Hypermobile joints

The anterior cruciate ligament (ACL)

Hypermobile joints are joints that move beyond the normal range with little effort. Joints most commonly affected are the elbows, wrists, fingers, and knees.

Considerations
Children are often more flexible than adults, but those with hypermobile joints can flex and extend their joints beyond what is considered normal. The movement is done without too much force and without discomfort.

Thick bands of tissue called ligaments help hold joints together and keep them from moving too much or too far. In children with hypermobility syndrome, those ligaments are loose or weak. This may lead to:

Arthritis, which may develop over time
Dislocated joints, which is a separation of two bones where they meet at a joint
Sprains and strains
Children with hypermobile joints also often have flat feet.

Causes
Hypermobile joints often occur in otherwise healthy and normal children. This is called benign hypermobility syndrome.

Rare medical conditions associated with hypermobile joints include:

Cleidocranial dysostosis
Down syndrome
Ehlers-Danlos syndrome
Marfan syndrome
Morquio syndrome
Home Care
There is no specific care for this condition. Persons with hypermobile joints have an increased risk for joint dislocation and other problems.

Extra care may be needed to protect the joints. Ask your health care provider for recommendations.

When to Contact a Medical Professional
Call your health care provider if:

A joint suddenly appears misshapen
An arm or leg suddenly does not move properly
Pain occurs when moving a joint
The ability to move a joint suddenly changes or decreases
What to Expect at Your Office Visit
Hypermobile joints often accompany other symptoms that, taken together, define a specific syndrome or condition. A diagnosis is based on a family history, medical history, and a complete physical exam.

Medical history questions that help document hypermobile joints in detail may include:

When did you first notice the problem?
Is it getting worse or more noticeable?
Are there any other symptoms, such as swelling or redness around the joint?
Is there any history of joint dislocation, difficulty walking, or difficulty using the arms?
The physical exam will include detailed examination of the muscles and skeleton. The joints may be moved to determine the direction and extent of mobility.

Further tests will depend on what condition is suspected.

Alternative Names
Joint hypermobility; Loose joints; Hypermobility syndrome

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Limited range of motion

The anterior cruciate ligament (ACL)

Limited range of motion is a reduction in the normal distance and direction through which a joint can move.

Considerations

Range of motion is the distance and direction of movement of a joint. Limited range of motion is a term meaning that a specific joint or body part cannot move through its normal range of motion.

Motion may be limited by a mechanical problem within the joint, by swelling of tissue around the joint, by stiffness of the muscles, or by pain.

Diseases that prevent a joint from fully extending may, over time, produce contracture deformities, causing permanent inability to extend the joint beyond a certain fixed position.

Causes

  • Ankylosing spondylitis
  • Cerebral palsy
  • Congenital torticollis
  • Dislocation (of most joints)
  • Fracture of elbow
  • Fractures through most joints
  • Juvenile rheumatoid arthritis
  • Legg-Calve-Perthes disease
  • Nursemaid’s elbow, an injury to the elbow joint — extremely common
  • Osteoarthritis
  • Rheumatoid arthritis
  • Septic joint (especially septic hip)
  • Syphilis

Home Care

Your health care provider may recommend range of motion exercises, designed to increase muscle strength and flexibility. Continue these exercises at home.

When to Contact a Medical Professional

Visit your health care provider if a joint does not move fully and easily in its normal way. If a joint develops (new) changes in its ability to move, the affected part should be examined to determine the cause.

What to Expect at Your Office Visit

The health care provider will perform a physical examination and will ask you about your medical history. Questions may include:

  • When did your symptoms start?
  • How bad is it?
  • What body part is affected?
  • Does the limited range of motion affect more than one body area?
  • Do you also have pain?
  • What other symptoms do you have?

Note: Limited range of motion may be discovered by the health care provider during an examination for other conditions, and the affected person may or may not have been aware of its presence.

The muscular system, nervous system, and skeleton may be examined in detail. Depending on the cause, joint x-rays and spine x-rays may be needed. Other tests may also be done.

Physical therapy may be recommended.