While many people talk about the benefits of stretching and flexibility, some people could actually do more harm than good by increasing their range of motion. There are two main components that hold a joint together and determine it’s range. First is the joint tissue itself (ligaments, joint capsules, etc.) and the second is the tension of the muscles that surround it. The laxity of the 1st component, the joint itself, is generally innate and does not change all that much unless it is involved in some type of trauma (dislocation, subluxation). People who are “loose-jointed” need to be very cautious about creating additional range of motion.
How do you know if you’re “loose-jointed”?
There is a quick and simple test called the Beighton score that has been used internationally to define generalized joint laxity in all populations and all age groups.
Joint hypermobility, or what some people will call “double jointed”, is deﬁned as a more-than-normal range of movement (ROM) in a joint, is either localized (increased ROM of a single joint) or generalized. Joint hypermobility depends on age, gender, family and ethnic background. To test your joint mobility, you can obtain your Beighton score by doing the following and totaling up your points achieved:
- One point if while standing forward bending you can place palms on the ground with legs straight
- One point for each elbow that bends backwards
- One point for each knee that bends backwards
- One point for each thumb that touches the forearm when bent backwards
- One point for each little finger that bends backwards beyond 90 degrees.
Most of the available prevalence studies used different cutoffs, ranging from >3 hypermobile joints to > 6 hypermobile joints of 9 assessed (both thumbs, both little fingers, both elbows, both knees and the trunk), and in some, only the dominant side was assessed. The most frequent choice of cutoff was > 4 hyper mobile joints. Generally a score of 4-5/9 or greater defines hyper mobility.
Also realize that an individual that is otherwise not hypermobile, can possess excessive laxity in a specific joint if there is a traumatic event such as a dislocation or subluxation. Muscles have elastic properties, much like a rubber band, so they can stretch and contract, as well as adapt to new lengths for better or worse. Joint tissues are more plastic in nature. Think of the ring on a six pack, once it is stretched out, it never regains its supportive nature.
So what do we do about it?
For those on the low end of the scale (3 or less), we generally see more muscular injuries, such as strains, pulls and tears, so in these individuals we must maintain good tissue quality in the muscles, as well as ideal “length-tension” relationships, making sure that the muscles do not become shortened over time due to poor posture, chronic sitting and/or improper training.
On the opposite end of the scale (4/5 or more), we generally see more joint injuries, such as sprains, dislocations and/or subluxations. We proceed with extreme caution in the ranges of motion we allow these individuals work within and do minimal to no “stretching”, unless a specific muscle shortening is present and even then we look to achieve more range of motion through active means. Those who score higher also require plenty of additional motor control and stability work to help hold the joints in place, since they get very little assistance from the ligamentous system.
The tricky thing about these high scorers is that they can sometimes present as being tight, but it is only reflexive stiffness that the body is creating to help stabilize a joint or area. If you go and have this person stretch that tight tissue, even though it may provide temporary relief, you are actually de-stabilizing that joint or area, leaving them more susceptible to injury. There is a reason that muscle was tight and by lengthening it you are giving them what is called “naive” range of motion, which is motion that they don’t have control of or know what to do with. At the very least, it is just going to tighten back up until you create the stability it is looking for.
The cruel irony of nature is that we tend to move towards activities that come easily, which are often the opposite of what we may need. Super limber dancers and yoga folks love to focus on mobility work but could ideally benefit from more strength and stability work, while gym rats and meatheads like myself will always gravitate towards the weights, while we really need to lock in on creating and maintaining mobility.
In everyone, regardless of their Beighton score, proper alignment, motion and most importantly, control of that motion is essential, providing what is called an “instantaneous optimal axis of rotation”, so that we can move freely. Note the word “instantaneous” and that this means that we must have reflexive control that may need to be trained by first acquiring conscious control and movement mastery before it becomes trained and automatic.
And whatever you do, don’t ever do this…