"People keep saying my son is double jointed. What does that mean?"

baby laying on back reaching for toes

Answer: I touched on this in stories this weekend but feel like it deserves an elaboration here. There is actually no such thing as "double-jointed", even though A LOT of medical professionals say it. It is actually just joint hypermobility, meaning the joint has more range of motion than what is considered to be "typical". The easiest joint to think of this is the knees. Think of people that stand with their knees in a backward “c”. When a knee is extended, 0 degrees is considered typical. Hypermobility beyond that would be, for example, -3 degrees of range(i.e: BEYOND the 0 that is expected. ⠀

To keep this as simple as possible, the 3 big things I think of when I think of hypermobility are: ⠀

  1. Muscle Tone - It is within normal limits (even if on the lower side of "normal", or is there true low muscle tone (hypotonia) contributing to hypermobility.

  2. Muscle Strength - Hypermobility in a joint can relate to muscle imbalances. For example, in the above knee description, overactive quad muscles (the muscles on the front of your thigh, which cause knee extension) with weaker hamstring muscles (the muscles on the back of the thigh, that cause knee flexion) can contribute to having too much range of motion into knee extension.

  3. Joint Laxity - There are a lot of structures (ligaments, tendons, muscles, capsules, etc) that are responsible for contributing to stability at a joint. If structures are lax or stretched out beyond what we would consider typical, you can see hypermobility. Basically, the structures aren’t quite doing their job. ⠀

My biggest focus when I’m seeing hypermobility is first & foremost strength. Strengthen the muscles as much as possible to contribute to stability at the joint. ⠀
Obviously, that’s not always enough, and things like braces or orthotics might be necessary to provide external stability, but that’s beyond this post.⠀

The last thing - please know that hypermobility at 1 or 2 joints may be totally ok. HOWEVER, if you’re seeing hypermobility in multiple joints (you can google the Beighton scale if your child is 6+ years old for an example), and/or things like frequent sprains and strains, frequent falls, frequent subluxations, or dislocations, PLEASE push for further assessment. Though some hypermobility is within normal, there are other times when something else is causing it, & those things warrant further investigation & support to reduce pain & maintain function & strength.

Hope that helps!

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Pin cover for hypermobility blog. Is my child double jointed? What does it mean to be double jointed? Child sitting on floor playing  with toys.
 
Dr. KC Rickerd, Pediatric Physical Therapist, PT DPT

KC is a pediatric doctor of physical therapy, wife and mom of three! She has spent her career working with children and young adults of all ability levels, and currently specializes in birth to three years.

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