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Interdisciplinary Approaches to Treating Myofascial Pain Syndrome
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
When there are trigger points in the muscles that cross hypermobile joints, the trigger points should be inactivated using techniques that do not extend the muscles to maximum length (Travel & Simons, 1992). Normal MTPT pressure release techniques call for a muscle to be placed on a limited or partial stretch during this procedure. The full passive stretch after pressure should be eliminated. Trigger point pressure release at the attachment trigger points, vapocoolant with stretch of the affected muscles, and a stretch rehabilitation program done with great frequency are counterproductive when treating these patients. Instead, the central trigger points in the belly of the muscle must be released and the muscle must be stretched manually (massage therapy). Also, the patient should not be given a stretch rehabilitation program to do at home. Experience teaches that a stretch program may actually cause more pain than it relieves. A muscle-specific strengthening program coupled with manual stretching and limited joint movement during the treatment phase will provide the most relief. Strengthening acts to stabilize joints; think football players who destroy ligaments in their knees. Their rehabilitation program consists of strengthening the muscles around the knee to stabilize it. People with hypermobility syndrome must stabilize all joints by strengthening and balancing the muscles around them.
Medical matters
Published in Roslyn Rogers, Anita Unruh, Managing Persistent Pain in Adolescents, 2017
Joint hypermobility describes an increased range of joint or spinal movement found in 10–30% of the population. It is more common in females than in males, and more common in people of Asian and African origin than in Caucasians. Benign joint hypermobility should be distinguished from joint hypermobility syndrome (JHS) with which it shares the common feature of lax joints and increased pain. JHS is defined by the Brighton 1998 classification. It is familial and is distinguished by chronic musculoskeletal pain, fatigue, soft tissue and visceral injury, skin abnormalities and neurogenic dysfunction. Subgroups of JHS include Ehlers-Danlos syndrome, Marfan’s syndrome and ontogenesis imperfecta.
Temporomandibular Joint Disorders
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Hypermobility can lead to joint dislocation. This occurs when the condyle of the mandible is displaced anterior and superior to the articular eminence of the temporal bone. It tends to occur in two age groups—young adults with generally hypermobile joints and the elderly who have loose ligaments and overclosure of the jaw due to lack of teeth. The frequency of dislocations should be recorded. Often patients may complain of ‘dislocation’ when in fact they are describing a click or locking.
Patients’ strategies for numeric pain assessment: a qualitative interview study of individuals with hypermobile Ehlers–Danlos Syndrome
Published in Disability and Rehabilitation, 2023
Colin M. E. Halverson, Tom A. Doyle
The Ehlers–Danlos Syndromes are a diverse group of hereditary connective tissue disorders [5]. Hypermobile Ehlers–Danlos Syndrome is the most common of the 13 types, accounting for approximately 84% of all patients with EDS [6]. It is characterized by joint hypermobility, fatigue, and chronic pain. Clinicians use clinical criteria developed in 2017 by the International EDS Consortium in order to make an accurate diagnosis [7] as there is as yet no known genotype associated with hEDS [8]. These diagnostic criteria include the Beighton scale to measure patients’ hypermobility and other clinical signs [5,7] as well as self-reported chronic pain and joint instability. The assessment of pain is thus of critical importance in understanding what barriers may exist to both treating and diagnosing hEDS. Diagnosis in particular is a long and often difficult process for patients with hEDS, with the average time to diagnosis reported to be around 11 years, and finding appropriate treatment is often an additional challenge [9]. The fact that pain assessment, so central to both, is an irreducibly subjective process only further complicates patients’ healthcare. It stands to reason that investigating patients’ beliefs about pain assessments and the practices that patients undertake when asked to quantify their pain can help alleviate some of the challenges surrounding the subjective self-reporting of pain. With a deeper understanding of these attitudes and practices, we may then be able to identify how best to amend or supplement current clinical practices with respect to pain reporting for the hEDS patient population.
Occupational Therapy Interventions for Clients with Ehlers-Danlos Syndrome (EDS) in the Presence of Postural Orthostatic Tachycardia Syndrome (POTS)
Published in Occupational Therapy In Health Care, 2022
David Levine, Brittany Work, Susan McDonald, Nicole Harty, Carolee Mabe, Alison Powell, Graceline Sanford
Ehlers-Danlos syndromes (EDS) are a group of genetic, connective tissue disorders that are heritable and can result in abnormal collagen synthesis, which may lead to skin hyperextensibility and tissue fragility, depending on the type (Malfait et al., 2017). Generalized joint hypermobility is commonly seen in individuals with some types of EDS (Gazit et al., 2016). Individuals with hypermobile EDS (hEDS), the most common type, can experience musculoskeletal problems such as joint dislocations, joint subluxations, and associated soft tissue injuries (Rombaut et al., 2010). Similar to EDS, the hypermobility spectrum disorders (HSD) are a group of conditions involving joint hypermobility and other articular and extra-articular symptoms (Malfait et al., 2017). HSD tends to be diagnosed after other conditions, such as hEDS, have been ruled out (Malfait et al., 2017). Common features seen in individuals with hypermobility conditions include chronic pain, micro and macrotrauma to joints and soft tissue, disturbed proprioception, bladder and pelvic dysfunction, and gastrointestinal disorders (Castori & Hakim, 2017).
Do asymptomatic generalised hypermobility and knee hyperextension influence jump landing biomechanics?
Published in European Journal of Physiotherapy, 2021
Ivana Hanzlíková, Kim Hébert-Losier
Joint hypermobility is characterised by increased joint movement beyond normal ranges expected in a given population [1]. The term generalised joint hypermobility is used when multiple joints (usually five or more) are affected [1]. Unlike joint hypermobility, generalised joint hypermobility is usually a congenital inherited disorder [1,2], but may be acquire by inflammation, degenerative, and endocrine processes [1]. Overall, the prevalence of generalised hypermobility reported to exist in the general population ranges from 2 [3] to 57% [4], with most studies reporting a prevalence from 10 to 20% [5] with females and children more often affected [6]. A recent framework for the classification of joint hypermobility [1] suggests dividing hypermobile individuals into 3 groups: individuals with asymptomatic joint hypermobility, individuals with a well-defined syndrome associated with joint hypermobility, and individuals with symptomatic joint hypermobility.