Impact of Joint Laxity and Hypermobility on the Musculoskeletal System

Wolf, Jennifer Moriatis; Cameron, Kenneth L.; Owens, Brett D.

doi:10.5435/00124635-201108000-00002

Cited by 134 publications

(117 citation statements)

References 66 publications

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“…n.s. not significant mobility tests (using the Beighton Score) have shown that a higher percentage of women than men have joint laxity 23,24) . It has also been reported that women exhibited significantly more joint laxity with an associated decrease in anterior joint stiffness compared to men 25) .…”

Section: Resultsmentioning

confidence: 99%

Analysis of scapular kinematics in three planes of shoulder elevation: A comparison between men and women

Nakayama

Onishi

Nojima

et al. 2018

JPFSM

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The aim of this study was to compare scapular kinematics between men and women during shoulder flexion, scapular plane elevation, and shoulder abduction. Eleven healthy men and 11 healthy women participated in this study. As participants performed shoulder flexion, scapular plane elevation, and abduction at a consistent speed, an electromagnetic motion capture system was used to analyze scapular motion. The change in scapular orientation from its resting position was calculated at 30°, 60°, 90° and 120° of humeral elevation. The study found that scapular upward rotation and posterior tilt angles increased significantly with each successive humeral elevation angle, but less so in women than in men. Scapular internal or external rotation differed significantly according to the plane of elevation, that is the scapula was internally rotated during flexion, with no change during scapular plane elevation, and it was externally rotated during abduction. This variation was more marked in women. This study revealed gender differences in scapular kinematics during shoulder motion. During shoulder elevation, the scapulothoracic joint played a greater role in men than in women, whereas the glenohumeral joint played a greater role in women.

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Section: Resultsmentioning

confidence: 99%

Analysis of scapular kinematics in three planes of shoulder elevation: A comparison between men and women

Nakayama

Onishi

Nojima

et al. 2018

JPFSM

View full text Add to dashboard Cite

show abstract

“…Another way to improve venous return in these patients is with the use of support garments like waist-high compression stockings and abdominal binders, but their efficacy has been questioned [3,20]. Finally, given the association with Ehlers-Danlos syndrome, continuous and appropriate physical therapy has an added benefit to these patients by improving proprioception, muscle strength, balance, and protecting the joints from damage [22].…”

Section: Discussionmentioning

confidence: 99%

Postural Orthostatic Tachycardia Syndrome (POTS): Association with Ehlers-Danlos Syndrome and Orthopaedic Considerations

Grigoriou

Boris

Dormans

2015

Clinical Orthopaedics &Amp; Related Research

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Background Postural orthostatic tachycardia syndrome (POTS) is the most common of several types of dysautonomia, characterized by dysfunction of the autonomic nervous system manifesting with symptoms of orthostatic intolerance with or without associated orthostatic hypotension and excessive autonomic excitation. Given the numerous presenting musculoskeletal symptoms of POTS and its known associations with other clinical entities like Ehlers-Danlos syndrome, POTS constitutes an unusual treatment challenge of which the orthopaedic surgeon and other related healthcare providers should be aware. Case Description We describe two patients with a diagnosis of POTS and musculoskeletal manifestations. The first is a 13-year-old boy with a concurrent diagnosis of Ehlers-Danlos syndrome and worsening back pain. The patient had resolution of his musculoskeletal symptoms after treatment with a Boston Overlap LSO brace and physical therapy and resolution of his cardiovascular symptoms after pharmacologic treatment. The second patient is a 17-year-old girl with an L1 vertebral hemangioma and pain of sudden onset radiating to her lower extremities. Her symptoms were controlled with therapy and gabapentin. Literature Review POTS is a poorly understood and controversial clinical entity with lack of awareness and knowledge regarding the syndrome by the majority of medical specialists. Its complex and wide range of clinical presentation has led to being commonly mistaken with malingering, depression and anxiety disorders. Review of the literature did not yield any previous studies addressing POTS and the special considerations for the orthopaedic surgeon caring for these patients; previous studies of large patient series focus on investigating the pathologic substrate of POTS and the efficacy of various treatment modalities on the cardiovascular dysregulation. Clinical Relevance These two cases show that understanding and knowledge of this syndrome and its comorbidities should guide any diagnostic approach or therapeutic intervention by the orthopaedic surgeon caring for patients with this syndrome. It is important that the surgeon is aware of the benefits of detailed patient education and physical conditioning, the increased perioperative complications, and the need for specialized anesthesia.

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“…Hypermobility has been suggested as a contributing factor for musculoskeletal injury in some people. 14,17 Hypermobility is common and is evident when someone is supple, with a wide range of joint movements, often due to laxity in the ligaments. 18 Joint hypermobility syndrome can be associated with back and neck pain, tendon injuries, muscular and joint pain and stiffness, 18 which can also be found in WRMSD, potentially making it difficult to differentiate WRMSD from hypermobility syndrome.…”

Section: Hand Wrist and Fingersmentioning

confidence: 99%

“…The ultrasound monitor needs to be adjustable and at a level to ensure that there is no neck extension. Ideally, the neck should be flexed slightly to approximately [15][16][17][18][19][20] . 13 When observing people in practice, it is common to see practitioners tilt their head to visualise the image particularly when looking at fine structures, e.g.…”

Section: Neckmentioning

confidence: 99%

Work-related musculoskeletal disorders in ultrasound: Can you reduce risk?

Harrison

Harris

2015

Ultrasound

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Work-related musculoskeletal disorders are a common cause of pain and sickness absence for ultrasound practitioners. This article aims to provide background information about factors increasing the chance of developing work-related musculoskeletal disorders and potential ways to reduce risk. Factors influencing ultrasound professionals' likelihood of developing work-related musculoskeletal disorders include poor posture, repetitive movements, transducer pressure and poor grip, stress, workload, limited support or sense of control and other psychosocial factors. The impact of these risk factors on the health and well being of ultrasound practitioners can be reduced by following recommendations published by professional bodies and the Health and Safety Executive. Ultrasound practitioners should remember that optimising the examination should not be at the detriment of their health. Some hints and tips to reduce the chance of developing work-related musculoskeletal disorders are provided.

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Impact of Joint Laxity and Hypermobility on the Musculoskeletal System

Cited by 134 publications

References 66 publications

Analysis of scapular kinematics in three planes of shoulder elevation: A comparison between men and women

Analysis of scapular kinematics in three planes of shoulder elevation: A comparison between men and women

Postural Orthostatic Tachycardia Syndrome (POTS): Association with Ehlers-Danlos Syndrome and Orthopaedic Considerations

Work-related musculoskeletal disorders in ultrasound: Can you reduce risk?

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