Introduction
Most children are very bendy compared to older people, as children get older their joints become less bendy. Hypermobility refers to an increased range of movement in multiple joints, for their age. It is extremely common in children, having being reported in 25 to 50% of those younger than 10 years of age. The older you are the less likely it is you will be hypermobile. It affects 7 – 10% of school age children in the UK. Hypermobility frequently runs in families. Most young people do not know they are hypermobile, you cannot catch hypermobility it’s just how you are made. It affects girls more than boys (Beighton 1973).
The term Joint Hypermobility can describe a wide range of children with flexible joints. At one end of the range are children who are hypermobile and may benefit from their flexible joints. They may be able to use their hypermobility to excel in areas such as gymnastics, dance, swimming, athletics etc. Most children with hypermobile joints do not need support with everyday activities. At the other end of the scale are people who experience pain and their joints may dislocate.
For further information see: Symptomatic Hypermobility
What are the main symptoms?
Hypermobility can be associated with recurrent pains at the end of the day or at night in the knees, feet and/or ankles. It might affect the fingers and hands. Rarely mild joint swelling may come and go but does not tend to persist.
Everyday Life
Hypermobility often improves with age. Families should be aware that its main risk comes from preventing children to live normal lives. Children should be encouraged to maintain a normal level of activity, including playing any sports they are interested in. Keeping active and strong is important and helps reduce joint pain as fitness and balance improve over time.
Cracking Joints
Research studies have shown that cracking joints does not cause arthritis in the joints. For example, Dr Donald Unger cracked the knuckles of his left hand every day for 60 years, but did not crack the knuckles of his right hand. At the end of 60 years both hands were the same with no arthritis. He won the Ig Nobel Prize for Medicine in 2009.
Sports and Activities
Keeping active and strong is important and helps reduce joint pain as fitness and balance improve over time. Make sure you warm up and cool down when playing sports. It is good to encourage children to have a variety of different sports and activities rather than concentrating on just one sport.
Joint Protection
Writing
It is easier to use thicker style pens/pencils or buy pen/pencils grips as this relieves pressure on fingers and thumb joints and can help to prevent hand pains.
The triangular pencil grip is thought to give better control of the pen or pencil whilst allowing your hand to relax more.
Stabilo Easy Graph pencils are designed for both right- and left-handed users. The triangular shape and moulded grip zones are great for encouraging children to hold the pencil correctly.
Ergonomically friendly pen/pencils can ease writing stress and fatigue e.g. PenAgain / Twist ‘n Write Pencils.
Writing is easier with a gel pen as the ink flows easily over the paper, avoid scratchy ball point pens which will take more effort to write with.
Writing on a sloping surface helps to relieve pain and achiness in the wrist and hand. This will also help your posture and shoulder position in writing. It may be useful to try this at home as well as at school. You can buy writing slopes to go on top of tables from a number of different suppliers. An empty arch lever file serves the same purpose and is light and easy to carry and will not make you look any different from your friends at school. However, buy one with a matt surface as a glossy surface will make your paper slip on it as you are trying to write.
Posture
Good posture is important at all times. A slouched posture may hurt your back and leads to weak muscles around your central core. This then affects the way you can use your shoulders and hips. Think about sitting and standing “tall”.
For further information see: Choosing the Right School Bag
Footwear
Children should try to wear supportive trainers and shoes, especially when their feet or knees are achy. A good foot position can help to relieve knee and leg pain. It may be helpful to wear trainers for PE instead of plimsolls (school pumps). The trainers should have a firm back at the heel, and offer good support. A good shoe cannot be bent in two. Slip on shoes may be too big. You may benefit from a fastening shoe which offers a deeper style and more support for your feet.
For further information see: Choosing Footwear in Children
Flat Feet
This is very common in children with or without Hypermobility. Some children complain of their flat feet having an achy pain. They would benefit from supportive shoes described above. However, in the home they should be encouraged to walk in bare feet (or slipper socks with the grippy soles) as this will strengthen their feet.
For further information see: Flat Feet in Young Children
Paediatric and Adolescent Rheumatology Team Royal Hospital for Children Glasgow 2019