By Redbud on Saturday, June 03, 2000 - 03:50 am:

Hi. I'd never heard of the term "hypermobility" before, until my 12 year old son was recently given an OT evaluation due to some problems with fine motor skills.
In the OT's report, she says, "He displays hypermobility in his fingers as evidenced by his ability to make 'shrimp fingers' (overlapping the first digit over the PIP
joint of the second digit and the second over the third, and the third over the fourth, etc. and his ability to flex his thumb at the dip joint and hyperextend it at the
CMC joint." He cracks his knuckles constantly.

So my question is -- is this good or bad? Or is it all benign? He has a terrible trouble with handwriting, but I don't know if it has anything to do with this
hypermobility in his hands. What can I expect in the future for him in regards to this?
Thank you for all replies.
Redbud

By Gwen on Saturday, June 03, 2000 - 03:50 am:

My understanding is that hypermobility is benign until pain becomes involved. Then it is Hypermobility Syndrome. A very good explanation is on
http://www.hmsa.freeserve.co.uk. "Pain and Hypermobility" by Prof.Grahame.

By NB on Saturday, June 03, 2000 - 03:50 am:

YES!!! hypermobility can cause problems in fine motor skills, handwriting etc.
i just got my three year old's ot report and it says fine motor skillls development hindered by hypermobility (and low muscle tone)
you may be able to arrange for your son to use a keyboard at school - your OT could help you to arrange this. you'll need to get some kind of indiv educational plan
drawn up, maybe a statement of needs. depends which country you are in.
splints are provided sometimes which might help.

benign -- well it wont kill him. and he may not get pain. BUT he needs to figure with his OT ways of getting round the problem so he can keep up with writing etc in
school.

but it is important the problem is recognised and dealt with and accomodations made where necessary. it is good the ot is recognisisng where the problem lies -
hopefully s/he has ideas on how to deal with it.

By Janie on Saturday, June 03, 2000 - 03:51 am:

Hi,
I'm 34 years old and was born with Hypermobility (Ehlers-Danlos Syndrome III). I've been cracking my knuckles for years...since I can remember. Many people
(friends and family) insist that it causes arthritis, but I only have arthritis in my back and that's one of the few things that I don't crack!!!!

A rheumatologist and geneticist explained to me that the reason I crack is to reallign the joints. There's so much play within the joint, that tendons get into the wrong
position, and cracking the joints lets the tendon go back into place. I know that there are those on this forum who think that cracking can cause or exascerbate
arthritis but that has not been my experience (and I'm a world-class cracker - ha ha), nor has it been the advice from the physicians I've spoken to.

Another issue...If people hassle the 12-year old for cracking, he just needs to explain to them that he needs to do this so that he can regain his range of motion and
eliminate pain. My hope is that he won't be scolded for cracking! Scolding by parents or older siblings can create further feelings of guilt that he's somehow a bad
person. He probably already has feelings of inadequacy because he can't handwrite the way his friends can. I hope he learns that we all have strengths and weaknesses
and that weaknesses are not faults.

Best wishes,
Janie

By Greg on Saturday, June 03, 2000 - 03:51 am:

Redbud,

I also have had fine motor troubles since I was 5 years old. I still write very messy now some 15 years later after extensive OT and PT. My EDS was never diagnosed
at a young age though.
You son's hypermobility of the fingers may not be somthing to worry about too much, but please do check out his other joitns and keep a watch on them. Many
times people who have hypermobile fingers, may also have other hypermobile joints, or possibley EDS. Please give your son a break on his writing, having teachers
all through my life make fun of me about how poor my writing was really hurt my self-esteem as a child. Good luck

Greg

By Rich on Saturday, June 03, 2000 - 03:51 am:

Hi. You have already receivied some good posts for your son's problem. Not much to add. Just one thing in reference to the cracking. I can't say it's good. I can't say
it's bad. All I know is, I have been cracking my knuckles since I was 12 and now my knuckles are very painful and swollen (I am 24 now). They are not getting amy
better. So, you see, everyone is different and just because cracking didn't bother one person doesn't mean it won't cause problems in another. My advice is better safe
than sorry. In RE: to aligining the tendons and joints as was expalined in another post to you. This is true. I don't know weather or not it is a safe way to align them
though. Check out some more posts. You will see a lot of reference to a treatment called prolotherapy. Lots of people underestimate the wide range of areas it can
be used. Prolotherapy can realign the tendons, ligaments and joints in the fingers (or any other joint for that matter) permenantly. In other words, after a few prolo
treatments, it is highly likely that the hypermobility will be greatly improved, and the "cracking" urge will diminish. I know because I am a prolotherapy patient.
Look up http://www.prolotherapy.com for more details. Good Luck!!

Rich

By Sue C on Saturday, June 03, 2000 - 03:52 am:

I agree with the good postings to your question.

I explain my excessive cracking as something that's necessary for me to move. I don't even notice it, and usually that explanation quiets people from asking again.

I don't have finger problems, perhaps because of my interests -- various forms of needlepoint and playing musical instruments.

He's at the age where instruments are introduced to kids in the US. I found that sax and lower clarinets and bassoon keep my hands curved in natural positions, and I
practice several hours a week for fun from age 11 to now at age 30. (Brass instruments typically use 3 fingers, rather than 9, so it's not as good for motion. Also,
tuba may be difficult, since a small jaw is often related to eds.)

Marching for 12 years also helped to keep me in good condition. My dislocations were much less frequent until I stopped marching 6 years ago.

Other "pushes" for music: it's not a contact sport (which he should avoid). Plus he may develop some better friends who don't tease him. And it's a life-long hobby.

(Let me know if you need any advice on playing different instruments. I've tried MANY, and settled on a few.... I found guitar to be impossible because of the
requirement of having tense fingers.)

Good luck!

By Johanna on Saturday, June 03, 2000 - 03:52 am:

Hi,

This reply is a little late but I hope you'll still read it. This morning I was cleaning my attic and I found my schoolstuff from primaryschool. I was shocked when I
noticed how for years in a row, all teachers ever wrote under my assignments, were things about my terrible handwriting. In six years they wrote over a 100 remarks
about my writing, none of them very constructive. I remembered what kind of obsession it became to me. Please let your son know it IS good enough to try, no
matter what teachers might say. Explain to teachers that he can't help it. In highschool teachers tend to be a bit more understanding when it comes to handwriting,
but still.

Good Luck, for both you and your son.

By Claudia on Saturday, June 03, 2000 - 03:52 am:

My daughter was diagnosed at 13 (now 16). She found much improvement from using ring splints. They are "cool Looking". A hand therapist can prescribe them.
Ours are from the silver ring splint company in Charlottesville, VA. She also pulls her finger joints for relief (no cracking). Cold always hurts her, and we use a
hand therapy spa - hot wax- for relief. The hand therapist suggested exercises. Good luck.

By Barbara on Sunday, January 14, 2001 - 07:01 pm:

Hypermobility can indicate Ehlers Danlos Syndrome which can have many other symptoms. Check http://www.egroups.com/links/dahrt and click on the Ehlers Danlos Syndrome folder for lost more information.

For hypermobile fingers, check out the Silver Ring Splint Company at www/silverringsplint.com I have had much success using these splints to treat hypermobile fingers.