Hypermobility and CTB

Hypermobility is often a significant perpetuator in chronic pain situations. There are different levels of it, Ehlers-Danlos being a more extreme version. But even much more minor versions of hypermobility contribute to pain issues. Ideally, the ligaments should have about 3% elasticity. Hypermobile people sometimes have double that or more, so there is a lack of stability in one or more joints. The muscles have to work harder to provide the stability that the ligaments are not providing. If the muscles around the joint are not coordinated and strong enough to manage, the body perceives this extra mobility as dangerous to the joint and will begin a process of putting trigger point fibers in the muscles as a way to provide more stability (splinting) without having to use more energy (ATP).

These muscle fibers become locked in contracture (energy free/permanent contraction) and essential become "fake ligaments." These are trigger point taut fibers. When there are significant amounts, the proprioception becomes impaired and nociceptive signals increase and cause CNS upregulation and referred pain. Reducing the trigger points, restoring pain-free ROM, then creating balanced strength around the joint is the solution. Muscles with trigger points don't respond well to strengthening, they are already compromised and get overloaded easily, creating more trigger points and pain. Trigger points must be reduced and pain-free movement restored first, then strengthening.

Updated on: 10/06/2024