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What is the hypermobility test that you or your Physical Therapist can do to determine if you have hypermobility syndrome? What are the implications for you if you happen to have hypermobililty syndrome? I discuss these issues in this video blog and work with Victoria — one of my clients — to determine if she has hypermobility syndrome (answer: she is).
Margaret: Hi, I’m Margaret Martin at MelioGuide. Thank you for tuning in.
Today, I am going to cover Hypermobility Syndrome. I have invited a very special client, Victoria, who we have (already) determined has hypermobility syndrome. In this video blog, we are going to recreate the hypermobility test that we did a few weeks ago on Victoria.
I invited Victoria to take the hypermobility test again because when Victoria originally came to see me for Physical Therapy she wanted an exercise program to strengthen her bones. However, when she started her exercise program she had two experiences:
- Her hesitation towards exercise because of negative consequences in the past.
- Like many of my clients who have hypermobility syndrome, she ran into problems early on with pain and discomfort when doing her exercises.
As Physical Therapists, it is important to find out that somebody has hypermobility. This allows you to take slower steps in working with somebody.
As individuals, if you test yourself and find out that you have hypermobility, there’s a lot of other implications that are important.
Hypermobility Syndrome Questionnaire
Today, what I would like to cover is the way in which you go about performing the Hypermobility test.
One of the first ways is simply a questionnaire. If you do not have the client with you or you decide you don’t have the time in your practice, you can at least have them complete a questionnaire.
Five questions that have an 85% specificity and sensitivity. This means that it is pretty accurate, and it was tested in both internationally and in different languages. These five questions are as follows.
Question 1 • Hands Flat on Floor
Margaret: Can you now, Victoria, or could you ever place your hands flat on the floor without bending your knees?
Question 2 • Hypermobile Thumbs
Margaret: Can you now or could you ever bend your thumb to touch your forearm?
Question 3 • Hypermobile Body
Margaret: As a child, did you amuse your friends by contorting your body into strange shapes or could you do the splits?
Victoria: I could do the splits.
Question 4 • Kneecap or Shoulder Dislocation
Margaret: As a child or teenager, did your shoulder or kneecap ever dislocate more than once?
Question 5 • Double Jointed
Margaret: And do you consider yourself double-jointed?
Victoria: I do.
Interpretation of Questionnaire Results
Margaret: If an individual scores 2 or more of the 5 questions, they have an 85% chance, really, of being hypermobile.
We’re going to run through the actual physical hypermobility test that allow you to be even more specific. Let’s go through the five tests. These tests are scored for a total of nine points.
Test 1 • Hypermobile Fingers
I have a very little bit of hypermobility. The audience can kind of see the difference between a relatively normal range of motion — which is to have your forearm and hand in a straight line and to bring your little finger back.
Could you repeat that same thing on the other hand for me? So for every finger that…little finger, right, left, that Victoria’s able to do at 90 degrees, that’s 1 point. So one point for right, one point for left.
Test 2 • Hypermobile Thumbs
The next one would be to bring your thumb down to your forearm. Okay. And could you repeat that on the other side as well? Okay. Very good. Thank you. And so then you get two more points.
Test 3 • Hypermobile Elbows
Then it’s the elbow, the ability to straighten the elbow past the horizon. I’m going to take my goniometer out. And so just measuring the distance from the inside of the arm down through and seeing how far she can go, and we’re getting about minus 20 degrees. Okay.
And could you repeat that on the other side, please? So straight out, and bring that elbow down. Okay, now weight is flexible here, but we’re still about minus 15. Okay. Very good. So again, you get one point for each side.
Test 4 • Hypermobile Knees
The other one that’s done double are the knees. Okay, so I’ll have you lie down on your back, please.
Thank you for lying down on your back.
Heels up, perfect.
Then if you could bring the back of your knees down, perfect.
Her ability to bend backward. All right. Just coming in at minus 10 degrees. Okay.
Test 5 • Hypermobile Hips
The last test that is done is the test where she would actually be standing straight and bringing her hands flat to the floor. So then the score is issued out of nine points.
But within the Hypermobility Syndrome, just because you score nine out of nine, doesn’t mean that you’re going to have more problems than somebody that scores one out of nine.
There’s a spectrum of other issues that you may face, that is important for you to be aware of and for your clinician to be aware of as well.
So please stay tuned for the other blogs where we’ll discuss yoga and hypermobility.
Physical Therapy for Hypermobility Syndrome
The physical test demonstrated in the blog is referred to as the Beighton Score.
Please note that this test does fall short of highlighting all potential hypermobile joints.
Physical Therapists are encouraged to assess individual joint especially when function or pain is involved. The updated criteria for clinicians is located here.