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Dyspraxia, Hypermobility,poor Muscle Tone And Hurty Legs And Back


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#1 lennie len

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Posted 20 October 2010 - 08:34 AM

I found out something interesting yesterday and thought I would share.

If you have hypermobile joints, poor muscle tone (common in dyspraxia), ankle, leg, back and other pain's are common.
I always knew this but couldn't work out why.

cut n paste time

"There are a group of children who generally have very mobile joints, particularly the knees, elbows and fingers which can bend backwards more than usual, and flattening of the arches of the feet. Medically this excessive mobility in joints is called joint hypermobility or ligament laxity.

Children with joint hypermobility also tend to have pliable muscles that are weak. This makes sitting and standing erect tiring and uncomfortable, and the child may complain of pain in the legs with walking. Sometimes this is referred to as “low muscle tone”.

Some children with joint hypermobility complain of pain and discomfort after being active, as well as pain in the legs at night. When a child has pain as a result of joint laxity, the term “benign general hypermobility disorder” is used to describe the condition.

What is the cause of joint hypermobility?

Joints are held together and by a joint capsule and ligaments. These structures are made of connective tissue which is tough, pliable and gives slightly when stretched. The amount of "give" in connective tissue differs between individuals. Stiffer connective tissue provides more protection for joints. In individuals with joint hypermobility the connective tissue is very compliant - it has a lot of give and is easily stretched. This allows the joints to bend more than usual and makes them more prone to injury.

Muscles have a covering of connective tissue called the myofascia. The tendons of muscles are also made of connective tissue. The myofascia and tendons together play an important role in transferring the pulling force created by muscle contraction to the bone. When the connective tissue has more give, the muscles need to work harder to transfer the force created by the muscle contraction to the bones to bring about movement. This means that holding a posture or position (called stability) and moving the body requires much more effort for a child with hypermobile joints than for other children.

Children with joint hypermobility often have a very cautious nature (often referred to as the highly sensitive child). The term for this temperament trait is behavioural inhibition (BI). Children with BI tend to avoid activities that are new, are perceived as being difficult and require intense physical effort. They also tend to be less persistent and give up easily. This tendency to avoid activities that are strenuous means that the child is does not develop the strength and endurance that other children gain from being active and taking on physical challenges.

How joint hypermobility affects a child's posture and movement

Babies and toddlers with joint hypermobility may be late in learning to crawl, climb and walk.

* Young children may avoid climbing and hanging activities that require strength and stability such playing on the climbing frame and monkey bars.

* Hypermobility in the joints of the feet and ankles causes flat feet and dropped arches. These children also tend to sprain the ankles frequently.

The posture of the feet is also affected by tightness in the muscles crossing the side of the hip and knee.

* Children with flat feet usually have weakness in the muscles of the foot and ankle, which makes running and jumping difficult. The child may walk with the feet turned outwards because of the weakness in the calf muscles.

* Muscle weakness along with joint hypermobility contributes to poor posture in sitting and standing. The child may stand with a hollow back, rounded shoulders and the knees bent backwards and pointing towards each other.

* Muscle weakness along with joint hyper-mobility contributes to poor posture in sitting and standing. The child may stand with a hollow back, rounded shoulders and the knees bent backwards and pointing towards each other.

* The extra pliability in the connective tissue means that the receptors in the joints and muscles that inform the brain about the body's position in space are less sensitive to changes in position and stresses on joints. This leads to poor body awareness and is one of the reasons why children with joint laxity sometimes have poor coordination and posture.

* Sitting erect is tiring - the child sits with a slumped posture and will often prop herself up on the arms. This makes sitting and writing at a desk difficult for the child. The slumped posture places more strain on the already weak muscles and ligaments of the spine.

* Handwriting may be tiring and difficult because laxity of ligaments in the hand and weakness in the hand and shoulder muscles makes holding and moving the pencil difficult.

More about handwriting difficulties

* Some, but not all children with joint laxity complain of pain in their joints after vigorous exercise. As a result these children avoid strenuous exercise, which means that they tend to be less fit and have weaker muscles than other children. This is a vicious cycle - because children with joint laxity need to strengthen their muscles to protect their joints.

Pain is usually associated with tightness in muscles. Night pain usually occurs when a child is going through a growth spurt.

* Children with joint hypermobility are more prone to injuries as well as back pain

* The occurance of scoliosis is greater in girls with joint hypermobility. It is important that the spine is checked for scoliosis at regular intervals.

