Orthopedics and traumatology

Joint hypermobility. When the child has a lot of flexibility


Many times we are impressed by the movements that babies can make, especially when they use their joints, since they are very flexible and this is due to a great elasticity of the tissues and this is called hypermobility. It is an alteration of the collagen in the tendons and ligaments, which makes the fibers thinner and less rigid.

It is a normal condition in childhood and it is usually transient and se characterized by exaggerated movements of the joints, beyond normal, due to hypermobility. It is more common between 2 and 6 years of age, although we can also see it in infants and it is normal for hypermobility to decrease towards adulthood, although it can persist in 2 to 3% of cases.

Many babies with this condition are diagnosed as hypotonic or low muscle tone, as these babies have very flexible joints, that bend easily and with muscle tone that does not put any resistance to movements.

In my pediatric practice, when I do the physical examination of these babies, I can achieve the following characteristics:

1. When placing it on the stretcher you can see that is a less active baby, does not move his arms and legs actively, that is, does not kick vigorously.

2. Your lower limbs are more stretched than normal, there is no resistance to flexion thereof, and there is no resistance to hip rotation or knee flexion.

3. The arms or upper limbs are generally almost straight and with little mobility. And his arms do not resist the movements that I practice on the physical exam.

4. When placed face down, they feel restless and tearful, since this position makes them uncomfortable because it is difficult for them to support their arms and lift their head.

5. Psychomotor development is delayed when it comes to rolling over, sitting up, crawling and walking.

6. When sitting with support, we notice how the shoulders are drooping and the arms are almost glued to the trunk, without much mobility. By doing it without support, we notice how the back is rounded and they can go forward, easily sticking the forehead to the floor. Their legs can be placed open, with the mules glued to the ground.

7. In general, the crawling stage is delayed or not performed because they lack muscle strength to perform the movements. TOBy placing them in a crawling position we can see how they stay lying on the ground or they only support arms and legs open and extended on the floor. Sometimes when they crawl on their own they can carry out the movement by dragging one leg or they sit and crawl by dragging the buttocks.

8. As you begin to stand, you notice how they have very little standing strength and fall easily. The legs tend to open them enough to seek stability and we can see the feet turned outwards and the knees go backwards due to hyperextension.

9. As the baby grows, other characteristics can be observed such as sitting with the legs in the shape of a W, that is, they bring the knees together and bring the legs out. They can also bring their fingers back to touch the forearm, spread their legs 180 degrees, put their toes in their mouths and, in general, do contortion or positions that a child without hypermobility normally cannot perform.

In general, these babies or children do not suffer from discomfort or pain, but when symptoms such as pain or other discomfort are added to this condition, we can diagnose the so-called joint hypermobility syndrome, which is characterized by:

- joint pain like hips, knees, elbows.

- Refers bone pain, called growing pains.

- Spinal problems, such as scoliosis.

- Problems writing, hold a pencil for a long time, manifesting pain in the fingers of the hand.

- Flat foot problems, painful genus recurvatum.

- tendonitis frequent and pains at the jaw level.

- They can express tiredness and weakness.

As a pediatrician, I must give recommendations to parents with children with this hypermobility condition:

- When making the diagnosis of hypermobility in the consultation, I indicate to the parents stimulation exercises to increase muscle tone:

- Do push-ups of the upper and lower limbs, firmly but delicately and daily.

- Place it face down on a canvas on the floor to stimulate and tone the muscles of the neck, back and hips.

- Play games in this position and stimuli with toys that attract attention so that they can maintain this position for a while, since it makes them uncomfortable and they usually cry to be turned over.

- And as a pediatrician, I must refer them to be evaluated by orthopedic traumatologists and physiatrists, to confirm the diagnosis and indicate the most convenient therapy for their improvement and growth without complications.

You can read more articles similar to Joint hypermobility. When the child has a lot of flexibility, in the category of Orthopedics and on-site traumatology.

Video: Hypermobility and Hypermobility Syndrome for Physical Education (October 2020).