PAIN and FATIGUE?

Hypermobile joints are less stable than normal and as result are more prone to injury especially when there is associated muscle weakness and poor coordination. Joint sprains and subluxations are the fairly common injuries in JHS and result from overstretching the lax joint ligaments and capsule. The overstretching leads to damage to the joint connective tissue which leads to inflammation, swelling and pain. Over time the inflammation and swelling decrease and the pain should become less. 

The RICE routine (Rest, Ice, Compression and Elevation) helps to minimize the amount of inflammation, swelling and pain following an injury. Rest does not mean keeping the joint quite still. It is important to start with gentle movements early on. This not only helps to reduce the swelling but also restores normal movement and importantly helps to overcome the fear of movement that can develop after an injury. Once the inflammation has subsided and the swelling starts to go down, a program of exercises to restore full range of movement, strength and coordination is very important, not only to ensure full recovery of function but also to help prevent injury in the future.

Pain from a TrP in a muscle often leads to spasm and or weakness in the affected muscles. This in turn leads to abnormal patterns of movement at the joints (referred to as muscle imbalance) overuse of muscles and formation of Tr P's in surrounding muscles. The formation of painful trigger points may be triggered by inactivity, anxiety and sleep apnea. Gentle stretching is great for relieving pain but to really be effective the tight and weak muscles containing the TrP's need to be strengthened in order to provide sustained relieve of pain.

A full physical assessment by a clinician with a special interest in joint hypermobility and chronic pain is very valuable. This will include looking for and ruling out any underlying disorders that may be contributing to pain and disability. Checking for sleep disorders is also very important.

Poor sleep not only increases pain but also affects attention and daytime fatigue.