• Emily Reul, PT, DPT

Can Being Extra Flexible Give Me Prolapse?

“Loose joints?” “Double jointed?” “Super flexible?” Sound familiar? Maybe you’ve used these terms to describe yourself before. These can all be descriptions of joint hypermobility. Our joints are expected to have a certain amount of motion, but when they move more than that we call this hypermobility. It’s not always a bad thing, but more motion means there is a greater need for stability. In our pelvic floor, stability is important. Pelvic organ prolapse (POP) has been shown to be linked with joint hypermobility (Durnea, 2014; Veit-Rubin, 2016). If you want to learn more about POP, read our blog here.

Being hypermobile does not automatically mean you will develop pelvic organ prolapse, but it puts you at a higher risk. Understanding how your pelvic floor works and being aware of how to support it and improve pressure management can help you decrease the risk of developing pelvic organ prolapse or of making it worse.

What causes hypermobility? There is often a genetic component which can affect the dominant types of collagen in your body. Collagen is a type of connective tissue that essentially helps to keep things together. We have type 1 collagen which is the most abundant and is the strongest. Type 3 collagen is more elastic and moveable, but in moderation that is a good thing! Our bodies are built to move. However, for individuals with hypermobility, they often have more type 3 collagen which makes them a little more bendy which in turn provides less stability.

How do we measure hypermobility? Each joint in the body has a certain “normal” amount of degrees of motion we expect it to have. You may have a provider use a goniometer to measure joint mobility to an exact number of degrees. However, a special tool, called the Beighton Scale, was developed to help identify overall joint hypermobility and is quick and easy to perform. The Beighton Score tests 9 joints. The 9 tests are as follows:

  • Pull the pinky finger back beyond 90 degrees (1 point for each side)

  • Pull the thumb back to touch the forearm (1 point for each side)

  • Bend the elbow backwards beyond 10 degrees (1 point for each side)

  • Bend the knee backwards beyond 10 degrees (1 point for each side)

  • Lie hands flat on the floor while keeping the knees straight and bending forward at the waist (1 point)

For each test, you get one point if you can perform the motion. A positive score (meaning you have hypermobility) would be at least 5 points for adults.

If you scored 5 or more points, don’t freak out! There are ways to help you prevent injuries like POP and chronic sprains. Strengthening is a great place to start. When you have strong muscles, they help to provide stability to the joints. When it comes to POP, it is important to strengthen both your pelvic floor along with the surrounding muscles (like your hips and core). If you don’t know where to start, see a pelvic floor PT!

A pelvic floor PT can also teach you manage the forces placed on your pelvic floor to decrease the risk of developing POP. We have many forces that exert downwards on the pelvic floor like the pelvic and abdominal organs, abdominal contents, intra-abdominal pressure (like when you sneeze or laugh), gravity, and forces from activity (like standing or jumping). But there are so many ways to counteract those forces from above including strength from the pelvic floor muscles, fascia, external supports (like the V2 supporter), and indirectly from out pelvic bones and pelvic girdle muscles.

You can live a happy and fulfilling life with hypermobility and prolapse! If you have POP, our Power Over Prolapse E-Course is full of information on prolapse and how to manage your symptoms and thrive.

Here are some other great resources to learn more about your pelvic floor:</