Double-Jointedness: Understanding Hypermobility, Flexibility, and Associated Risks

Are double-jointed people more flexible?

While individuals commonly referred to as "double-jointed" possess increased passive range of motion at specific joints due to hypermobility, this does not automatically equate to overall functional flexibility, which is a trainable quality encompassing controlled movement throughout a joint's full range.

What Does "Double-Jointed" Actually Mean?

The term "double-jointed" is a common colloquialism, but it is anatomically incorrect. No one possesses extra joints. Instead, the phenomenon it describes is called hypermobility, or joint laxity. This refers to a greater-than-average range of motion in one or more joints, allowing them to extend or bend beyond what is typically considered normal. It's a spectrum, with some individuals exhibiting mild hypermobility in a single joint, while others may have generalized joint hypermobility throughout their body.

The Anatomy of Hypermobility

Hypermobility is primarily a structural characteristic of the connective tissues surrounding a joint. Several factors contribute to this increased range of motion:

• Ligamentous Laxity: Ligaments are strong, fibrous bands that connect bones to other bones, providing stability to joints. In hypermobile individuals, these ligaments may be more elastic or longer than average, allowing for greater joint movement. This is often the primary contributing factor.
• Joint Capsule Structure: The joint capsule is a fibrous sac that encloses the joint. A looser or more elastic joint capsule can also contribute to increased range of motion.
• Bone Shape: The shape and congruence of the articulating bone surfaces can play a role. For instance, shallower joint sockets or flatter bone ends may permit greater movement.
• Muscle and Tendon Elasticity: While less significant than ligamentous laxity, highly elastic muscles and tendons can also contribute to a greater range of motion.
• Genetic Predisposition: Hypermobility often has a genetic component and can run in families. Conditions like Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD) are examples of inherited connective tissue disorders that can cause significant hypermobility.

Hypermobility vs. Flexibility: A Key Distinction

It's crucial to differentiate between hypermobility and flexibility:

• Hypermobility: This refers to an inherent structural characteristic of a joint, allowing for excessive passive range of motion. Passive range of motion means the joint can be moved by an external force (like gravity or another person) beyond its typical limits, often without conscious muscular control to hold it in that position. It's often localized or generalized joint laxity.
• Flexibility: This is a trainable physical quality that describes the ability of muscles and connective tissues to lengthen, allowing a joint to move through its full, pain-free active range of motion with control. Active range of motion means the individual can move and hold the joint in that position using their own muscle strength. Flexibility requires both adequate tissue extensibility and muscular control and strength throughout the entire range.

While hypermobility can provide a predisposition for achieving certain ranges of motion, it does not automatically mean a person is functionally flexible. A hypermobile individual might be able to passively put their leg behind their head, but without the requisite strength and control in the surrounding muscles, they may lack the active flexibility to perform controlled movements throughout that range. Conversely, a person without hypermobility can significantly improve their flexibility through consistent, targeted training.

The Advantages of Being Hypermobile

For some individuals, hypermobility can be an athletic advantage:

• Enhanced Performance in Certain Sports: Gymnasts, dancers, contortionists, and martial artists often benefit from increased joint range of motion, allowing them to achieve aesthetically pleasing or technically demanding positions.
• Easier to Achieve Certain Ranges of Motion: Basic movements like touching toes or achieving a deep squat may come more naturally to hypermobile individuals due to less anatomical restriction.

Potential Risks and Considerations for Hypermobile Individuals

Despite some advantages, hypermobility comes with specific risks that require careful management:

• Increased Risk of Injury:
  • Dislocations and Subluxations: Joints can more easily move out of alignment (dislocate) or partially dislocate (subluxate) due to lax ligaments providing less stability.
  • Sprains: Ligaments can be overstretched or torn more easily.
  • Chronic Pain: Repetitive microtrauma or instability can lead to chronic joint pain.
• Proprioception Deficits: Hypermobile joints may have reduced proprioception (the body's sense of its position in space), making it harder to sense joint position and control movement, further increasing injury risk.
• Osteoarthritis Risk: Long-term instability and excessive joint movement can lead to increased wear and tear on articular cartilage, potentially accelerating the development of osteoarthritis.
• Systemic Conditions: In some cases, generalized hypermobility is part of a broader connective tissue disorder like Hypermobility Spectrum Disorder (HSD) or Ehlers-Danlos Syndrome (EDS), which can have implications beyond the musculoskeletal system.

Training Recommendations for Hypermobile Individuals

For hypermobile individuals, the focus of training should shift from merely achieving range of motion to controlling and stabilizing it.

• Prioritize Strength and Stability: Instead of pushing for extreme end-range flexibility, concentrate on building strength in the muscles surrounding the hypermobile joints. This creates dynamic stability and supports the lax ligaments. Exercises should be performed through a full, but controlled, range of motion.
• Focus on Proprioceptive Training: Incorporate balance exercises, single-leg stands, unstable surface training (e.g., wobble boards, bosu balls), and exercises that require precise body awareness to improve joint position sense.
• Controlled, Functional Movements: Emphasize movements that mimic daily activities or sport-specific actions, performed with excellent form and control, rather than passive stretching into extreme ranges.
• Avoid Passive Overstretching: While gentle stretching can be beneficial for muscle length, avoid pushing hypermobile joints into their end ranges passively, as this can further stretch already lax ligaments and increase instability. If stretching, ensure active muscular engagement to control the movement.
• Core Stability: A strong core is fundamental for overall body stability and can help reduce the load on peripheral joints.
• Professional Guidance: Working with a qualified fitness professional, physical therapist, or kinesiologist experienced with hypermobility is highly recommended. They can design a safe and effective program tailored to individual needs and limitations.

Conclusion: Understanding Your Unique Joint Mobility

To answer the question directly: "double-jointed" people are indeed more mobile at specific joints due to hypermobility, which is an inherent characteristic. This can contribute to certain aspects of flexibility, but it is not synonymous with overall functional flexibility. True flexibility involves not just range of motion, but also the strength, control, and stability to move through that range effectively and safely.

For hypermobile individuals, understanding this distinction is paramount. Their training should emphasize stability, strength, and proprioception to harness the advantages of their unique joint structure while mitigating the associated risks. Embracing a balanced approach to fitness is key to optimizing performance and ensuring long-term joint health.