I found out that I was hypermobile before I found out I was neurodiverse. I was working in primary care at the time and had been dealing with horrible, debilitating shoulder pain for years. Finally, I went in to see a physical therapist, who told me that my shoulder had been out of its joint the whole time! She relocated it, and I felt better immediately.
But why did this happen?
After my visit with the physical therapist, I sought out the help of a physiatrist to gain a better understanding of why my body moved in such odd ways. Turns out I was hypermobile. It also turns out that there is a fascinating connection between neurodiversity and hypermobility.
What is Hypermobility?
Joint hypermobility is characterized by extreme flexibility in the joints, leading to significant pain. It is a connective tissue disorder where loose or weak ligaments allow your joints to move too far out of range. Symptoms include frequent joint and ligament injuries, such as dislocations and sprains, joint and muscle stiffness, fatigue, and clumsiness or poor balance, as well as persistent pain.
Hypermobility is not all about the joints. It can be stretchy skin or easy bruising; these are not necessarily painful. Joint hypermobility, on the other hand, very much is.
Hypermobility —like autism—also occurs on a spectrum. In fact, many medical professionals refer to the condition as hypermobility spectrum disorder (HSD). Different people experience different degrees of symptoms, but while everyone’s experience is different, there is a lot of overlap.
The Connection Between Hypermobility and ADHD
As I learned from my own personal experience, I’m not the only neurodivergent person with hypermobility spectrum disorder. In fact, a recent study performed by the Brighton and Sussex Medical School found that more than 50% of participants with a diagnosis of autism, attention deficit hyperactivity disorder (ADHD), or a tic disorder demonstrated higher-than-average levels of hypermobility.
Another interesting correlation is that hypermobility is closely related to a condition known as postural orthostatic tachycardia syndrome (POTS). POTS is a condition that causes your blood pressure to drop and your heart to beat faster when transitioning from sitting or lying down to standing up, resulting in lightheadedness and fainting. Studies have found that about 20% of pediatric patients with POTS also exhibited hypermobility, such as Ehlers-Danlos syndrome or hypermobility spectrum disorder. Interestingly enough, doctors have started treating POTS with a medication commonly used to treat ADHD: guanfacine. The results have been promising, with about 72% of patients responding to this medication.
There is still a lot of research to be done to better understand the connection between neurodivergence, hypermobility, and POTS. However, the going is slow, since most doctors only specialize in one medical field. They focus on either connective tissue disorders or neurodivergence, but rarely both. This makes it hard to make connections and draw conclusions across the two medical fields. But connecting the dots between these conditions could help patients better understand their bodies, and be less frustrated when their bodies don’t work the way they want them to.
Testing for Hypermobility
The gold standard for testing joint hypermobility is called the Beighton Scoring System, which is a 9-point scale measuring the mobility of the following joints:
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- Knuckles of the pinky fingers
- Base of both thumbs
- Elbows
- Knees
- Spine
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If you or your child can easily bend forward and place your hands flat on the ground without bending your knees, you may be hypermobile. Likewise, if you can touch your thumb to the forearm on the same arm, or if you have suffered multiple dislocations in your lifetime, you may be hypermobile. If your child exhibits hypermobility coupled with pain, you should contact your doctor or physiatrist.
You can learn more about how to test for hypermobility in this Ehlers-Danlos Society article.
Treating Joint Hypermobility Syndrome
There is no cure for joint hypermobility syndrome, but there are many effective ways to treat the symptoms of this condition.
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- Implement lifestyle changes that improve posture and decrease fatigue.
- Avoid activities or movements that trigger your symptoms.
- Instead of heavy exercise, practice gentler, more isometric movements with less stretching and pulling.
- Work with a physical therapist to strengthen joints and muscles, and prevent hyperextension.
- Medications may help alleviate the symptoms of joint hypermobility disorder. Some common options include anti-inflammatory medications, tricyclic antidepressants, seizure medications like Gabapentin or Lyrica, steroid injections, pain medications, and muscle relaxers.
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It’s crucial to speak with your or your child’s doctor, physiatrist, or physical therapist about how to best treat the symptoms of joint hypermobility syndrome. Every patient is different, and only a qualified medical professional can provide guidance for treating your symptoms. If you notice signs of hypermobility in your child, and they are complaining about pain, please reach out to me or another pediatrician. The more your child understands about the way their body works, the better able they will be to manage their symptoms, and live a comfortable and full life.
Contact Orchid Pediatrics
At Orchid Pediatrics, we stay ahead of the latest research and innovation in the fields of behavioral and developmental pediatrics. We want to provide you and your child with comprehensive, forward-thinking care that addresses all of their needs—physical and mental. If you would like to talk to us about your child, please call (503) 408-2007 or complete the brief form below to send a message to our clinical team.
*** Disclaimer
This blog is for entertainment, informational, and general educational purposes only and should not be considered to be healthcare advice or medical diagnosis, treatment or prescribing. The Content is not intended to be a substitute for professional medical care. Always seek the advice of your qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
