Hypermobility By: Che Phillips



It is common knowledge that women are more flexible than males. Yet what is not so well known is because of the increased suppleness of females, they are more prone and at greater risk of injury than their male counter parts. A recent statistic states that in high risk sport, women are 6 times at a greater risk than men to suffer a season ending knee injury.

Within this statistic, teenage girls are at the greatest risk of injury because in the growing years, the joints lack the ligament and muscles stability until the body tissue matures. Adding to this issue, at different stages of the female menstrual cycle the body is at a greater risk. An increase in oestrogen levels has been shown to affect how far a joint will move. A joint will always have an “end point” where it physically should stop. Going past this end point it enters onto a region where injury will most likely occur. Higher than normal oestrogen levels may cause a joint to travel past this end point into this very dangerous zone. 

 Not all females are at risk. As stated earlier the more flexible one is, the greater the risk of injury. As humans we all fit into two  



categories, hyper-mobile or hypo-mobile. “Hypers” as is the subjects are known among health professionals are the ones who are at a greater risk of injury. There is a quick test you can do to see which category you fit. 


The first is to hold your little finger vertical and pull the end back, if it hyper extends at the tip that’s a point. If you can pull your thumb down to touch your forearm, and if it does that’s another point. The third step is hold your arms straight out to the side, again if your elbows hyper extend that’s a point. Then lock your knees straight in standing and if the knee hyper extends, that’s a point. Finally standing straight and keeping your knees locked, if you can touch the floor with your palms that is the final test.


 Figure 1. Testing positions for assessment of joint hypermobility. (A) Hyperextension of the 5th digit beyond 90°. (B) Passive opposition of the thumb to the forearm. (C) Hyperextension of the elbow. (D) Hyperextension of the knees. (E) Forward flexion of the trunk with palms of the hands resting easily on the floor. (Reproduced from (Beighton & Horan, 1969). )
So accounting for left and right with the little finger, thumb, elbows and knees and only one test for the palms on the floor, this all comes to a total out of 9. If your score falls between 0-2, you are Hypo mobile and your risk of this type of injury is low. If you score either 3 or 4 you are classed as a low risk Hyper mobile person. If you score 5 to 9 you are at a great risk of injury, especially if you’re a female and are at a stage of your Menstrual cycle where oestrogen levels are high. 

So what do you do now if you score 5 or above? The most sensible course of action is to see a qualified physiotherapist who will be able to screen your body to identify any weaknesses, particularly in the major weight bearing joints and analyze your sport or fitness routine. They will then give you appropriate strengthening and stabilizing exercises to address any weaknesses. Then you would have taken a huge step to remaining injury free. Because, prevention is always better than cure!




 Written by Che Phillips: Exercise Scientist/and Physiotherapist

Beighton, P., & Horan, F. (1969). Orthopaedic Aspects of the Elthers-Danlos Syndrome. The Journal of Bone and Joint Surgery, 51(3), 444-453. 

Park, S.K., Stefanyshyn, D.J., Ramage, B., Hart D. A., & Ronsky, J. L. (2008). Relationship between knee joint laxity and knee joint mechanics during the menstrual cycle. British Journal of Sports Medicine, 43, 174-179  

Myer, G.D., Ford, K. R., Paterno, M.V., Todd G.N. and Hewett, T.E (2008) The Effects of Generalized Joint Laxity on Risk of Anterior Cruciate Ligament Injury in Young Female Athletes. American Journal of Sorts Medicine, 36, 1073-1084. 

Magee, D.J. (2006) Orthopedic Physical Assessment, 4th ed. Elsivier Sciences USA

One Response to “Hypermobility By: Che Phillips”

  1. Rebecca March 25, 2011 at 9:09 pm Permalink

    I have hypermobile elbows, best partytrick in the world;)

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