Who Diagnoses Hypermobility?

Who Diagnoses Hypermobility?

Hypermobility syndrome is excessive joint flexibility causing joint pain, instability, and other related symptoms and proper diagnosis is important for proper management and treatment. In this blog, I will explore who can diagnose hypermobility syndrome, the criteria used to identify hypermobility, and why an accurate diagnosis is essential for effective treatment.

Who Can Diagnose Hypermobility Syndrome?

Typically, by the time you have reached the potential for hypermobility diagnosis, you have seen a wide range of providers with most of them gaslighting you, making you wonder if it is all in your head! Hypermobility does not just impact your joints so it is common to see specialists such as rheumatologists, cardiologists, neurologists, orthopedists, primary care physicians, physical therapists, chiropractors, acupuncturists, and massage therapists.

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When seeking a diagnosis for hypermobility syndrome, individuals have several healthcare professionals to consider. While rheumatologists, orthopedic surgeons, and physiotherapists are commonly associated with diagnosing hypermobility, chiropractors also play a significant role in identifying and managing this condition. Chiropractors are trained to assess musculoskeletal issues, including joint hypermobility, and can provide valuable insights and treatment options.

Believe it or not,  joint hypermobility, is not something that is taught in schools and typically when it comes to seeking healthcare providers, those who are familiar with this condition have taken the initiative to learn about it themselves.

What Are The Criteria For Identifying Hypermobility?

One of the key criteria used to identify hypermobility is the Beighton score. This scoring system measures joint flexibility by assessing specific movements in various parts of the body. While the Beighton score is widely used, it’s not the only method for diagnosing hypermobility syndrome. When it comes to the rehab. clinicians, physical therapists, and Chiropractors who treat joint hypermobility may consider factors such as medical history, symptoms, and additional clinical examinations when making a diagnosis.

Hypermobility is a connective tissue condition and can be seen in people with Ehlers-Danlos Syndrome (EDS), Hypermobility Spectrum Disorder (HSD), Mast Cell Activation Syndrome (MCAS), and Marfan Syndrome. The physical therapists and chiropractors who treat patients with hypermobility are familiar with the different presentations that the population may present with and during the history intake, and from pattern recognition, can easily identify hypermobility.

In my practice, once I suspect EDS, knowing that there are subtypes of EDS that do not have an identified gene associated with them, I advise the patient to receive genetic counseling and subsequent testing. However, just because there may be no identified genes found does not mean that the patient is not hypermobile.

Is The Beighton Score The Same As Other Criteria?

While the Beighton score is commonly used to assess joint hypermobility, healthcare professionals may use alternative criteria or additional assessments based on their clinical judgment and expertise. Ultimately, the goal is to obtain a comprehensive understanding of the individual’s condition to guide appropriate treatment.

How Can You Vet For The Right Provider?

When seeking a healthcare provider for the diagnosis of hypermobility syndrome, it’s essential to vet for qualifications, experience, and expertise. Look for providers who have specific training or experience in musculoskeletal conditions, including hypermobility syndrome. There are resources such as EDS Society that are a good resource to start your search.

Why Is Diagnosis Important In Treatment?

A timely and accurate diagnosis of hypermobility syndrome is crucial for effective treatment and management. When it comes to joint hypermobility, the treatment rendered to the non-hypermobile population can cause pain and injury to the Bendy population. It is very important and I can’t emphasize enough, to seek care from the providers who understand hypermobility and this goes for the joint issues as well as non-joint complaints.
If you think you are hypermobile and want to know what your next option is, contact me.
Dr. Shakib

Recommended Reading:

What Is The Best Hypermobility Treatment?

TMJ and Hypermobility

 

What Is The Best Hypermobility Treatment?

What Is The Best Hypermobility Treatment?

What Is Hypermobility?

Hypermobility is the ability of your joints to move beyond their normal range of motion. This is typically a result of a connective tissue disorder due to its collagen configuration. Connective tissue is like the body’s glue, giving support and structure to organs and structures by holding them together, kind of like how tape holds things in place. There is a difference between hypermobility and flexibility which I wrote about in my previous blog.

What Causes Hypermobility?

As mentioned above, Joint Hypermobility seen in conditions such as Ehlers-Danlos syndrome (EDS), Hypermobility Spectrum Disorder (HSD), Mast Cell Activation Syndrome (MCAS), Sjogren’s Syndrome and Marfan syndrome is a connective tissue disorder. It impacts all of your joints from how your head sits on your neck to how your toes are. It can come in a spectrum of presentations going beyond joint hypermobility which is the focus of my practice and the realm of my expertise.

What Are The Symptoms Of Hypermobility?

