The SI joint and hypermobility

Hi everyone,

In my last few posts I’ve been talking about how I’ve recently learned I have a genetic condition called joint hypermobility. My body produces connective tissue differently than a “normal” person. As a result, my ligaments, tendons, and other connective tissues a little bit “stretchier” than they’re supposed to be.

For most of my life, I never knew I had a problem. This is partly because hypermobility is still so under-recognized, and also partly because at points in my life when I had a good baseline of muscle strength, it was able to make up for my connective tissue not being super strong.

How does this relate to the SI joint?

The reason I started writing about genetic hypermobility conditions, also referred to as connective tissue disorders, is that I’ve been learning that these are risk factors for developing SI joint dysfunction.

In general, if you are genetically hypermobile, it is going to unfortunately be easier for you to develop injuries that involve a ligament sprain and/or altered joint mechanics… such as SI joint dysfunction.

So I do believe a higher percentage of my readers are likely to be hypermobile, as compared to the average population.

Genetic hypermobility conditions are different from just having one or two joints that are hypermobile.

Unfortunately, the term “hypermobile” can be confusing because it can also used to describe any joint that has an excessive amount of motion. You can be a non-hypermobile person genetically, but still have an SI joint that becomes hypermobile after an injury that causes the ligaments to be sprained.

I know this can be confusing– it really just comes down to terminology. Translated from the Latin roots, hypermobile means “too much motion.” The word alone doesn’t say whether it’s a result of one injury, or a genetic predisposition.

However, this post is about the genetic kind of hypermobility– where your body is actually programmed to make your connective tissue differently.

What are some signs and symptoms that you might be hypermobile?

To be clear, there are a range of connective tissue disorders that can have different symptoms, depending on which types of proteins are affected. A geneticist can help to evaluate and narrow things down further.

However, as a general overview, here are some of the symptoms to look out for:

  • Flat feet
  • “Double-jointed”– people with connective tissue disorders are likely to have been those kids growing up who could do all kinds of crazy tricks bending their fingers and hands
  • Chronic, widespread pain
  • A history of joint dislocations (shoulder, hip, etc).
  • Frequent injuries, such as ankle sprains

There are other symptoms which may also be part of hypermobility disorders, such as fatigue, light-headedness, and digestive issues, to name a few. (Again, this is why it’s so important to check in with a medical professional!).

What are the next steps to take?

If you think you might have a hypermobility condition, you can speak with your primary care doctor about meeting with a geneticist. The geneticist will examine you and also take a detailed family history, and then possibly recommend genetic testing. (Some geneticists are actually doing telehealth right now, if in-person visits are a concern!).

Treatment considerations for hypermobile people

For the sake of this blog post, I am going to focus on the musculoskeletal aspects of hypermobility, as that’s where the SI joint is most involved.

I believe hypermobility played a role in why it was so hard to find someone who understood my SI joint issues.

As I’ve mentioned previously, the first person who was able to successfully identify my SI joint issue and realign my joints was a chiropractor, who I ended up seeing for many years. Those adjustments, while very helpful in the short term, never really changed anything in the long term.

In fact, I believe my chiropractor came to think of me as a difficult patient, as he would tell me, in a frustrated voice, that he had other people with SI joint issues who didn’t need to be adjusted so often.

I ended up discovering through my own experience that the more forceful chiropractic adjustments were actually backfiring, by putting too much stress on the ligaments and destabilizing them, even though they were temporarily helping to fix my alignment. Once I switched to the much more gentle Muscle Energy Technique, things got a lot better.

Now, I know that this experience is actually fairly common for hypermobile patients– we really are supposed to have the most gentle adjustments possible, because our ligaments really don’t respond well to having a strong force applied. (Thank you, Muldowney Physical Therapy, for validating this for me!).

I would say that the principles I discuss for SI joint healing– a balancing act between letting your ligaments rest, while finding ways to strengthen the muscles around them that are as gentle as possible– are a great way forward for anyone, but even more so for hypermobile people.

A non-hypermobile person may be able to tolerate a more forceful chiropractic adjustment (although I still don’t love the idea, for safety reasons). But for a hypermobile person, the need to find treatments that are gentle, while building up muscle strength to take the pressure off of our “stretchy” ligaments, is even greater.

I hope this helps!

There is still more to say about hypermobility conditions, but I wanted to be sure to at least get this out there!

For more info, I recommend checking out the following resources:

Ehlers-Danlos Society— Ehlers-Danlos Syndrome, or EDS for short, is one of the main types of hypermobility disorders. The Ehlers-Danlos Society has some really amazing resources for patients. You can check out this article on some of the subtpes of EDS, as well as this article on some of the other hypermobility syndromes.

They also have a practitioner directory, with listings all around the world.

Benign Joint Hypermobility Syndrome article from the American Osteopathic Association (there is different terminology that is used for various hypermobility-related disorders; this is one term that refers to joint hypermobility disorders that seem to fall outside of the category of conditions such as Ehlers-Danlos, for example).

New England area hypermobility resources: My personal hypermobility treatment team.

At the end of the day, we really need more research, as we have really just began to scratch the surface in our understanding of these disorders.

However, I hope this post has given you some useful info, and has helped you to become aware of whether or not hypermobility has played a role in your own story.

Stay tuned for more to come!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s