Children's Hospital Colorado — Shine

Dr. Schmitt's Corner S E NS E ING AK M Written by Barton D. Schmitt, MD, FAAP, author of My Child Is Sick!, American Academy of Pediatrics, Denver, CO. Copyright 2000–2013. Last revised January 28, 2013. of LOOSE JOINTS More than 10 percent of children nationwide have hypermobility syndrome, also known as loose joints. Children with this condition experience excessive joint movement beyond their normal range. WHAT CAUSES IT? The ligaments that hold the joints together are loose or lax. Genetic differences in the elastic (collagen) tissue found in ligaments are the underlying cause. If one member of a family has loose joints, it is likely some relatives of that person will have them as well. HOW IS IT DIAGNOSED? WHAT IS THE TREATMENT? Lab tests or X-rays are of no value in making this diagnosis. The diagnosis is made by finding several of the following excessive movements during a physical exam: • The thumb can touch the forearm. • The fingers can be bent backward more than 90 degrees. • The elbow can be bent backward more than 10 degrees. • The knee can also be bent backward more than 10 degrees. • The palms of the hands can be placed flat on the floor while bending from the waist with the legs straight. • The feet are flat with the absence of an arch. • A few children with hypermobility syndrome are doublejointed and can dislocate some of their joints at will. Usually no treatment is necessary. Pain relievers such as Tylenol® or ibuprofen can be taken for occasional joint pain. There is no medical or surgical treatment that will tighten the joints. Teenagers involved in competitive sports can stabilize their joints by strength training to increase the muscle mass that surrounds the joints. A physiotherapist can help design a conditioning program. Most importantly, your child should not be restricted from participation in any activities. HOW LONG WILL IT LAST? WHAT ARE THE SYMPTOMS? Usually there are no symptoms. Joint pain may follow vigorous activities, but the pain is usually mild and transient. Injuries during sports are slightly increased. They usually involve overstretching the loose ligaments around a joint (for example, a sprained ankle). In extreme cases, loose joints can cause recurring dislocations. Normal variation in the looseness of joints persists throughout life. After puberty, it tends to improve in many children. Barton D. Schmitt, MD, FAAP, is a Board-Certified Pediatrician at Children's Hospital Colorado. shine 3

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