Joint hypermobility means that you are able to move joints beyond their normal range of movement. For example, a hypermobile person may be able to put their leg behind their head or bend their thumbs back to their wrists. It can affect one or two joints or all of the joints can be unusually bendy. Joint hypermobility is common and most hypermobile people live normal lives and some use their hypermobility to their advantage (e.g. in dance or gymnastics).
Hypermobile people can be more likely to injure themselves, e.g. twist an ankle, or may be more susceptible to dislocations of joints because their joints are already lax owing to the looser and more stretchy connective tissues (ligaments, tendons and soft tissues) supporting them.
Most hypermobile people respond well to treatment, although they may take longer to heal, and most will not go on to experience further problems. Others, however, may only partially recover and go on to re-injure the same joint and/or other joints in the body.
PGP and hypermobility
A hypermobile woman may be more likely to experience PGP owing to the already lax connective tissue supporting the pelvic joints but not every woman who has hypermobile joints will experience PGP. The hypermobility may increase the likelihood that one of the pelvic joints will move or get stuck in the wrong position, resulting in the asymmetrical movement which is central to PGP problems.
However, the treatment follows the same principles with or without joint hypermobility. Please see our Treatment section for more information.
If you are hypermobile and have PGP you are likely to respond well to manual therapy of the pelvic joints followed by a specific exercise programme when pain has reduced, though you may take longer to recover. If this is the case you may find information on our What to do if treatment is not helping, Emotional impact of PGP and Practical suggestions pages helpful.
If you feel you may have an undiagnosed hypermobility syndrome you can contact one of the charities listed below for further information about the symptoms, diagnosis, treatment and management of hypermobility syndromes.
Some people who are hypermobile may experience long-term pain, fatigue, frequent dislocations or subluxations (partial dislocation) of one or more joints, and recurring ligament, tendon or soft tissue injuries. Hypermobile people who experience these types of symptoms, along with many others, may go on to being diagnosed with a hypermobility syndrome (also known as a heritable disorder of connective tissue – HDCT), usually by a rheumatologist.
Joint hypermobility syndrome (JHS) is the most common hypermobility syndrome and many healthcare professionals believe that JHS is part of the same spectrum as Ehlers-Danlos syndrome-hypermobility type (EDS-HT). People with JHS and EDS-HT may also experience a variety of gastrointestinal (stomach and digestive system) symptoms, symptoms of the autonomic nervous system and problems with bladder function. Symptoms can vary between each individual, ranging from mild, with few symptoms, to more severe, affecting many systems of the body. It is common for physiotherapists, occupational therapists, pain consultants, psychologists and rheumatologists, among many others, to be involved in the management of the condition.
The majority of people with JHS and EDS-HT can lead a normal life and can manage their symptoms well if they receive the right healthcare support. Those who are more severely affected often require interventions from a team of healthcare professionals and are likely to have to make considerable adaptations to their daily lives.
Other connective tissue disorders
There are also rarer types of hypermobility syndrome, including other types of Ehlers-Danlos syndrome, including classic or vascular variations with symptoms relating to severe skin and cardiac problems, and Marfan syndrome which is linked to problems with the heart, lungs and eyes.
PGP and hypermobility syndromes
If you have a diagnosed hypermobility syndrome and are also experiencing PGP, you may respond well to manual therapy in conjunction with any other treatments already in place for managing your hypermobility syndrome. If you are seeing a physiotherapist for the management of your hypermobility syndrome as well as a manual therapist (physiotherapist, osteopath or chiropractor) for PGP symptoms, it is helpful for both practitioners to liaise regarding your care and treatment plans. It is also important to manage your pain, if this is not already being managed, this can allow manual therapy treatment to be more effective. Please see our Pain section for more information.
Hypermobility syndrome symptoms will differ between women prior to experiencing PGP; women will experience differing levels of pain and functional ability depending on how severely they are affected. The severity of how you are already affected is likely to impact on the rate at which you may recover from PGP.
If your symptoms of PGP persist despite having a course of manual therapy from a manual therapist experienced in treating PGP, and ideally hypermobility syndromes, you should consult your GP or one of the other healthcare professionals involved in your care for further advice and treatment options.
For more information about the symptoms, diagnosis, treatment and management of hypermobility syndromes, please visit:
Hypermobility Syndromes Association: www.hypermobility.org
Ehlers-Danlos Support UK: www.ehlers-danlos.org
Ehlers-Danlos Society International: www.ehlers-danlos.com
Marfan Association UK: www.marfan-association.org.uk