Low muscle tone or muscle weakness

Children with joint hypermobility often also diagnosed with having “low muscle tone". This is unfortunate as it detracts from the fact that the poor postural and movement function is caused by muscle weakness and that the child needs strengthening exercise.

Low muscle tone is often treated by tactics to increase sensory input and awareness. However, the only way to increase muscle awareness is to engage in strengthening exercises which have been shown to increase muscle position sense.

What can be done to help a child with joint hypermobility

* The increased hypermobility of the joints cannot be changed - the joints will always be more flexible than usual. But weak muscles can be strengthened to provide additional support for the joints.
* Tight muscles can be stretched to improve posture and movement patterns.
* Pain from tight and weak muscles can be managed with an exercise programme. Tight muscles and fascial systems may need to be mobilised by a physiotherapist who has myofascial mobilisation skills.
* Children who avoid effortful physical activity can be taught to enjoy exercise and to take on challenges.
* Exercises that increase muscle strength will also improve joint position sense and awareness of body position.
(and you would need advice from a physio for this)

sorry this is long, but a lot of you guys have children who have the above.

If I'd have known the above I could have been better prepared for a phone call I received from school tother day (long story).

#2 heisadiamond

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Posted 20 October 2010 - 08:53 AM

I am not sure if DS has hypermobile joints how could I check?
He has been referred to OT for problems with his gross motor skills.
He always complains that his legs and spine are hurting if he has to walk anywhere.
The BI description describes him to a tee, he is very cautious about activities and complains when it is gym at school "That they make him do dangerous things"
He is unable to ride a bike, climbing frames etc.

#3 Snickas

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Posted 20 October 2010 - 08:54 AM

wow, J has been dx with hypermobility and low muscle toned, but also the physio mentioned about not having any arches in his feet and is flat footed, but instead of his feet being turned outwards, they turn inwards when hes walking, which is what is causing the poor coordination and poor balance with J plus tiredness. But its only says about feet being turned outwards above ??? I must research this further...am waiting on several books. Thanks Len, I'm really trying to raise my knowledge in these areas atm due to J's recent reports.

I hope that phone call wasn't too much of a shock for you :hugs2:

Edited by Snickas, 20 October 2010 - 08:54 AM.


#4 lennie len

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Posted 20 October 2010 - 09:54 AM

Snix, are his feet flat to the ground? He can have insoles in his shoes to support his feet and have them in a mor normal position which would help with the rest of his body posture.
Paed would refer to Orthotics and they would do plaster cast of feet in order to make correct fitted insole.

Heisdiamind, this is nothing to worry about, it is something that we need to be aware of and the child should receive some support from physio in form of strengthening exercises (this could be alternative P.E activity too, schools do a Madeline Portwood excerise thingy, I duno what it entails. Bobble is going to start one).
Generally OT check out fine motor movement, like handwriting, using bottons, zips, operating school taps etc.
Physio check out gross motor movement.
I will be badgering our paed for Meg as she is having severe pains, she has been virtually unable to walk, sometimes sliding along on her bum, and has been unable to get into school.
She was sent for xray of spine yesterday for scoliosis.

Any concenrs I would ask paed for referal for physio.
School can do the referal to OT, seeing as fine motor is considered more something that could affect somene in classroom.

Edited by lennie len, 20 October 2010 - 09:55 AM.


#5 Vickimom

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Posted 20 October 2010 - 11:13 AM

very interesting, not sure what mine actually have .... the paed says Fred is hypermobile, with low muscle tone, the physio says there is nothing wrong

winston has low muscle toneand hypermobile joints, again the physio says nothing wrong

the funny thing is no one has mentioned dyspraxia except the opthalmist who says his eyesight is fine and it could be he is tripping over due to dyspraxia!

#6 lennie len

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Posted 20 October 2010 - 11:55 AM

Could be Vicki, you'd have to read up on Dyspraxia to see if anything seems familiar.

#7 Mrs K

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Posted 20 October 2010 - 05:22 PM

When mm had OT they dx Hypermobilty in arm/hans joints and fingers.....also he finds it very tiring to sit properly to write he props himself up with his arms when writing!


Interesting reading Lennie, Thanks

#8 worried mummy

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Posted 20 October 2010 - 07:27 PM

Really interesting. Thanx.
My DD was diagnosed with hypermobility.

#9 Vickimom

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Posted 20 October 2010 - 09:33 PM

lennie: have just wikipedia'd it and it sounds like both the boys!




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