Hypermobility in childhood
What is hypermobility?
Hypermobility - let's break this word down. Hyper means more, much, big, excessive and mobility means movement, moving. Thus, hypermobility is the term used to describe the ability to move joints beyond the normal range of movement. Where does it occur? It can be total, i.e. on the whole body, or partial, only in a certain body part. It is essentially an excessive motion in the joints. Connective tissues of any such child with hypermobility are looser and more flexible than their peers.
It primarily affects the knee joint, small joints on the hand, hip, elbow joint. As a result such people can, for example, do the splits, put their leg behind their head, bend their thumbs backwards to their wrists, bend their knee joints backwards without any warm-up. There is a risk that without sufficient muscular and ligament support that excessive relaxation can lead to back pain later. It can also lead to overloading of the supporting joints such as the lumbar, knee, shoulder joints, and even headaches.
How does hypermobility manifest itself?
Hypermobile syndrome (HS) can manifest itself in babies and can subsequently cause a delay in psychomotor development. In older children aged 3-5 years, HS can manifest itself in the development of flat feet, pain and scoliotic posture to scoliosis. Hypermobile syndrome manifests itself either alone or in conjunction with other diseases, or as a result of illness or injury. According to leading specialists Beighton and Horan, examination consists of measuring the range of motion in four pairs of joints and a separate evaluation of the forward bend.
Since muscles and tendons are the most stressed (professionally called hyper laxicity), pain most often occurs in them. Poor (incorrect) posture, long standing, long walks are contributing to hypermobility. Result of which injuries, sprains, strains and tendon tears occur more often than in ‚healthy‘ children. Thus, healing (convalescence) also takes longer.
When does hypermobility occur?
Hypermobility occurs mostly at preschool age and girls are especially prone to it. It is due to hormonal changes in the body. But also in children of both sexes, if at least one of the parents is hypermobile. It does however usually recede gradually during adolescence.
Hypermobility is a relatively common deviation. On average it occurs in 10-21% of children aged 5 to 18 years and gradually disappears with age. In adulthood it occurs in about 5-7% of adults. HS can also be triggered in sports where excessive musculoskeletal overload occurs, such as: gymnastics, athletics, ballet. These sportsmen often achieve better results due to the relaxed joints. However, at a later age this will end their sports career.
How does HS occur?
The biggest premise is a disorder of the structure of collagen in the joints, as a result of which there is a loosening of ligament structures, loosening of muscles and / or a change in the quality of tissues. It is very appropriate to follow a few principles, namely, proper posture, which helps prevent pain, and also helps prevent scoliotic posture or scoliosis. Proper posture should be observed not only when standing, but also while sitting, lying down, when lifting heavy loads.
How we can eliminate joint overload and how to prevent minor and more serious injuries
• Learn the proper body posture. Not only how to stand properly, walk, sit, in what position to sleep, but pay attention, for example, to a suitable bag for school children, which is often excessively heavy and incorrectly anatomically shaped. The right height of the desk (since the child spends most of their time sitting at a desk). The table should meet the correct parameters (height, width, enough space): when placing the forearm on the table, the shoulders should not lift upwards.
• The chair is also important: avoid chairs on wheels, chairs that turn to the sides, too soft, without a backrest. The chair should be firm, with a backrest. The height of the chair should be adjusted so that the child can touch the backrest. The legs should be the entire surface of the foot on the ground, the legs spread the width of the hips, the hips and knees at right angles.
• Learn to sleep properly. This means, in the first place, to have a suitable mattress, rather harder, certainly not soft, beware of too large a pillow under the head. The pillow should only be high enough for the head to reach the extension of the spine, so a large head tilt is inappropriate.
• Overweight. Yes, overweight is present in many families today. Even young children stop moving, sports are eliminated, parents are more afraid of injuries than overeating. Overweight and obesity lead to a greater load on already overloaded joints, muscles, ligaments.
• Suitable footwear. There is a need for footwear that suitably supports the proper development of the longitudinal and transverse arches. Avoid high heels in girls shoes and inflexible hard sole shoes. Look for shoes with a gentle arch and the ankle joint support.
• It is necessary to pay attention to the appropriately chosen sport, but if we already have a hypermobile child who performs sports such as ballet, athletics, dance, football. It is also necessary to choose the right compensation. The recommendation is to do a sport with a whole body load (skating, skiing, swimming), suitable warm-up and, after training, stabilization exercises, rehabilitation.
In infancy, HS can cause delays in psychomotor development. In older age, pain or swelling of the joints may occur (for example, swelling of the knee, swelling of the ankle), in adulthood HS may lead to pseudo radicular syndromes, scoliosis, dislocations. Problems with back pain, headaches, flat feet may occur.
Mgr. Radoslava Sefferova,
www.kompletfyzio.sk