Developmental conditions

The term generalized joint hypermobility (GJH) is used when a person has several joints that are more flexible than usual. This happens when the connective tissue which makes up the joint structures (capsule and ligaments) is more compliant (more easily stretched) than usual.

Many children with hypermobile joints have movement difficulties. Why is this and what can be done to overcome these difficulties?

Infants with joint hypermobility have joints that are able to bend further than usual and a trunk and limbs that appear to be floppy and weak. 

The increased range of  movement at the joints (sometimes called joint laxity or being double jointed) is due to differences in the connective tissue that forms the joint capsule and ligaments.

 

Many children with movement difficulties also behavior, emotion regulation and attention difficulties which impact on their function and participation at home and at school. These children often have a diagnosis of sensory processing disorder and receive sensory integration therapy. 

 

About 6-8 % of children appear to be developing in the usual way yet seem to have difficulties with coordination and with learning new skills which affects their function and participation at home, at school and in the playground. 

Developmental Coordination Disorder (DCD) is the internationally accepted name for this condition. 

About 15-20 percent of children are born with a temperament style that is very cautious and often quite fearful.  Elaine Aron coined the phase “highly sensitive child” for these children describing them as being very aware and quick to react to everything.  

Children on the autistic spectrum often have difficulties with posture, coordination and motor planning. In fact recent studies show that movement difficulties are very common in children on the spectrum.  

Many children with joint hypermobility (low muscle tone) have problems with flat feet. Flat feet are associated with leg muscle tightness, weakness, balance problems and rotational malalignment of the leg. 

Some children with flat feet also experience pain with walking distances and running.

There are a group of children who tend to walk on their toes some, if not all, of the time, despite there being no neurological or muscular condition that would commonly cause toe walking. 

The medical term for habitual toe walking is idiopathic toe walking. (Idiopathic = arising spontaneously or from an obscure or unknown cause)  

Children with joint hypermobility and low muscle tone often sit between their legs (known as W-sitting or M-sitting.  This position imposes abnormal stresses on the hip and knee joints and tightness in hip muscles and tibial torsion which in turn cause hip and knee pain during and after exercise.   

hypermobile child with poor standing posture

Children with movement difficulties (joint hypermobility, low muscle tone, ASD and developmental coordination disorder often have weak core muscle strength and stability, and poorly developed postural response mechanisms. This affects their posture in sitting and standing, as well as their gross motor skills.