Being very flexible is often seen as an advantage, whether in sport, dancing or everyday activities. But for a significant portion of the population, this characteristic may reflect a clinical condition called hypermobility spectrum syndrome. It is estimated that the problem affects around 10% of adults and approximately 34% of children and adolescents, which makes it much more common than one might imagine.

Joint hypermobility is related to collagen fragility, protein essential that provides support and resistance to various tissues of the body. Collagen is an important structural protein, with a triple helix shape. In hypermobility, it is more fragile and loose, not properly structuring the tissues.

Symptoms and consequences of joint hypermobility

Not every hypermobile person has symptoms. In some cases, increased flexibility is of no consequence. In others, however, the condition can significantly affect health and well-being. Among the most common symptoms are chronic pain, joint instability and increased risk of injuries, such as sprains and dislocations.

Early osteoarthritis, loss of muscle mass, reduced bone density and changes in the autonomic nervous system can also occur, which lead to dizziness, fainting and cardiovascular and gastrointestinal changes. In the most severe forms, hypermobility can be part of rare genetic diseases, such as Ehlers DanlosMarfan syndrome and osteogenesis imperfecta.

Diagnosis of joint hypermobility

The diagnosis is essentially clinical, based on the patient’s history and physical examination. Complaints such as chronic pain since childhood, frequent sprains, repeated dislocations, fragility fractures, persistent fatigue and headaches may raise suspicions.

One of the main instruments used is the Beighton score, which assesses the hyperextension capacity of joints such as elbows, knees, fingers and spine. Additional tests, such as bone densitometry, genetic tests and assessment of body composition, may be requested to investigate complications or associated conditions.

Hypermobility doesn’t just affect the musculoskeletal system. Many patients report intense fatigue, diffuse body pain, cardiac arrhythmias, fainting, gastrointestinal disorders and difficulty carrying out daily activities. These symptoms can compromise quality of life and make school, professional and social routine difficult. Therefore, early recognition is essential to avoid worsening and improve the prognosis.

Treatment and care in everyday life

Although there is no cure for collagen fragility, treatment can control symptoms and improve joint stability. The basis is the regular practice of physical activityespecially muscle strengthening exercises, such as weight training, always with professional guidance.

Other measures include maintaining good hydration, increasing electrolyte intake, avoiding exposure to extreme temperatures and respecting the body’s limits, with regular rest breaks. Depending on the case, specific supplements and treatments may be indicated. Monitoring must be carried out by specialists familiar with the subject, such as orthopedists, rheumatologists and physiatrists.

Given the high prevalence, especially among young people, recognizing the signs and seeking medical evaluation is the first step to ensuring quality of life and preventing future complications.

By Frederico Barra

President of the Osteometabolic Diseases Committee of the Brazilian Society of Orthopedics and Traumatology (ABOOM/SBOT).