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Exercise as it relates to Disease/Exercise and hypermobility syndrome

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Someone with hypermobility can become flexible much quicker than the average person. This move which can take a normal person months can be achieved in days to weeks for someone with hypermobility

Hypermobility syndrome also called Ehlers-Danlos Syndrome Type III is a disorder that is quite common yet doesn't have a lot of research. Hypermobility syndrome is strongly inherited and more common in females.[1] People with hypermobility are born with a higher range of motion in their joints caused by a heritable collagen defect.[2] There are other types of Ehlers-Danlos Syndrome so it is important to rule these out before to avoid the complications of that specific type, these include :

Type I & II: elastic skin slight hypermobility Type IV: thin skin, possible organ failure, only the fingers are hypermobile
Type V: linked to a single family, unknown facts Type VI: joint laxity and severe muscle weakness
Type VII A & B: congenital hip dislocation & severe joint laxity Type VIIC: severely fragile skin [3]

Symptoms

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-Bruising -Delayed motor development
-Excessive joint motion -Flat feet
-Fractures -Gaining flexibility quicker than the average person
-Higher chance of scoliosis -More prone to joint injuries such as dislocations and sprains
-Nerve compression disorders -Osteoarthritis
-Painful joints -Soft tissue rheumatism [4][5]

Diagnoses

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Beighton Score test

Beighton score over 4 is considered Hypermobility

  • Touching thumb to wrist (1 point per side)
  • Little finger goes beyond 90 degrees (1 point per side)
  • Hyperextension of the knee (1 point per side)
  • Hyperextension of the elbow (1 point per side)
  • Touching the floor with hands flat and legs straight (1 point)

Treatment

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General

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Short term solutions Long term solutions
-Analgesics such as NSAIDS -Education
-Compression -Keeping weight at the lower end of a healthy BMI
-Taping -Physical activity
-Physiotherapy [6]

Exercise

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Life long commitment to exercise can lower the discomfort associated with hypermobility syndrome. As with all recommendations it is best to live an active life so aim for 30 minutes a day of light to moderate exercise. Exercises should be gentle and pain free. These include:

-Cycling -Light strength training -Pilates
-Rowing -Some forms of dance -Some forms of yoga
-Swimming -Tai Chi -Walking [7][8]
-Core exercises -Balancing on one leg -resistance bands [2]

However there are exercises that should be avoided these include:

  • Exercise that includes excessive stretching [9]
  • Sports with high collision risks such as hockey and football [8]
  • It is best to avoid breast stroke as it may cause hip pain [9]

Further reading

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References

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  1. Chelsea. What is HMS?. Available: http://hypermobilityhope.blogspot.com.au/p/what-is-hms.html. Last accessed 23rd Oct 2013.
  2. HMSA. (2013). Genes & Inheritance. Available: http://hypermobility.org/help-advice/genes-inheritance/. Last accessed 23rd Oct 2013.
  3. Ehlers-Danlos National Foundation . What are the types of EDS?. Available: http://www.ednf.org/index.php?option=com_content&task=view&id=1348&Itemid=88888969. Last accessed 23rd Oct 2013.
  4. William C. Shiel Jr., MD, FACP, FACR. (2011). Hypermobility Syndrome. Available: http://www.medicinenet.com/hypermobility_syndrome/page2.htm. Last accessed 21 Oct 2013.
  5. MAJ Michael R. Simpson, DO, MC, USA. (2006). Benign Joint Hypermobility Syndrome: Evaluation, Diagnosis, and Management. The Journal of the American Osteopathic Association. 106 (9), 531-536.
  6. Dr A J Hakim MA FRCP. (2013). Clinician’s Guide to JHS. Available: http://hypermobility.org/help-advice/hypermobility-syndromes/jhseds-hm-clinicians-guide/. Last accessed 23rd Oct 2013.
  7. Arthritis Research UK (2011). Condition: Joint Hypermobility. UK: Arthritis Research UK. 1 - 24.
  8. Robyn Hickmott . (2013). Joint hypermobility syndrome. Available: http://www.medicalobserver.com.au/news/joint-hypermobility-syndrome. Last accessed 23rd Oct 2013.
  9. Adam. (2012). Hypermobility and Sport. Available: http://thesportsphysio.wordpress.com/2012/08/19/hypermobility-and-sport/. Last accessed 23rd Oct 2013.

References

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  1. HMSA. (2013). Genes & Inheritance. Available: http://hypermobility.org/help-advice/genes-inheritance/
  2. a b Chelsea. What is HMS?. Available: http://hypermobilityhope.blogspot.com.au/p/what-is-hms.html.>
  3. Ehlers-Danlos National Foundation . What are the types of EDS?. Available: http://www.ednf.org/index.php?option=com_content&task=view&id=1348&Itemid=88888969
  4. http://www.medicinenet.com/hypermobility_syndrome/page2.htm
  5. Benign Joint Hypermobility Syndrome: Evaluation, Diagnosis, and Management
  6. Dr A J Hakim MA FRCP: Clinician’s Guide to JHS
  7. Joint hypermobility syndrome
  8. a b Hypermobility and Sport
  9. a b Arthritis UK