I am a sufferer of hypermobility syndrome and it is very painful. People with hypermobility have weaker connective tissue such as ligaments that allow joints to go beyond their normal range of movement which in turn causes inflammation around the joints and the muscles to become overworked. Because we have no idea of the normal range of movement we also lose our sense of position which is called proprioception.

The usual method of determining if someone has hypermobile joints is the Beighton score which involves checking if you can bend over and touch the floor with the palms of your hands without bending your knees, checking elbows and knees for hyperextension (bending backwards) and fingers for excessive movement (towards the hand and the forearm). This of course isn't totally reliable as you can have hypermobility in other joints and not the ones they test.

There are varying degreees of hypermobility and some people have it wthout pain, others have it with pain and some have severe cases that lead to problems with the internal organs. I fall into the second category.

I have hypermobility in the shoulders, one sacroiliac joint (the joint that joins the pelvis to the spine), one hip, both knees, both elbows and one ankle. I was always very flexible as was my Mum and had no idea I had hypermobility syndrome until my sacroiliac joint began to get painful.

When the joints move too far the muscles surrounding the joint become overworked, as they get completely over-loaded another set take over then they become over-loaded and another set step in so it can spread from head to toe because the muscles can't cope without the help from the ligaments.

Ligaments secure a joint and stop it moving excessively, this is called form closure. The muscles compress and secure the joint to keep it stable and this is called force closure. Due to the lack of form closure and the muscles becoming overworked so therefore a lack of force closure too people with hypermobility cannot stabilise the joints.

The pain from hypermobility is constant, usually better after rest and progressively worse as the day goes on and the joints move too much. Unlike typical back problems etc it does not get better with activity because we move wrong. Hypermobile patients usually have impaired motor control because of this loss of support around the joints so each movement aggravates the problem further.

The muscles get full of knots and trigger points from repeated overuse so they in turn cause their own pain and stretching must not be done around the unstable joints.

Hypermobility does seem to be inherited, I can think of a few family members who have joints that move too far, once you know how to spot them you can tell easily.

I was diagnosed by a chiropractor when I sought help for my back problem and she just looked at my knees and elbows then my back and said I was way too flexible. The solution of course is not to have repeated mobilisations of joints but to work on stabilising them.

Pilates is one of the best forms of exercise for hypermobility as the pilates method teaches patients to keep the joints in a neutral position and work on stabilising them there. It also addresses motor control which is vital so you actually know what your joints are doing and can avoid excessive movement.

Another treatment is prolotherapy which is where an irritant is injected into the ligaments to create inflammation and the hope is they will heal with the joint in place and become useful again. It's not foolproof though as if the joints move too far when undergoing treatment, let's face it a course is several weeks so hypermobile patients are bound to move too far in that time, the ligaments heal in a faulty position and it doesn't help at all. It is also not available on the NHS for ligament treatment and a course can run into hundreds of pounds with no gaurantees it will work.

The majority of people don't really understand hypermobility and can't see what the problem is as most people strive for flexible joints. Again as patients are not restricted in movement many people think there's nothing wrong but of course they don't feel and can't see the pain with every movement.

It's a very painful condition that can restrict the patient in many ways and obviously has no cure so it is always present. The best way to deal with it is to strengthen the muscles far beyond "normal" and make sure they are in balance so they don't pull the joints out of alignment.

I'm giving this one star only because I have to rate it, it's a very painful condition that deserves no stars.

Thanks for reading.