What is hypermobility? 

Hypermobility refers to the ability of connective tissue to bend or stretch beyond the typical range. Depending on the severity, patients may be diagnosed with hypermobility spectrum disorder (HSD) or hypermobile Ehlers-Danlos syndrome (hEDS). While joint hypermobility is often emphasized, connective tissue actually surrounds and supports every single structure in our body, from joints, muscles, and bones, to major organs, to nerves and blood vessels, and more! This means connective tissue hypermobility can impact a wide variety of functions in our bodies. Common symptoms of hypermobility include: 

• Being very flexible or “double jointed” 
• Frequent sprains, subluxations, or dislocations
• Clumsiness or problems with balance
• Fatigue and weakness
• Thin, soft, or stretchy skin
• Bruising easily
• Feeling dizzy or lightheaded when standing up
• Anxiety/panic
• Environmental allergies and sensitivities
• Gastrointestinal problems
• Motion sickness 

How does hypermobility impact my pelvic floor? 

While you might guess that hypermobility causes a “loose” pelvic floor, that is not always the case. Muscle tension is very common in people with hypermobility because the body is trying to compensate for too much motion in the joints; the pelvic floor is no exception! Pelvic floor muscles can become tight and tense as a compensatory strategy for loose pelvic joints or an unstable core. This can cause symptoms like: 

• Pelvic pain 
• Pain with sex 
• Urinary urgency and frequency 
• Urinary incontinence 
• Bladder pain 
• Constipation or pain with defecation 

On the other hand, people with hypermobility can be more prone to things like prolapse, where the tissues surrounding the pelvic organs have too much mobility and the organs don’t get the support they need. Many times, there is a combination of tension and laxity, or an imbalance of tension that leads to symptoms. 

How can physical therapy help? 

Our physical therapists take the time to get to know your situation and ask the right questions to understand how symptoms are affecting your life. We also do a comprehensive exam to get a full and robust picture of the unique mechanical factors affecting your pelvic floor and your entire body. Our whole-body approach to treatment means we can put together the puzzle pieces to help with pelvic floor, low back, neck, head, and other symptoms within an integrated course of care. Treatments may include: 

• Targeted manual releases of the pelvic floor 
• Osteopathic treatment of the spine 
• Visceral mobilization 
• Craniosacral therapy 
• Dry needling 
• Specialized stabilization exercises 
• Functional retraining 
• Visual biofeedback via ultrasound imaging

How do I find out if I am hypermobile? 

Hypermobility is a spectrum and requires a medical provider for an official diagnosis. However, these screening tools can help you determine if you may be hypermobile. (https://www.ehlers-danlos.com/assessing-joint-hypermobility/) 

• The Beighton Scale: give yourself one point for each of the following if you can do them 
  • Bend forward and put your palms flat on the ground while keeping your knees straight 
  • Bend your elbows backwards more than 10 degrees (1 point for each arm) 
  • Bend your knees backwards more than 10 degrees (1 point for each leg) 
  • Bend your pinky backwards more than 90 degrees (1 point for each hand) 
  • Bend your wrist forward and pull your thumb to touch the front of your forearm (1 point for each hand) 

• The 5-Part Questionnaire for Hypermobility: give yourself one point for each question you answer yes to 
  • Can you now [or could you ever] place your hands flat on the floor without bending your knees? 
  • Can you now [or could you ever] bend your thumb to touch your forearm? 
  • As a child, did you amuse your friends by contorting your body into strange shapes, or could you do the splits? 
  • As a child or teenager, did your kneecap or shoulder dislocate on more than one occasion? 
  • Do you consider yourself “double-jointed”? 

If you scored 5/9 or more on the Beighton Scale or more than 2/5 on the 5-Part Questionnaire, there is a good chance you are hypermobile.  

Do you have questions? Are you looking for hypermobility-aware and trauma-informed care for your pelvic floor or other musculoskeletal problem? Click here to schedule a free 15-minute consultation with one of our therapists to discuss your problem and what your individualized care might look like.