Do you know if you are hypermobile? What are the implications for you if you happen to be one of those people who is hypermobile? And is there a hypermobility test that you or your Physical Therapist can do to determine if you are hypermobile? I discuss these issues in this video blog and work with Victoria — one of my clients — to determine if she is hypermobile (answer: she is).
The Hypermobility Test
Margaret: Hi, I’m Margaret Martin at MelioGuide. Thank you for tuning in.
Today, I am going to cover Hypermobility Spectrum Disorder. And I have invited a very special client, Victoria, who we have determined is hypermobile. But we’re going to go through determining that as we did a few weeks ago.
So one of the reasons I asked Victoria here is that one of the first things when Victoria came to see me and wanted an exercise program to strengthen her bones was,
- A, her hesitation towards exercise because of negative consequences in the past, and,
- B, like many of my clients who are hypermobile, she ran into problems early on, pain, discomfort, you know, with doing exercises.
And so the importance of finding out, A, as clinicians, that somebody’s hypermobile, really allows you to take slower steps in working with somebody.
And for individuals, if you test yourself and find out that you’re hypermobile, there’s a lot of other implications that are important. Now both of those things will be covered in future blogs.
Hypermobility Spectrum Disorder
Today, what I would like to cover is the way in which you go about testing for the Hypermobility Spectrum Disorder.
So one of the first ways is simply a questionnaire. So 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.
So five questions that have an 85% specificity and sensitivity, meaning, it’s pretty accurate, and it was tested in both internationally and in different languages. These five questions are as follows.
So, can you now, Victoria, or could you ever place your hands flat on the floor without bending your knees?
Margaret: Okay. Can you now or could you ever bend your thumb to touch your forearm?
Margaret: Okay. 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.
Margaret: Okay. As a child or teenager, did your shoulder or kneecap ever dislocate more than once?
Margaret: Okay. And do you consider yourself double-jointed?
Victoria: I do.
Margaret: Okay. So if an individual scores 2 or more of the 5 questions, they have an 85% chance, really, of being hypermobile.
Now if you are fortunate enough to have them with you, or you can, at home, do these tests on yourself, we’re going to run through the actual physical tests that allow you to be even more specific. So let’s go through the five tests. These tests are scored for a total of nine points.
So the very first test, and I’m going to show you, I have a very little bit of hypermobility, so that the audience can kind of see the difference between a relatively normal range of motion, is to have your forearm and hand in a straight line and to bring your little finger back. Okay. Very good.
And 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.
Okay. 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.
Then it’s the elbow, the ability to straighten the elbow past the horizon. And so 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.
The other one that’s done double are the knees. Okay, so I’ll have you lay down on your back, please. Thank you for lying down on your back, since you’re not a chicken, laying eggs. Thank you. And heels up, perfect. And then if you could bring the back of your knees down, perfect. And so her ability to bend backward. All right. Just coming in at minus 10 degrees. Okay.
The last test that is done… So she would score one point for each knee. 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 Spectrum Disorder, 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 the implications for yoga.
Resources for Individuals
Individuals seeking further help or advice on hypermobility should use this resource.
Resources for Health Professionals
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. Clinicians are encouraged to assess individual joint especially when function or pain is involved. The updated criteria for clinicians is located here.
Protect your Joints
Read more articles like this on Protect Your Joints.