Do you think or know that you have a double-jointed shoulder?
Are you able to extend your arms from the shoulder easily and painlessly outside of the typical range of motion?
Then you may have a hypermobile or double-jointed shoulder. Being able to move your arms outside the typical range of motion may seem like an advantage – and it can be for an athlete or musician – you should be vigilant about protecting your shoulders and other joints.
That’s because while you might not be in pain or having problems with your shoulder or arm at the moment, having a double-jointed shoulder or a hypermobile joint in general can lead to painful and problematic shoulder conditions in the future.
What Is A Hypermobile Shoulder?
Hypermobile or double-jointed shoulders happen when the ligaments and joint capsule – the tissues that hold the shoulder together – become too loose.
Weak muscles in and around the shoulder joint can also be part of the problem if you have a double-jointed shoulder.
If you have hypermobility syndrome, your other joints may be affected as well. Knees, elbows, wrists, and finger joints are often affected as well as shoulder joints.
Double-jointed can be considered an advantage for some athletes, particularly in sports like dancing or gymnastics where flexibility is prized, or even playing musical instruments that require a lot of dexterity.
Swimmers and rowers also have a higher instance of hypermobility syndrome, since having double-jointed shoulders can be beneficial in terms of performance, but detrimental to the health of the joint in general.
However, being double-jointed can also make you more prone to injury and issues like chronic joint pain.
It can also be a symptom of hypermobility syndrome, which can cause connective tissue problems elsewhere in the body along with conditions like asthma, irritable bowel, and other health issues.
If you think you are double-jointed and have any of these symptoms, see an orthopaedic surgeon with experience treating hypermobility syndrome as soon as possible.
The Muscles of The Shoulder
Your shoulder joint is made up of a group of four muscles and the associated bones and tendons that allow you to lift and rotate your arms.
The ball and socket motion of the shoulder joint itself rotates, moves, and otherwise works when the humerus (your upper arm bone) fits into the scapula (your shoulder blade).
These bones are surrounded by the supraspinatus, infraspinatus, teres minor, and the subscapularis.
All of the aforementioned muscles make up the rotator cuff, which keeps your shoulder stable and allows you to do everything that you do with your arm.
Note that hypermobility or double-jointedness is also referred to as joint laxity, hyperlaxity, loose joints, or hypermobility syndrome.
Generally, but not always, hypermobility is the term that is used when it is related to other medical issues – always speak with your doctor or physiotherapist if you have any questions.
What Causes A Double-jointed or Hypermobile Shoulder?
Having hypermobile joints is fairly common, especially for children because the connective tissues surrounding their joints aren’t fully developed.
Hypermobile joints can appear and become a problem despite any previously existing health conditions; this is referred to as benign hypermobility syndrome.
However, when joints hyperextend, it can lead to long term damage in the immediate joint area and even other seemingly unrelated areas of the body.
Being double-jointed or hypermobile can be caused by a variety of factors, including bone shape or the depth of the sockets of the joint, muscle tone, muscle strength, and inability to determine proprioception (an inability to sense how far you are stretching a muscle or joint).
A family history of hypermobility or conditions like Ehlers-Danlos syndrome, Down’s syndrome, or Marfan syndrome may contribute as well, as well as a history of injuries like shoulder dislocations or dislocations of other joints like the jaw or knee cap.
Women are also more likely than men to be double-jointed, and age also matters.
Younger people are more likely to have supple joints in general with associated double-jointed shoulders or hypermobility, and those same joints can freeze or stiffen up with age.
If you are in your twenties or thirties, having a double-jointed shoulder may not seem particularly troublesome, but being double-jointed or hypermobile can cause significant problems later in life.
What Are the Signs and Symptoms of Multidirectional Shoulder Instability and How Are They Related to Having A Double-Jointed Shoulder?
If you have no problem completing the Beighton test or Brighton criteria as well as the Wynne-Davies criteria (the latter of which you are more likely to encounter),
If you have no problem completing the Beighton test or Brighton criteria, then you might be double-jointed or have hypermobility syndrome, which can lead to multidirectional instability of the shoulder.
