Understanding Pain and Fatigue in association with hyper-mobility syndrome
People with hyper-mobility syndrome often experience pain in their joints and muscles. This is expected after injury, but also the pain can occur with mild strenuous exercise or without any apparent cause.
With hyper-mobility joints are less stable than normal and as result are more prone to injury especially when there is associated muscle weakness. Sprains and subluxations of joints can be common and can result from over-stretching joint ligaments. This can then often lead to joint damage and associated connective soft tissue which leads to inflammation and pain. If improper treatment is done, this can lead to chronic pain.
Rest, Ice, Compression and Elevation can help in the initial stages following an injury to reduce inflammation, swelling and pain. It 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 structured rehab exercises should be done to restore full range of movement, strength and coordination. Exercises should not only be done to ensure full recovery of function but also to help prevent future injury.
So where is the associated pain?
Pain is obviously related to the degree of damage. If mobility, muscle strength, coordination and balance is not restored after an injury the joint ligaments and muscles that stabilise the joint may continue to be a source of pain. Fear of movement and reduced activity levels can in turn lead to hyper-sensitisation in the local tissues and the joint receptors. In turn they respond in an abnormal fashion and this in turn leads to over activity in the sensory areas of the brain.
Hyper-mobility and muscle pain from trigger points
Trigger points are small bands of thickening within a muscle fibre which are very sensitive to compression and are a common source of muscle pain, often associated with hyper-mobility. Trigger points develop in weak fatigued muscles. They lay silent in muscle tissue and become painful when pressed. Furthermore, trigger points are a very common cause of referred pain. Trigger points can sometimes become sensitised when the muscle contracts or is over stretched.
Pain from trigger points can be a dull nagging ache and can be spread over a wide area. Sometimes the pain is felt in the area of the trigger point, but often it is experienced at a distance spot being pressed (referred pain). As a result this can lead to abnormal movement patterns and muscle imbalances.
The formation of painful trigger points can also be triggered by weakness, more posture and inactivity. When an individual develops widespread and persistent pain, long with fatigue and other symptoms a diagnosis of fibromyalgia may be given.
Here at Dynamic Osteopaths we have found in clinical practice there to be a link between hyper-mobility syndrome and an increase in painful tigger points, especially when muscles are weak. We have found the best way to treat and deal with the pain is a structured physical rehabilitation programme aimed at specific muscle strengthening and correcting muscle imbalances.
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