sports, health and fitness, a Web site guide to self-care, and hundreds of Mayo Clinic articles and booklets in print and online. He is a contributing editor to Mayo Clinic's "Fitness for EveryBody" book.
"There are many myths and misconceptions about exercise and fitness in general, and also many traditions that don't stand up to scientific scrutiny," he says. "My goal is to provide the most up-to-date and accurate information on sports medicine and fitness topics in a way that you can practically incorporate into your life."
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Question
Joint hypermobility: What causes 'loose joints'?
My doctor recently commented that I have "loose joints." What does this mean?
Answer
from Edward R. Laskowski, M.D.
"Loose joints" is a lay term that may be used to describe hypermobile joints. Joint hypermobility — the ability of a joint to move beyond its normal range of motion — is common in children and decreases with age.
Having a few hypermobile joints isn't unusual. In most people, joint hypermobility causes no problems and requires no treatment.
But in some people, hypermobility causes joint pain and results in a higher incidence of dislocations, sprains and secondary osteoarthritis. Doctors refer to this as benign hypermobility syndrome. In benign hypermobility syndrome, the ligaments that provide joint stability are loose and weak. This increases the risk of ligament injury or strain and can cause pain.
If you have joint pain and other symptoms hypermobility, your doctor may check for specific signs, which include the ability to:
- Bend your little fingers backward to a 90-degree angle
- Bend your thumbs to your forearms
- Hyperextend your elbows 10 degrees beyond neutral
- Hyperextend your knees 10 degrees beyond vertical
- Bend forward with your knees straight and place your hands flat on the floor
Results of this assessment are known as Beighton scores. The highest possible Beighton score is 9 — one point for each hypermobile joint. A Beighton score of 4 or higher, along with pain in at least four joints for more than three months, indicates benign hypermobility syndrome.
Treatment of benign hypermobility syndrome includes:
- Physical therapy to strengthen joints and learn how to prevent hyperextension
- Activity modification to relieve pain
- Analgesics
Occasionally, joint hypermobility is a sign of a rare, serious disorder, such as Ehlers-Danlos syndrome or Marfan syndrome. For this reason, joint hypermobility accompanied by joint pain should be evaluated by a doctor to determine the cause.
- Sheon RP. Clinical manifestations of the hypermobility syndrome. http://www.uptodate.com/home/index.html. Accessed July 16, 2009.
- Tofts LJ et al. The differential diagnosis of children with hypermobile joints: A review of the literature. Pediatric Rheumatology. 2009;7:1. http://www.ped-rheum.com/content/7/1/1. Accessed July 16, 2009.
