Carrying and holding kids is such a natural thing to do. But when your child has hypermobility due to low muscle tone, joint issues or a connective tissue disorder, how you accomplish these simple tasks makes a difference. Your actions can do more than get them from one position or location to another: they can build a child’s skills, or they can increase the risk of damage by creating excessive flexibility or even accidentally injure a child’s joints.
How could something so simple be both a problem as well as an opportunity? Because hypermobility creates two issues that have to be addressed: Less strength and stability at vulnerable joints, and less sensory feedback regarding pain and position sense in your child. The ligaments, tendons, muscles and joint capsule at every hypermobile joint are more likely to be damaged when excessive force is placed on them.
Knowing how much force is too much isn’t easy without some instruction from a skilled therapist. Depending on your child to react quickly and accurately to accidental stretch or pressure by crying or pulling away isn’t a good idea. Their excessive flexibility reduces firing of receptors deep within all of these tissues in response to excessive force. You may have looked at your child’s shoulders or ankles and think “That looks uncomfortable. Why isn’t she fussing?” This is the reason. It means that you will have to be altering your actions to reduce the risk of harm.
As I mentioned earlier, this is also an opportunity. It is an opportunity to teach your child about safe movement and positioning, right from the start. Even the youngest child will pick up on your emphasis on alignment, control and safety. They are always listening and learning from you every day, so incorporate effective movement into your handling and help your child build awareness and independence today!
Here are some strategies for you and your child:
- Always spread the force of your grasp over their body, and place your hands on the most stable locations, not the most flexible. Lift a child through their trunk, not by holding their arms. If they cannot steady their head, support it while you lift. If you feel those little bones in their wrists and ankles moving under your grasp, support those joints instead of pulling on them. Not sure how to do this correctly? Ask your therapist for some instruction.
- Do not depend on a child’s comfort level to tell you how far a joint should stretch. Think about typical joint movement instead. If their hips spread very wide when you place them on your hip, think about holding them facing forward, with their knees in line with their hips, not pressed together.
- Give them time to move with you. Those over-stretched muscles are at a mechanical disadvantage for contraction. This means that when you tell a child to sit up, you have to give them time to do so before you scoop them up. They aren’t being defiant or lazy (I have not, in fact, ever met a lazy baby!). This is a neuromuscular issue.
- Discourage unsafe movements. Some children find that overstretching their joints gives them more sensory feedback. It feels good to them. This is not OK. You will not be able to stop them every time, but they will eventually learn that their is a right way and a wrong way to move. Knowing why isn’t necessary. Yet. Teach them to respect joint movement and use things like graded joint compression and vibration (your occupational therapist should be able to help you with this) to give them the sensory feedback they want.