Hypermobility in children

Hypermobility refers to an increased range of movement in the joints due to loose or more elastic connective tissues. While many children are naturally more flexible, some experience pain, fatigue and joint instability, which may indicate a medical condition requiring management.

What causes hypermobility in children?

Hypermobility is often due to genetic factors affecting connective tissue, such as:

• Benign joint hypermobility syndrome (BJHS): Increased flexibility without an underlying disorder.
• Ehlers-Danlos syndrome (hEDS): A hereditary condition that affects connective tissue strength.
• Marfan syndrome: A genetic disorder that impacts connective tissues, leading to joint laxity and other features.

What are the symptoms of hypermobility?

While many children with hypermobility have no symptoms, others may experience:

• Joint pain and fatigue, especially after physical activity.
• Frequent joint dislocations or subluxations (partial dislocations).
• Poor coordination or clumsiness, leading to frequent falls.
• Muscle stiffness or weakness, particularly in the lower limbs.
• Digestive issues, such as constipation or reflux, in connective tissue-related conditions.

How is hypermobility diagnosed?

A diagnosis is based on:

• Physical examination: Assessing joint flexibility using the Beighton score (a scale measuring hypermobility in different joints).
• Medical history: Evaluating symptoms, family history, and impact on daily life.
• Further testing: If a connective tissue disorder is suspected, genetic testing or specialist assessment may be required.

What are the treatment options?

Management strategies for children with hypermobility include:

• Physiotherapy: Strengthening muscles to support the joints and improve stability.
• Pain management: Using ice, heat, or over-the-counter pain relief if needed.
• Encouraging low-impact exercise: Swimming and cycling help build strength without excessive joint strain.
• Supportive footwear: Reduces strain on joints and improves posture.
• Occupational therapy: Helps with fine motor skills and daily activities if coordination is affected.

Can hypermobility cause long-term problems?

Most children with hypermobility experience fewer symptoms as they grow and develop stronger muscles. However, in some cases, it may lead to:

• Chronic pain and fatigue in adulthood.
• Joint instability, increasing the risk of sprains and dislocations.
• Associated conditions, such as postural orthostatic tachycardia syndrome (POTS) or digestive issues in connective tissue disorders.

Hypermobility in children is common and usually harmless, but for some, it can cause pain, joint instability, and fatigue. Early diagnosis and management through physiotherapy, supportive care and appropriate activity choices can help reduce symptoms and improve quality of life.