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Joint hypermobility in women: Symptoms, causes and what you can do to tighten loose joints


by Caitlin Chambers, MD, sports medicine physician and orthopedic surgeon

There’s no doubt that healthy joint flexibility is essential to an active life. From taking a leisurely jog to striking a near-impossible yoga pose, the elasticity between our limbs can help us do amazing things. With joint flexibility, it may seem that some is better, but more is best.

However, you can have too much of a good thing. It’s possible to have too much flexibility in your joints. This ability to bend and flex further than normal is called joint hypermobility – a condition that women are especially prone to.

While hypermobility may not cause any problems at first (or ever), sometimes it can evolve into serious joint pain. With a correct diagnosis, physical therapy and exercises you can do at home, you can help your body stay appropriately loose and away from pain.

What is joint hypermobility?

Joint hypermobility happens when your joints are looser than those of the average person. This condition goes by other medical names like joint laxity, ligamentous laxity and generalized joint hypermobility syndrome. Your grandmother would probably just say you’re double-jointed.

Hypermobility can happen anywhere there’s a joint in the body, specifically in:

  • Shoulders
  • Hips
  • Knees
  • Elbows
  • Wrists
  • Hands
  • Fingers and thumbs

Like I said earlier, having hypermobility in your joints isn’t necessarily a bad thing. In fact, athletes in activities that require high flexibility and limb extension – like yoga, swimming, gymnastics and martial arts – find it to be a nice advantage. But when hypermobility starts causing pain, that’s when it becomes a problem.

What causes hypermobility (and why is it more common in women)?

Hypermobility can occur due to several factors:

  • Genetics from a family history of hypermobility
  • Conditional training
  • The shape of your bones (i.e. depth of the hip socket)
  • The strength and tone of your muscles
  • Age (hypermobility tends to decrease after your 30s or 40s)
  • Specific conditions associated with hypermobility such as Ehlers-Danlos Syndrome and Marfan Syndrome

As a sports medicine physician and orthopedic surgeon, I tend to see hypermobility more in women than in men. There are several factors that tip the scale:

  • A woman’s body has a structure that’s more prone to laxity
  • Soft tissues in women are more likely to be looser
  • Hormones can play a role (for example, hypermobility tends to increase during pregnancy)
  • Women tend to participate in more sports that emphasize flexibility, like dance, gymnastics and figure skating

Why can joint hypermobility lead to pain?

If the extra movement from hypermobility causes you pain or swelling, you should take notice. The excess motion seen in hypermobility can sometimes lead to injury. For example, a flexible ankle can lead to pain when stretched too far.

When your joints are loose, the muscles around the joint need to work harder to provide stability. Sometimes, these muscles are already strong and can be pretty resilient. Other times, these muscles may not have the strength to properly support your joints.

In either case, a weak joint can cause your surrounding muscles to tire out, become strained and start to hurt – the stronger the muscles, the longer it takes for them to wear out. It might feel like the joint itself is in pain when it’s actually your muscles that need help. Over time, your compensating muscles can build in ways that throw off your body mechanics, causing pain.

How do you strengthen and tighten loose joints?

Fortunately, there’s plenty you can do with hypermobile joints to head off pain. By being aware of the symptoms and performing strengthening exercises at home, you can tighten up the best muscles for keeping your joints supported and in line.

The best strengthening exercises to counter hypermobility target specific areas around the joint. For example, exercising your core, back and glutes help stabilize your hip joint, reduce pain and prevent hip injuries. Same with strengthening the rotator cuff to help protect you from pain and possible shoulder injuries. Wherever you have a hypermobile joint, look for exercises that build nearby muscles – even light weight lifting can help.

Exercises that can help with joint laxity

We’ve included some excellent strengthening exercises to get you started. Find and use the ones that are right for your particular joints:

Wall push-ups

  • Stand facing a wall, about 12 to 18 inches away.
  • Place your hands on the wall at shoulder height.
  • Slowly bend your elbows and bring your face toward the wall, moving your hips and shoulders forward together.
  • Push slowly back to the starting position.
  • Complete the motion five times, rest for a minute, repeat another eight times, rest another minute, then finish with 12 times.

 

Resisted rows (with exercise band) 

  • Wrap one end of the band around a solid object, such as a bedpost, at about waist level.
  • Place your hands in the other end of the band, then stretch your hands apart so that each hand holds an end of the band.
  • With your elbows at your sides and bent to 90 degrees, pull the band back to move your shoulder blades toward each other, then back apart.
  • Repeat the motion 15 times, rest for a minute, repeat another 15 times, rest another minute, then finish with 15 times.

 

Shoulder blade squeeze

  • While standing with your arms at your sides, squeeze your shoulder blades together and down. (As you’re squeezing, don’t raise your shoulders up.)   
  • Hold for six seconds, then return your shoulders back to their original position.
  • Repeat 8 to 12 times every hour.

 

Clamshell

  • Lie on your side with your affected hip joint facing up. Keep your feet and knees together with your knees bent.
  • Raise your top knee while keeping your feet together, opening your legs up like the shell of a clam. (Don’t let your hips roll back.)
  • Hold for six seconds, then slowly lower your knee back down. Rest for 10 seconds.
  • Repeat 8 to 12 times, then lie on your other side with your affected hip joint facing down.
  • Repeat the exercise another 8 to 12 times.

 

Straight-leg raises

  • Lie on your side with your affected hip joint facing up.
  • Keep your knee straight on your top leg by tightening your front thigh muscles.
  • Align your hip and legs straight with the rest of your body, your knees facing forward. (Don’t drop your hip back.)
  • Lift your top leg straight up toward the ceiling, about 12 inches off the floor, making an angle with your two legs. Hold for about six seconds, then slowly lower your top leg back down.
  • Repeat the motion 15 times, rest for a minute, repeat another 15 times, rest another minute, then finish with 15 times.
  • Lie on your other side with your affected hip joint facing down and repeat the exercise for another three sets of 15.

 

Bridging

  • Lie on your back with both knees bent at about 90 degrees.
  • While lying down, push your feet into the floor, squeeze your buttocks and lift your hips off the floor until your shoulders, hips and knees are all in a straight line.
  • Hold the position for six seconds as you continue to breathe normally, then slowly lower your hips back down to the floor and rest for up to 10 seconds.
  • Repeat 8 to 12 times.

 

Taking care of hypermobile joint pain

If your joints are hurting due to hypermobility, it’s also a good idea to make an appointment with a physical therapist. Once we pinpoint the exact location and cause of your pain, we can start treatment to help strengthen and tighten up the muscles and ligaments around your joints. Through physical therapy, we’ve found many patients have had their flexibility return to normal along with a reduction in pain.

Do you have more questions about hypermobility? Do you already have pain from joint hypermobility? If so, the women’s sports medicine team at TRIA’s Woodbury clinic can help.

Our physicians and physical therapists have the technology and training to find the location and cause of your pain. Then, they can create a specially tailored plan to help strengthen your joints and get you back on track.

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Call 952-831-8742

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