Parents of hypermobile kids are taught early on not to pull on limbs while dressing them or picking them up. It is less common to teach children how to protect their own joints.
In fact, parents may be encouraged by their child’s doctors to let them be “as active as they want to be, in order to build their strength”. Without adding in education about good joint protection, this is not good advice. This post is an attempt to fill in the space between “don’t pull on their limbs” and “get them to be more active”.
Why? Because hypermobile joints are more vulnerable to immediate injury and also to progressive damage over time. Once joint surfaces are damaged, and tendons and ligaments are overstretched, there are very few treatments that can repair those situations. Since children often do not experience pain with poor joint stability, teaching good habits early is essential. It is always preferable to prevent damage and injuries rather than have to repair damage. Always. And it is not as complicated as it sounds.
The basic principles of joint protection are simple. It is the application that can become complex. The more joints involved in a movement or that have pre-existing pain or damage, the more complex the solution. That is why some children need to be seen by an occupational or physical therapist for guidance. We are trained in the assessment and prescription of strategies based on clinical information, not after taking a weekend course or after reading a book. I am thinking of writing an e-book on this subject, since there really is nothing much out there for hypermobile people at any age….
Some of the basics of joint protection are:
- Joints should be positioned in anatomical alignment while at rest and as much as possible, while in use. Knowing the correct alignment doesn’t always require a therapist. Bending a foot on it’s side isn’t correct alignment. Placing a wrist in a straight versus an angled position is.
- Larger joints should execute forceful movements whenever possible. That means that pushing a heavy door open with an arm or the side of your body is better joint protection than flattening your hand on it. The exception is if there is damage to those larger structures. See below.
- Placing a joint in mid-range while moving protects joint structures. As an example, therapists often pad and thicken handles to place finger joints in a less clenched position and allow force to dissipate through the padding. We discourage carrying heavy loads with arms held straight down or with one arm/hand.