Why Are Hyper-mobile’s Always Getting Injured?
Recently I’ve been seeing a lot of people from the Ehlers-Danlos support group who are struggling with chronic pain and injuries and are reporting receiving very little care and feeling gaslit medical professionals such as Doctors and physios. These people are reporting being labeled as hypochondriacs and don’t seem to be getting a treatment that improved their condition.
One question I was asked by a client with Ehler’s was ‘Why are hyper-mobile’s always getting injured?’. As someone hypermobile myself I can relate, I personally have hypermobility and used to struggle a lot. However, as a personal trainer with years of experience, I’ve also worked with many hypermobile clients who never seemed to get injured. I also have hypermobile friends who have never been to the physio in their lives. This observation leads me to question the common perception that hypermobile individuals are always at higher risk for injuries.
A little look into the prevalence of injuries in Ehlers found a little study by Nathan et. Al. (2018) The study involved 114 participants (62 women and 52 men), with 26% being hypermobile. No significant link was found between hypermobility and sports injuries (p=0.66). However, non-hypermobile individuals had a notably higher incidence of joint and ligament sprains in all sports (p=0.03). Only hypermobile individuals experienced joint dislocations, and their injuries lasted longer than those of non-hypermobile participants.
This is very similar to my personal experience, most of my injuries were dislocations or full ligament tears or injuries like dysplasia or SIJ pain that the doctors didn’t know much about.
So why are there all these people who are really struggling with Ehlers Danlos?
Limited Representation and Research
Firstly, a little look through google scholar and we can see that hypermobility specific conditions don’t seem to be that well researched. When stiff individuals get injured, their problems often resolve naturally – injuries like torn muscles, mildly sprained ankles and tendinopathies do generally go away eventually with rest or get better regardless of treatment, and there’s a wealth of research and information on these types of injuries. In contrast, injuries among hypermobile individuals are less studied, we don’t why there is less research, one reason could be that there are less of them, or that these injuries do disproportionately affect women – a group historically underrepresented in medical research.
Gender Disparities in Research
Hypermobility is more common in women, yet female-specific health issues receive less research funding and attention. This disparity could be the reason behind why so many injuries and conditions related to hypermobility lack comprehensive studies and standardized treatment protocols. For instance, when I looked up exercise and rehabilitation research on hip dysplasia, which frequently occurs in hypermobile individuals, there was far less research compared to ACL ruptures, which are common among male athletes. Consequently, ACL injuries and joint sprains benefit from extensive studies, rehabilitation programs, and surgical techniques that are well-documented and taught in physical therapy and osteopathy programs. Funding it appears, seems to follow male sport. At school we barely learned anything about hip dysplasia or any dislocating joints.
Gaps in Professional Education
Looking through the Ehlers Danlos support group there seems to be many reports that most therapists lack detailed knowledge about hypermobility-related conditions like dislocations, joint pain and hip dysplasia, as I was an Ehlers Danlos patient before I studied, I can relate. Many seem very aware of what it is but have very little knowledge of related injuries or how to fix them. Many are unaware for example that in hip dysplasia the hip usually moves/mildly subluxes in an anterior direction or which muscles need to be stretched or strengthened.
Even when I was studying there was a debate about whether the SIJ actually moved. We weren’t taught that this happened in some but not all people. Another thing I noticed was there were very few hypermobile people studying physiotherapy or Osteopathy. This gap in knowledge can lead to ineffective treatment plans. When I had hip dysplasia, my boyfriend, an orthopedic surgeon specialising in dysplasia, helped me create a tailored plan—an advantage not available to everyone.
Misdiagnosis and Medical Gaslighting
Another issue is the misdiagnosis and medical gaslighting of hypermobile individuals. Many people with Ehlers-Danlos Syndrome (EDS) report being dismissed or misdiagnosed by mainstream medicine. EDS affects connective tissue, and while severe types can cause significant pain, hypermobile EDS should not be an isolated cause of chronic pain. Often, I found in clients, what is perceived as EDS-related pain is actually due to missed injuries, autoimmune diseases, tendinopathies, or spasms from compensatory movement patterns.
Unique and Common Injuries in Hyper Mobiles
There are specific injuries that hypermobile individuals are more prone to, such as subluxations, dysplasia, and SI joint issues. However, I’ve also encountered individuals in hypermobility groups attributing all their pain to EDS without proper assessments. For example, a person with a Beighton score of 4 might have pain due to gait issues and muscle spasms rather than EDS. Some physiotherapists who struggle to identify the root cause of these problems might blame the patient instead of admitting their limitations.
Conclusion
To answer the question my answer would be. They are not getting injured more than the average population. Just that when they do, they get unique injuries specific to the Ehlers population that, it seems, most physios and Osteo’s don’t seem to know how to treat. Because conditions caused by over mobility don’t resolve naturally, they then end up with a cascade of injuries from compensation patterns. There also seems to be an epidemic of physios reaching for the hypermobility diagnosis when there is often something else there. Often people will be porned of with just Ehlers when they actually have an autoimmune disease or the wrong diagnosis for another condition.
Hypermobile’s do get injured, but the story is more nuanced than it appears. The lack of research, gender disparities, and gaps in professional education contribute to the higher perceived injury risk. Many people seek an EDS diagnosis to validate their pain, but what’s often needed is a proper diagnosis and effective treatment of the actual issues causing their discomfort.
Addressing these gaps can help improve care for hypermobile individuals, ensuring they receive the attention and treatment they deserve. This includes advocating for more research into female-specific health issues and educating healthcare professionals on the unique needs of hypermobile patients. By doing so, we can move towards a more inclusive and understanding healthcare system.