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Hypermobility Syndrome

Joint Hypermobility, Ligamentous Laxity, and “double-jointedness

What does it mean when someone says they are double-jointed



As I was growing up, I always thought that it was cool when someone was “double jointed.” The ability to “skip rope” with your own arms, keeping hands clasped and bringing both arms from in front of you, stepping over them and then from the back over the head again without changing grip. To me, this was the definition of double-jointedness. Ligamentous laxity, hypermobility, and double-jointedness are all interchangeable terms, but the reason behind the increased flexibility may differ between individuals.

Why are some people more flexible?

In all cases of joint hypermobility (JHM), there is a difference in the connective tissue as compared with the general public. Not all patients have medical issues because of their underlying cause, but some do. A group of hereditary disorders of connective tissue (HDCT) include joint hypermobility syndrome (JHS), Ehlers-Danlos syndromes (EDS), Marfan syndrome (most well known as the condition Abraham Lincoln had), osteogenesis imperfect, and Stickler syndrome. JHM lends itself to less medical issues than the others and may even be advantageous for dancers, musicians, and athletes.

How does having ligamentous laxity affect the feet?

Whereas, I still think this is a cool ability, I have come to notice a few of the possible downsides as it pertains to the foot and ankle. Yet, remember, not everyone suffers and some gain competitive advantage from joint hypermobility. Two conditions in the foot and ankle result from JHM: lateral ankle instability, and painful flatfoot. More will follow in coming weeks on each of these conditions.

Abraham Lincoln

How do I know if I have joint hypermobility?

I know that I don’t have it. Let the record show! I am secretly jealous of the increased flexibility that these individuals have. There is a scale called the Beighton [BAY-TUHN] Score. It is a tool used by clinicians to assess joint hypermobility and other syndromes. It is a 9 point scale based on simple exercises that demonstrate whether a patient has this ligamentous laxity. A Beighton score of 4/9 or greater, now, or in the past. Other physical exam findings like pain in joints longer than three months in four or more joints, dislocation or subluxation in more than one joint, skin or eye abnormality, varicose veins. There are major and minor criteria, if you are concerned see you doctor.

What is your number?

Images courtesy of: (Abraham Lincoln)

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