Hypermobility in babies and children

How to test for hypermobility?

One way to assess whether hypermobility is present is using the Beighton score:

• The little finger can be bent upwards to 90 degrees: one point on the right and one on the left.
• The thumb can go down to the forearm: one point on the right and one on the left.
• The elbow can be overextended 10 degrees: one point on the right and one on the left.
• The knees can be overextended 10 degrees: one point on the right and one on the left.
• Palms facing the floor with knees straight: one point.

A score of 4 points or more indicates that the child has increased joint mobility.

However, it is important to distinguish between whether the child has: increased mobility in a single joint, generalized hypermobility or hypermobility as part of a hereditary connective tissue disease, e.g.:

• Ehlers-Danlos syndrome: Hereditary connective tissue disease caused by collagen defects and/or collagen deficiency. Characterized by: Hypermobility of joints, hyperelasticity of the skin, tissue insufficiency and bleeding tendency.
• Marfan syndrome: Hereditary connective tissue disease caused by a gene defect in fibrillin-1. Characterized by increased longitudinal growth of bones in the arms and legs, as well as effects on vision and the heart.
• Osteogenesis imperfecta: Hereditary connective tissue disease that affects collagen synthesis. Characterized by an increased tendency of bone fracture.

What symptoms/signs might there be?

• Flat feet
• Knock knees or overextended knees
• Overextended elbows and finger joints
• The child tries to sit in the W position.
• Balance and coordination problems
• Decreased stamina
• Alternating pain/fatigue, especially after physical activity
• Frequent sprains

When should you seek help?

It is important to seek help if the child experiences persistent pain from the joints during or after physical activity.

What can you do as a parent?

Good shoes

Good footwear supports stability around the foot and reduces discomfort. A good shoe has:

• Fixed heel cap
• Is flexible
• Width that fits the foot
• Fits well

Small children (0-2 years)

Support the child’s motor development by focusing on preventing the child from straining the joints in extreme positions. For example, you can encourage sitting positions other than the W position, such as sitting long or mermaid position, or support with hands around the hip/knee when the child is crawling.

Older children (from 2 years old)

Support your child in participating in regular games and sports activities, as varied use of the body creates the greatest balance, coordination and endurance. It is also important that the child learns to listen to their body and tell you if they experience pain or fatigue.

Treatment of hypermobility

Pediatrician

Pediatricians are doctors who specialize in the assessment and treatment of children aged 0-17. It is relevant to seek medical attention if you are in doubt about whether your child is hypermobile as part of a hereditary connective tissue disease.

Pediatric physiotherapist

Pediatric physiotherapists are physiotherapists who specialize in assessing, treating/training and advising children and young people with congenital and acquired disabilities. A pediatric physiotherapist can help organize relevant exercises and games, as well as advise on assistive devices and health services.

Osteopath

Osteopaths can provide treatment that prevents compensations by supporting optimal blood flow and nerve supply to muscles and joints. In addition, osteopaths can advise on the child’s motor development.