Simone Biles, Michael Phelps, Patrick Mahomes, and Shohei Ohtani are all athletes who have benefited from hypermobile joints. However, hypermobility can be both a blessing and a curse. Joint hypermobility, or “double-jointedness”, is when joints are able to move beyond their normal range of motion, and the connective tissue holding joints together is loose or weak. Most people with hypermobile joints do not experience any issues, but some suffer from ligament and tendon injuries, joint pain, tiredness, anxiety disorders, and bowel issues.
Benefits of Hypermobility
In throwing and overhead sports, hypermobile shoulder joints can allow for an increased range of motion, which leads to increased torque generation. This can result in increased throwing velocity in baseball pitchers, javelin throwers, and football quarterbacks.
In gymnastics, figure skating, and dance, increased flexibility allows athletes to perform complex movements with greater ease and achieve extreme physical positions for aesthetic purposes. There are also proposed advantages in sports such as swimming and volleyball, but more research must be done to show evidence of clear advantages.
Drawbacks of Hypermobility
Joint hypermobility has been associated with injuries such as ankle sprains, ACL tears, shoulder instability, and hand osteoarthritis. Hypermobile athletes have been shown to have threefold higher odds of having shoulder injuries.
When joint hypermobility leads to pain in joints or muscles, it is often classified as joint hypermobility syndrome. Joint hypermobility syndrome is diagnosed through a physical exam and Beighton score test of flexibility. Joint hypermobility syndrome tends to run in families and is associated with a defect in collagen production. Collagen is a protein that adds flexibility to ligaments and tendons. Collagen fibers are initially coiled, causing them to have a low stiffness under a small load. When the fibers straighten out and become taut, they become much stiffer. Collagen is also what gives gelatin its characteristic elasticity. A medical condition related to joint hypermobility is Ehlers-Danlos syndrome, which is a genetic disorder affecting 1 in 5,000 people and causes the body to produce weaker collagen. This results in problems in connective tissues, including cartilage, bone, blood, and fat.
Ehlers-Danlos syndrome. Image from Royer and Han, 2022
Joint hypermobility syndrome can also lead to a range of non-musculoskeletal symptoms. One study found that joint hypermobility syndromes are a common cause of dizziness and fainting in young females. Another study found that 37% of individuals with joint hypermobility syndrome reported at least one gastrointestinal complaint.
Treatment
There’s currently no cure for joint hypermobility syndrome. Treatments involve strengthening muscles through exercise and managing pain. Other recommendations include avoiding extreme ranges of motion, wearing orthotics, having good posture, and Dynamic Neuromuscular Stabilization.
Featured image from Injurymap
Additional Reading: What is HSD?, Mechanobiology in the Comorbidities of Ehlers Danlos Syndrome, Joint Hypermobility and It’s Co-Morbidities