Hyper mobile joints

[UncleEJ]

I suspect that my 3 yo DD has hyper mobile joints. All of her fingers are double jointed and can bend back way to far. She is very flexible everywhere and sits in awkward positions. She is a bit floppy. She is also very tall and thin for her age. So far she seems to be developing just fine, walked on time, ect. But I wonder if I should have her checked out about this. Might physical therapy be helpful in this situation? I have a friend with joints like this and she dislocates her knees quite often. I hate being a worrywart about it but I also want to help her if this is something that could affect her later on. Anybody have any experiences to share?

[Momof3littles]

I would get an eval.  FWIW, I worked in early intervention as a PT prior to becoming a SAHM.  It could be several things, but if she feels generally "floppy" when you pick her up she could have hypotonia, which is low muscle tone.  There are other factors and things that would be assessed, but a PT eval would be appropriate for what you describe.  You could go through the school system for at least the evaluation, or you could do an eval at a private outpatient practice specializing in pediatrics. 

 

[UncleEJ]

I would get an eval. FWIW, I worked in early intervention as a PT prior to becoming a SAHM. It could be several things, but if she feels generally "floppy" when you pick her up she could have hypotonia, which is low muscle tone. There are other factors and things that would be assessed, but a PT eval would be appropriate for what you describe. You could go through the school system for at least the evaluation, or you could do an eval at a private outpatient practice specializing in pediatrics.

Thank you.

[gardenmom5]

I would have it checked out.  a physical therapist should be able to help with floppy. it can be a problem down the road.

 

I do reading about yoga as well as a beginner practioner.  one story was how some of the acrobats from circ du solei started doing yoga.  they were *too* flexible to be able to hold positions.

[PhotoGal]

You can also go to an orthopedist. He/she may want to send you to genetic testing for syndromes associated with hypermobile joints. My younger daughter has this and her knees were dislocated at birth. We are going to the geneticist in a couple weeks.

 

Hope that helps!

[PhotoGal]

Just wanted to add that if it is just hypermobile joints, she could outgrow it in time.

[Momof3littles]

The PT can do an eval and refer you on if they feel the floppiness and hypermobility are enough to warrant additional medical followup.  I agree that genetic syndromes, etc. can be involved in some cases, but that's not the majority, and IME most PTs would err on the side of referring you on to a specialist if they are seeing something more atypical than run of the mill hypotonia.

[mama55]

http://ednf.org/sites/default/files/MRGEDS2010S.pdf

http://www.marfan.org/about/signs

 

I probably wouldn't do physical therapy for a three year old without joint injury or developmental delays, but it is a good idea in later years.  There are other associated issues that can be more serious, but they are rare and probably most doctors would not test for them at this age.  Still, if you are concerned, see a doctor!  

[UncleEJ]

Thank you all for your input. I don't suspect any genetic problems but you never know. She seems to be built very similarly to DH's brother. I know he has had some joint issues as an adult but I think he was ok as a kid. I guess I have to decide whether to pursue it or not.

[mommymilkies]

I would get her checked out sooner rather than later.

[mom2scouts]

I had hypermobile joints and my dd is also hypermobile.  It helps that dd is a gymnast and spends time strengthening muscles, but I still worry about joint injury.  I've had knee dislocations that make exercise, even walking and swimming, painful.  I've been told that it is helpful to build up the muscles around the joints to prevent dislocations.  Maybe a doctor or PT can give you exercises to do at home.

[Joanne]

I do not have help or answers for you.

 

My dd has juvenile rheumatoid arthritis (yes, I know they changed the name) and hypermobility. Her Rheumatologist recommended we see a geneticist to rule out Ehler-Danlos mentioned here:

 

http://rheumatology.oxfordjournals.org/content/44/6/744.fullI

 

 

[sbgrace]

I was going to mention Ehler-Danlos, though I'm sure there are other things that would cause this. There are forms that don't have major life effects.

 

I'd see if your doctor can refer to genetics for you. There are often long wait lists for the older kids/non-life threatening stuff, so I think it's worth pursuing now. Knowledge is a good thing imo.

[Element]

It could certainly be Ehlers-Danlos. I would recommend scheduling an appointment with a pediatric geneticist.  He or she will be able to refer you to the proper specialists if that is the diagnosis. Children with EDS can be helped by OT and PT, but they also need to be evaluated by pediatric cardiology, ophthalmology, and neurology to check for other complications that can sometimes come with EDS. PT should help a little with the dislocation issue. Good luck to you. I hope you find some answers. My dd was about that age when we noticed something was not quite right with her. It took 3 or 4 years to get a diagnosis (because we didn't know to ask a geneticist) but everything made sense once she finally had one. 

[UncleEJ]

Thank you all for the information. I will look into it all more. She has one other issue that I feel like may be related to her being hyper mobile. She was born with a Diastasis Recti. She had a gap in the muscles vertically. You could see it when she cried. They told me the muscles would "stitch" back together as her abs got stronger with sitting up, crawling and standing. This did not happen. At age three you can still see the bulge come through when she is laying down and sits up, like after a diaper change. At her 18 month check-up, the Dr didn't seem concerned and she hasn't been back since. I think I will definitely make her an appointment soon. DH thinks I am worrying over nothing but my mommy instinct is telling me to look into this further.

[Momling]

My daughter has quite flexible joints - especially knees, elbows and back. Ballet has been great for her since it's desirable to have hyper-extended joints but it's also necessary to develop strength (which doesn't come naturally to her) to control the extension. When your child gets to be 6 or 7 or so, I'd look into serious, good quality ballet instruction if she shows interest in dance.

[Momof3littles]

Thank you all for the information. I will look into it all more. She has one other issue that I feel like may be related to her being hyper mobile. She was born with a Diastasis Recti. She had a gap in the muscles vertically. You could see it when she cried. They told me the muscles would "stitch" back together as her abs got stronger with sitting up, crawling and standing. This did not happen. At age three you can still see the bulge come through when she is laying down and sits up, like after a diaper change. At her 18 month check-up, the Dr didn't seem concerned and she hasn't been back since. I think I will definitely make her an appointment soon. DH thinks I am worrying over nothing but my mommy instinct is telling me to look into this further.

 

There is connective tissue that holds the rectus together, so it may be worth exploring whether it is related to any hypermobility you are seeing. I think you are right in following your instinct.  Hopefully it is nothing very concerning, but it would be good to pursue whether there's a relationship between that and the hypermobility.  That piece of info would probably lead me to pursue it through your MD first and ask about ruling in/out any genetic condition.

[Catherine]

Another vote for getting it checked out. Like the poster whose son has dilatation of the aortic root, which I think can be seen in Marfan's, there are potential serious consequences associated with some genetic syndromes. I think what you are describing is concerning enough to bring it all up to her pediatrician.