A Spotlight on Muscular Skeletal Conditi
By Tom Middleton, Advanced Practice MSK Physiotherapist, Connect Health
M
y last physio patient has just
musculoskeletal (MSK) pain or be part of
left the clinic and their knee
a much more complex condition
arthritis flare up has settled
affecting multiple bodily systems. The
down well with some advice and
Beighton score is a quick and easy tool
exercises. Next in I have a referral for
commonly used to diagnose generalised
Laura (not her real name), a 26-year-old
joint hypermobility in children and
retail assistant who is off sick. She has a
adults. It gives a score out of 9,
history of long-standing anterior knee
whereby positive is > 5 for
pain and previous patella dislocations. I
adults up to age 50.
note her medical history also states previous physio attendances for back pain, wrist and hand pain, neck pain and ankle sprains. She has chronic fatigue, multiple allergies, genitourinary issues, anxiety and problems with palpitations
and dizziness. She’s had an inflammatory condition excluded and it doesn’t really fit that picture. Her GP is querying fibromyalgia. I’m surprised by her having problems with multiple bodily systems at such a young age and wonder if they could be linked? I’m a little daunted by her complexity and just know my 20-minute appointment will not be enough!
somebody with a kind of joint hypermobility with one or more
associated MSK problem. It may present just in the peripheral joints, localised to one joint or a group, historical (once hypermobile but no longer) or generalised / widespread hypermobility. Hypermobility Spectrum Disorders (HSDs) can be visualised on a continuum from asymptomatic joint
hypermobility at one
Simply put this is excessive joint
Ehlers Danlos
can vary from a single joint to a pair / group, to a more generalised
end to Hypermobile Syndrome (hEDS) at the other.
Olympic swimmer Michael Phelps). This
The Ehlers Danlos Syndromes
is termed asymptomatic joint
These are a group of 13 conditions
hypermobility affecting the spine and multiple joints. For some people this may never lead to pain and in fact be advantageous (You’ve probably heard of
hypermobility. However, for some hypermobility can contribute to
OH TODAY
This is the recognised term for
What is hypermobility? movement. Think “double jointed”. This
14
Hypermobility Spectrum Disorder
Winter 2021
mainly characterised by joint hypermobility, skin hyperextensibility
