hypo/hyper mobility Flashcards
Mobility:
Structurally, mobility depends on the extensibility of the soft tissues and surrounding structures.
Physiological, mobility is the ability of the body to initiate, perform, control and sustain active movements and simple to complex motor skills.
Hypermobility
Defined as an increased degree of the motion at a joint.
Can occur at 1 joint (often trauma related) or can be generalized throughout the body (pregnancy).
Ranges from mild laxity to joint instability.
Hypermobility and compensatory weakness can be caused by soft tissue tightness and hypomobility in another area.
Can be seen with postural dysfunction, ie spine.
Hypermobility is often found next to a hypomobile joint.
It does not always mean pain and dysfunction.
Joint laxity may be at risk for musculoskeletal symptoms and injury.
Joint Laxity
reduced/decreased tensile quality of ligamentous support.
Hypermobility syndrome
occurs in up to 5% of persons with hypermobility. There is joint P, overuse syndromes like tendonitis, abdominal weakness, hyperextensiblity, and mitral valve prolapse.
Causes of Hypermobility
Compensation: hypomobility, postural dysfunction.
Increased flexibility: body type, occupation, ADLS.
Hormonal influence: pregnancy.
Joint trauma: sprain, dislocation.
Pathologies and conditions: rheumatoid arthritis, Marfan’s syndrome, nerve lesions.
Contraindications Hypermobility
Do not mobilize a hypermobile joint, Yo!
Do not stretch MM crossing a hypermobile joint past the normal end range.
Signs & Symptoms Hypermobility
Joint has greater than normal ROM.
When symptomatic, pain can be felt if ligaments are intact.
Laxity in the joint capsule.
MM crossing the joint may be HT to support
Assessment Hypermobility
Postural imbalances may be visible.
Tenderness in MM crossing may be present.
AROM and PROM greater than normal.
End feel later than normal, P may be present.
Ligamentous stress test.
Treatment Hypermobility
No techniques are used specifically on the hypermobile joint. It is combined with compensatory hypomobility Tx prox and dist.
TP’s may be present in MM crossing the joint. They are treated with ischemic compressions and MM seperations (stripping) followed by heat only, do not stretch!
Self Care Hypermobility
In order to stabilize a hypermobile joint, strengthening exercises are recommended. Begin with isometric, progress to isotonic when MM are able to support the joint in a normal position.
Refer to Dr. if an underlying pathology is suspected and not Dx.
Hypomobility
Defined as the loss of motion at a joint, including the loss of normal joint play movements.
The adaptive shortening of tissue.
Can occur in one joint or throughout the body.
Dominant side tends to be more hypomobile.
Other joints become hypermobile to compensate.
Can lead to MM strains, peripheral NV compression, tendonitis, and reduction in ADL’s.
Capsular Pattern of Restriction:
involves the entire joint capsule, causing a predictable pattern of restriction with PROM.
Causes Hypomobility
Compensation from hypermobility or postural dysfunction.
Body type, occupation, ADL’s.
Intra articular/extra articular adhesions from trauma, surgery, immobilization.
Surgical fixation: Pins, screws, plates, rods, surgical ligament/MM shortening.
Pathology: Dupuytren’s contracture, frozen shoulder, ankylosing spondylitis, NV lesions
Contraindications Hypomobility
Do not mobilize a joint that has been surgically repaired with metal appliances, obvsies!
If ligaments have been surgically shortened, do not restore full ROM in the direction that will stretch the repaired tissue.
Signs and Symptoms Hypomobility
