Hypermobility has existed for generations, but has never been considered as a medical pathological condition. Even now older generation of doctors dismiss it and do not understand why flexible people need medical attention.
What is Joint Hypermobility?
Joint Hypermobility is a hereditary condition that features joints which are moving beyond the normal range expected for that joint. Very often if the individual has sufficient muscle strength, there are no symptoms accompanying this state and having an extra few degrees of movement, can be an advantage in many sports disciplines.
In the last fifteen years the number of children that have been referred for physiotherapy treatment has significantly increased, and young patients present more symptoms related to this condition such as reduced proprioception, weak muscles, reduced stamina (endurance), painful joints and muscles, clumsiness, to mention but a few.
The connective tissues of hypermobile people are weaker compared with non-hypermobile individuals and therefore their muscle needs to be twice as strong to stabilise their joints and to be able to function normally, otherwise they would use twice as much energy on simple tasks, which will lead to fatigue and pain.
This is why we often find that pain is induced by sports and aerobic exercises as the muscles are not strong enough due to inactivity and deconditioning.
What’s changed in recent times?
So, what has changed in the last few decades that has increased the amount of complaints within our young hypermobile generation and in the number of physiotherapy referrals?
From my observation and questionnaires I can see that their way of life has changed dramatically.
- Our children sit at their desk and in front of their computers, mobiles and TV for far too long, on average 9-10 hours a day (including their homework time). They go to school at the age of 4 when often they are not developed and ready for formal primary learning.
- Due to lack of facilities, they are expected to sit on the floor or at little tables and play games or do mental learning. The average time spent outdoors is half an hour to an hour a day.
- Furthermore, many children are driven to school for different reasons and spend a long time in the car due to heavy traffic and rush hour during school pick-up times.
All of this contributes to the fact that children nowadays are a lot weaker in general and that their physical performance overall has reduced, which we can also see by comparing results over the years and many PE teachers and coaches will confirm that.
With older children and adolescent children, the pressure on academic performance is much greater than on physical development. The Physical Education has changed from formal conditioning exercises to games and sports, without preparing the body for higher physical demands. To play sports one must be fit and strong, otherwise there is a potential risk of injuries. Professional athletes train hard to condition their bodies in preparation for the high demand in their chosen discipline.
Physical education and the law
There is a law that all schools should offer physical activities 75 minutes per week to each student in primary schools and 90 minutes per week for secondary schools, but unfortunately the physical education is often the first subjects to be cancelled due to other priorities.
Physical education is only compulsory until the age of 16 and will only continue further if it has been chosen for further education. Some schools offer more hours for physical education, but there are also independent schools that do not offer any PE lessons.
Therefore, if your child is hypermobile and does not do exercise at school or outside of school, they will most likely have many different symptoms due to weakness and deconditioning of the muscles. These children will often lean on a wall to support his/her body during standing, and walking for long distances can prove to be to challenging and painful.
The physical guidelines published by UK Government recommend
- For children under five years- 180 minutes which is 3 hours each day once the child can walk
- For children 5 -18 years old- 1 to several hours every day of moderate or vigorous intensity exercises that strengthen the muscles and bones
- For adults 19-64 and alder -150 minutes (2.5h)/week of moderate to vigorous physical activities (and adults should aim to do some physical activities every day) Muscle strengthening activities should be also included.
Why is lack of exercise a bigger problem for hypermobile families today?
These guidelines and recommendations are for an average non- hypermobile child and adult.
Parents, who accompany their child for their physiotherapy assessment, are often also hypermobile but did not realise as they had no or very little symptoms while they were growing up.
The reason for this is, that the parents in general had developed more strength in their childhood or adolescent years due to more physical activities, which created a better functioning support system for their joints.
They were not pushed in buggies for too long, walked to school, had more physical activities at school, played outside with their friends and were not driven because there were not so many cars. And finally, there was no computers and mobiles. The choice on TV programmes was so limited that they most likely only spend 1 hour a day in front of the television, watching their favourite programme.
Summarising, in my opinion the hypermobility became a big problem for many families only because of weakness developed due to a sedentary life.
The positive news is that we can reverse it by implementing a few simple steps. Take a look at our guide to 7 Ways to Help Hypermobile Children Be Confident, Flexible People.