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Marlton Pediatrics

Joint Hypermobility Syndrome (Normal Loose Joints)

Definition

  • Children with this syndrome have loose joints
  • Movement at their joints are excessive
  • Joints can be stretched beyond the normal range
  • Affects over 10% of children

Call or Return If

  • Joint swelling occurs
  • Joint pains become frequent
  • You think your child needs to be seen
  • Your child becomes worse

 

About This Topic

Symptoms

  • Usually, there is no pain or other symptoms.
  • Joint pains may follow hard sports or play. The pain is from over-stretching of the ligaments around the joints. It is usually mild and doesn't last long.
  • Some of these children are "double- jointed" (usually refers to fingers). Many can easily do the "splits" or other extreme postures.
  • Slight increased risk for dislocated shoulder or kneecap with injuries.

Diagnosis
The diagnosis is made by the findings below on physical exam:

  • Thumb can touch the wrist
  • Little finger can be bent backward more than 90 degrees
  • Elbow can be bent backward more than 10 degrees
  • Knee can also be bent backward more than 10 degrees
  • Palms of the hand can rest flat on the floor while bending from the waist. The knees must remain straight.
  • Feet are flat with no arch
  • A few children with this are double-jointed. This means they can dislocate some of their joints at will.
  • Lab tests or X-rays are of no value in making this diagnosis.

Cause

  • The ligaments that hold the joints together are loose or lax.
  • The elastic (collagen) tissue found in ligaments stretches more than normal. This difference is genetic.
  • Loose-jointed findings are often present in other family members.

After Care Advice

Overview:
  • Loose joints are a normal variation, not a disease.
  • Pain is not common.
  • Here is some care advice that should help.
Pain Medicine:
  • Pain medicines (Tylenol or ibuprofen) can be taken if the joint hurts.
  • The pain is from a stretched ligament.
  • Pains should not occur often.
Strength Training:
  • Teenagers who take part in sports can stabilize their joints by strength training.
  • Reason: Increases the muscle mass that goes around the joints.
  • During weight training, avoid doing full range of motion. Reason: Can overstretch ligaments even more.
  • A physical therapist can help design a training program.
Avoid Surgery:
  • There is no medical or surgical treatment that will tighten up the joints.
Stay Active:
  • You do not need to limit your child's sports or play. Your child can participate in all activities.
 
What to Expect:
  • Overall, the extra looseness of joints is lifelong.
  • During the teenage years, it may improve in some children.
  • Injuries during sports are slightly increased. They usually involve stretching the loose ligaments around a joint. A common example is a sprained ankle.
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