Hypermobility Syndrome (Loose Joints)

What is hypermobility syndrome?

Children with this condition have loose joints. Movement at their joints is excessive (beyond the normal range). Over 10% of children have this condition.

What causes it?

The ligaments that hold the joints together are loose or lax. Genetic differences in the elastic (collagen) tissue found in ligaments is the underlying cause. Loose-jointed findings commonly are present in other family members.

How is it diagnosed?

Lab tests or X-rays are of no value in making this diagnosis. The diagnosis is made by finding several of the following excessive movements on physical exam:

• The thumb can touch the forearm
• The fingers can be bent backward more than 90 degrees
• The elbow can be bent backward more than 10 degrees
• The knee can also be bent backward more than 10 degrees
• The palms of the hands can be placed flat on the floor while bending from the waist with the legs straight
• The feet are flat with absence of an arch
• A few children with this are double-jointed (they can dislocate some of their joints at will)

What are the symptoms?

Usually there are no symptoms. Joint pains may follow vigorous activities, but the pain is usually mild and transient. Injuries during sports are slightly increased. They usually involve overstretching the loose ligaments around a joint (for example, a sprained ankle). With severe loose joints, recurrent dislocations can be a problem.

What is the treatment?

Usually no treatment is necessary. Pain medicines (Tylenol or ibuprofen) can be taken for occasional joint pains. There is no medical or surgical treatment that will tighten up the joints. Teenagers involved in competitive sports can stabilize their joints by strength training to increase the muscle mass that surrounds the joints. A physiotherapist can help design an conditioning program. Most importantly, your child should not be restricted from participation in any activities.

How long will it last?

Overall this normal variation in the looseness of joints persists throughout life. After puberty, it tends to improve in many people.