This test is a standard way to measure hypermobility.
If you can easily extend your arm past the normal rotation, along with other tests like the ability to extend your thumb and elbow beyond the normal range, or place your hands flat on the floor when you are touching your toes.
Joint stiffness, easily dislocated shoulder joints or other joints, shoulder joint pain, foot and ankle pain, and neck or back pain can all be indicators of hypermobile joint syndrome or double-jointedness (and these can lead to multidirectional shoulder instability and other conditions).
Even if you don’t have issues with your shoulder now, you may want to have your hypermobility checked by an orthopaedic surgeon if you have any of these symptoms.
What Issues Are Related to A Double-Jointed Shoulder?
If you have a double-jointed shoulder, you may experience pain and stiffness in your other joints as well. This issue is referred to as hypermobility syndrome.
Multidirectional instability or loose shoulder joints may also be a side effect of a double-jointed shoulder – if you have these types of issues, the “ball” of your shoulder joint may feel like it is slipping or popping out of the socket.
Multidirectional instability can occur in athletes in general, but if you already have a double-jointed shoulder it may be more likely.
Long term conditions, like frozen shoulder syndrome and even arthritis can develop if you have a double-jointed shoulder.
That’s why it is essential to have your shoulder joint checked out by an experienced orthopaedic surgeon, and potentially work with a physiotherapist if you think you may have a double-jointed shoulder or a hypermobile shoulder.
How Is A Double-jointed or Hypermobile Shoulder Diagnosed?
A double-jointed shoulder diagnosis involves the aforementioned Wynne-Davies criteria and Beighton test as well as other physical tests.
If you have pain in your shoulder during or after exercise, changes in mobility or function, or a sudden change in the appearance of your shoulder (e.g. swelling or the “pop-eye” appearance), then you should definitely see a doctor about the possibility of having a double-jointed shoulder or a related condition.
How Is A Double-Jointed Shoulder Treated?
A combination of physiotherapy and over-the-counter pain relief medications along with an exercise regimen designed and approved by a physiotherapist is typically used to treat hypermobile or double-jointed shoulders.
Splints, taping, firm elastic bandages, and other prophylactic options can also be used during exercise or other activities that may result in further damage to your shoulder joints.
If you have other conditions related to hypermobile or double-jointed shoulders such as multidirectional instability or more serious problems like frozen shoulder syndrome, you should see an orthopaedic surgeon right away in order to plan surgical or nonsurgical treatments that can help stabilize your shoulder and prevent future injuries or problems.
Surgery is generally not advised for people with double-jointed shoulders or hypermobility unless there is another shoulder injury or shoulder condition involved, such as a rotator cuff tear (LINK) or tendon tear.
What Type of Exercises Should You Do If You Have A Double-Jointed Shoulder?
Of course, always consult with your physiotherapist or orthopaedic surgeon before you begin or change an exercise program.
The recommended exercise programs will likely be focused on exercises that both activate and stabilize the joint, as well as strengthening the rotator cuff.
Building up your rotator cuff is essential if you have a double-jointed shoulder or shoulders, or are dealing with hypermobility syndrome.
That’s because the rotator cuff can help support your shoulder joint and protect it from damage if you hyperextend the joint or otherwise overuse it.
Integration techniques involving lifting weights are often used as well, in order to build up strength in the muscles surrounding the shoulder joint and arm region.
How Do You Prevent Injuries or Dislocation If You Have A Double-jointed Shoulder?
You should perform exercises that help develop the muscles around the joint, of course (and your physiotherapist and doctor can help you develop a customized regimen).
They will also teach you how to determine the normal range of motion for your shoulder joint – this will help you avoid hyperextension.
In addition, you may need to protect your double-jointed shoulder during exercise or other physical activity with padding or specialized braces.
Your physiotherapist will design a detailed joint strengthening program specifically for you and your individual needs.
Do you think you might have a double-jointed shoulder?
Then you should contact an orthopaedic surgeon who is experienced with these issues as soon as possible.