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Joint hypermobility: What causes 'loose joints'?By Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/hypermobility/AN01646
- With Mayo Clinic physical medicine and rehabilitation specialist
Edward R. Laskowski, M.D.read biographyclose window
Edward R. Laskowski, M.D.Edward R. Laskowski, M.D.
Dr. Edward Laskowski is certified by the American Board of Physical Medicine and Rehabilitation, including subspecialty certification in sports medicine, 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 College of Medicine, Mayo Clinic.
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 an avid hiker, cyclist and climber. He approaches sports medicine from the perspective of a physician and an athlete.
In 2006, President George W. Bush appointed Dr. Laskowski to the President's Council on Physical Fitness and Sports, and he has received a Distinguished Service Award from the Department of Health and Human Services for his contribution to the Council.
Dr. Laskowski was a member of the medical staff of the Olympic Polyclinic at the 2002 Winter Olympics in Salt Lake City and has provided 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 website guide to self-care, and hundreds of Mayo Clinic articles and booklets in print and online. He is a contributing editor to the "Mayo Clinic Fitness for EveryBody" book, and he has presented lectures throughout the world on health, fitness and sports medicine topics. His teaching expertise has been recognized by his election to the Teacher of the Year Hall of Fame at Mayo Clinic.
"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."
Joint hypermobility: What causes 'loose joints'?
My doctor recently commented that I have "loose joints." What does this mean?
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 of 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
- Pain relievers (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 and treatment of the hypermobility syndrome. http://www.uptodate.com/home/index.html. Accessed July 23, 2011.
- Simpson MR. Benign joint hypermobility syndrome: Evaluation, diagnosis, and management. Journal of the American Osteopathic Association. 2006;106:531.
- Tofts LJ, et al. The differential diagnosis of children with joint hypermobility: A review of the literature. Pediatric Rheumatology. 2009;7:1.