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"Hypermobility Syndrome" L. Russek (Physical Therapy Journal) 1999 • “HMS has been given relatively little attention in the literature. Most reports are in the rheumatology literature, with virtually none in the orthopedic or physical therapy literatures.” • HMS patients, however, usually see orthopedists or physical therapists for acute joint pain, and are treated without the underlying problem, aka their HMS, ever being acknowledged. • “Because HMS lacks a definitive pharmacological or surgical treatment, physicians may have perceived little benefit in its diagnosis.” • “Individuals may be improperly identified as having hypochondria, as malingering, or as having nonspecific chronic pain, without further investigation into the source of their complaints … Failure to recognize the underlying HMS may lead to unnecessary or inappropriate diagnostic studies, surgical procedures, and patient management.” • “HMS may be from 1.1 times to 5.5 times more prevalent among females than...

R. Grahame (UCL Hospitals) HMS and Pregnancy • Symptoms of HMS during pregnancy include, o Joint and spinal pains increase o Tendency to premature labour and delivery o Tendency to rapid labour o Resistance to effects of local anaesthetics can cause problems during the epidural o Healing of tear or episiotomy may be impaired and/or prolonged o Pelvic floor problems (especially uterine prolapse), therefore post-natal exercise is very important o 50% chance child will have HMS Larson, Baum, Mudholkar 1981 • “Hypermobility was a predominantly female characteristic” • Joint laxity declines naturally with age, but “not to a statistically significant degree” • In men, joint laxity started to decline in mid-twenties, in women it continued through mid-forties Bridges, Smith, Reid • Most patients with hypermobility had common musculoskeletal problems as the main reason for their referral (usual to a rheumatologist) • “Results show that joint hypermobility is common, familial, found in associati...