I have written a blog on this very subject that I strongly recommend you to check out. Symptoms of hypermobility can include joint pain, stiffness, frequent dislocations or subluxations, chronic fatigue, muscle weakness, poor posture, and joint instability which can occur in all joints, particularly in the hips, knees, elbows, ribs, jaw, and shoulders.

I was interviewed to talk about hypermobility by JJ Virgin on Instagram where I talked about hypermobility, its different presentation, treatments in general, how every hypermobile patient should know about pelvic floor dysfunction, and message to healthcare providers.

How Is Hypermobility Treated?

The treatment for hypermobility typically involves a combination of strategies aimed at managing symptoms and improving joint stability. This may include physical therapy, occupational therapy, chiropractic treatment, pain management, orthotic devices, lifestyle modifications, joint-specific interventions, and education/self-management. What you should know is that whomever you see for hypermobility treatment should know and treat hypermobility. What applies to the ‘Normie’ does not apply to the Zebras!

How Can Physical Therapy Help With Hypermobility?

Physical therapy plays a crucial role in managing hypermobility by strengthening muscles, improving joint stability, and enhancing flexibility. What matters the most is that the therapist KNOWS about joint hypermobility and treats hypermobile patients and you can get hurt doing the therapy done for the non-hypermobile patients. Physical therapy modalities can be performed by a physical therapist and chiropractors whose focus in practice is functional mobility and postural training.

Can Occupational Therapy Benefit Those With Hypermobility?

Yes, occupational therapy can be beneficial for individuals with hypermobility, especially those experiencing difficulties with daily activities. Occupational therapists can provide strategies and adaptive equipment to help individuals perform activities of daily living more comfortably and efficiently. These methods can also be used by physical therapists and chiropractors who treat hypermobility with a focus on the whole body.

Can Chiropractic Care Help With Hypermobility?

Chiropractic care focuses on the diagnosis and treatment of musculoskeletal disorders, including hypermobility. Not every chiropractor is the right chiropractor for hypermobility and you should only consider upper cervical chiropractors and those treating hypermobility. With Cranio-cervical instability and the potential CSF leak, adjustment of the neck and the rest of the spine can be questionable.

What Are Some Joint Protection Techniques For Hypermobility?

In my practice the majority of my patients are hypermobile. I have found that while each person may have their default movement patterns that are dysfunctional, the best protection is to engage bigger muscle groups to make up for the lax ligaments.

It is important to understand what the tendencies are, learn what to replace them with, and avoid doing activities the wrong way. That is like needing to move your house items and learning to bubble wrap your treasured belongings instead of just putting them in a box and closing them.

At my clinic, my patients learn the basic foundations of movement and understand their bodies, their tendencies, and the how-to’s and that has been the biggest tool to avoid injuries and stay active.How Is Pain Managed In Hypermobility?

Pain management for hypermobility may involve the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or other pain medications to alleviate joint discomfort. Additionally, techniques such as heat therapy, ice packs, and massage can provide temporary relief from pain and stiffness. At times procedures such as Prolotherapy, PRP, and Stem Cells have also been helpful and the results vary from case to case. I refer my patients to the doctor that is local to my clinic who does these injections and is familiar with hypermobility. It is best to ask your rehab. clinician for a potential referral if it suits your issue.

Are Orthotic Devices Helpful For Hypermobility?

Most hypermobile patients have flat feet when standing up or have an already existing bunion. My goal as a rehab. clinician is to bring the function back to the movement and for that reason, I am a big fan of developmental kinesiology exercises such as Dynamic Neuromuscular Stabilization. While I am not a fan of orthotics as the only way to overcome feet issues, I do recommend hard orthotics that can be put in and taken out of shoes vs built-in orthotics in shoewear. That is because the loose ligaments of the foot bones are the reason behind flat feet when standing up and there is no way around that.

I also suggest shoes that are slightly above the ankle to protect the area and compression socks. You can find the hypermobility products that I share with my hypermobile patients on my website.

What Lifestyle Modifications Can Help Manage Hypermobility Symptoms?

Maintaining a healthy weight, practicing relaxation techniques to manage stress and anxiety, and getting an adequate amount of sleep, proper intake of electrolytes can all help manage symptoms of hypermobility and flare-ups and improve overall well-being. Learning how to get out of bed, how to sit and stand, how to open doors and load dishwashers, and how to sleep are some of the examples of what I go over with my patients to avoid or manage hypermobility flare-ups.

 

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If you are hypermobile, the first step toward health is to find providers who are familiar with hypermobility. If you are not happy with your rehab. team, contact us today. We know your challenges and most likely have the solution for you.

Dr. Shakib

Recommended Reading:

The Difference Between Flexibility, Hyper-mobility & Instability

TMJ and Hypermobility