Table of Contents

Understanding Hypermobility

Definition and Types of Hypermobility

Joint hypermobility is when a person’s joints have an unusually large range of movement. Hypermobility syndromes cause pain and can lead to subluxations or dislocations. Many people can be hypermobile in their joints. However if this causes an individual pain, along with other symptoms like muscle stiffness, fatigue, and recurrent injury, this is then classed as a hypermobility syndrome.

Hypermobility types range from benign joint hypermobility syndrome (JHS), which is generally not associated with health issues, to conditions like Ehlers-Danlos syndrome, which involves more complex systemic symptoms.

Chair of Sussex Ehlers-Danlos Syndromes (EDS), Jane Green, said:  ‘It took 54 years to receive my autistic and hypermobility EDS diagnosis, so it is really validating to realize that all my varied issues are real and linked up. I wasn’t making up all my pain, both visible and invisible, I wasn’t being a hypochondriac, and nor am I dim.  It wasn’t my fault for not being strong and healthy or picking up ‘common-sense’ things that others expected me to do…”

Symptoms and Diagnosis of Hypermobility

Many people with hypermobile joints don’t have any problems, and some people – such as ballet dancers, gymnasts and musicians – may actually benefit from the increased flexibility. However, some people with joint hypermobility can have a number of unpleasant symptoms as well, such as:

Silhouette of a person bending backward in a flexible yoga pose against a dusk sky, illustrating the concept of hypermobility which may be related to ADHD.
  • Pain and stiffness in the joints and muscles
  • Clicking joints
  • Joints that dislocate (come out of the correct position) easily
  • Fatigue (extreme tiredness)
  • Recurrent injuries – such as sprains
  • Digestive problems 
  • Dizziness and fainting
  • Thin or stretchy skin

Living with a hypermobility disorder often means managing various co-morbidities. These can include dysautonomia issues like PoTS, chronic fatigue, pain, and gastrointestinal challenges, alongside visual stress. Notably, neurodivergent conditions such as Autism (ASD) and ADHD are also frequently observed among individuals with hypermobility, highlighting the complex interplay between physical and neurological health in these disorders.

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ADHD Overview: Symptoms and Types

Attention Deficit Hyperactivity Disorder (ADHD) manifests through symptoms like inattention, hyperactivity, and impulsivity. Its types include predominantly inattentive, predominantly hyperactive-impulsive, and combined type.

Diagnosis and Management of ADHD

Diagnosis relies on a comprehensive clinical evaluation, and management can include medications like stimulants, behavior therapy like ADHD Coaching, or a combination of treatments.

The Link Between Hypermobility, Neurodiversity, and ADHD

Statistical analysis suggests that neurodivergent people are 4 times as likely to be hypermobile than the general population, and this is more likely for females. 

Brief Explanation of Hypermobility and ADHD

The link between neurodiverse adults and hypermobility is emerging as an area of interest due to observed overlaps in conditions like ADHD and autism with hypermobility syndromes. 

Types of neurodiversity associated with hypermobility include ADHD, autism spectrum disorder (ASD), and dyspraxia, among others. 

Research Findings on Hypermobility and Neurodiversity

Research suggests that the prevalence of hypermobility is notably higher in these neurodiverse populations compared to the general population, indicating a potential shared underlying mechanism or genetic predisposition contributing to this association.  Studies show individuals with ADHD are more likely to exhibit signs of hypermobility, with some research suggesting shared genetic pathways.

Led by Brighton and Sussex Medical School (BSMS) and funded by the MRC, MQ Mental Health Research and Versus Arthritis, one research study found that more than 50% of participants with a diagnosis of Autism, attention deficit hyperactivity disorder (ADHD), or tic disorder (Tourette syndrome) demonstrated elevated levels of hypermobility, compared with just 20% of participants from the general population.

In another study, the researchers examined the frequency of Benign Joint Hypermobility Syndrome (BJHS) in children with ADHD. They found BJHS in 31.5% of the patients with ADHD and 13.9% in the control group. The difference was found to be significant. Also, there was a statistically significant increase in the Beighton total score in ADHD patients compared with the control group. 

Theories Explaining the Connection

Theories include genetic overlaps and the impact of ADHD on the body’s physical stress response, potentially exacerbating hypermobility symptoms. 

A study on chronic pain within neurodivergent women found that 75% of participants experienced chronic pain in some way. It is theorized that dopamine dysregulation within neurodivergent people could be the cause of their increased pain sensation. This is because dopamine is involved in pain perception in the body.

Genetic Factors in Hypermobility and ADHD

Joint hypermobility often runs in families and is believed to be linked to genetic variations affecting collagen, a crucial protein in the body’s tissues. Weaker collagen can lead to more flexible ligaments and joints, allowing for an extended range of motion and sometimes resulting in joint instability or increased vulnerability to injury.

Research into the genetics of both hypermobility syndromes and ADHD indicates a fascinating overlap, suggesting that these conditions might share common hereditary elements. Scientists are investigating specific genetic markers that could predispose individuals to both hypermobility and ADHD, reflecting a potential intertwined genetic basis. This exploration into the genetic linkage aims to uncover the molecular underpinnings that could explain why individuals with hypermobility are at an increased risk of developing ADHD and vice versa.

Neurological Considerations

From a neurological perspective, the relationship between ADHD and hypermobility invites an examination of how the brain’s executive functions—those affected by ADHD—interact with the body’s motor control. ADHD’s hallmark symptoms of inattention and hyperactivity may impact an individual’s muscle tone and coordination, potentially leading to or exacerbating joint instability and hypermobility. This area of research explores the bidirectional influence where ADHD-related neurological patterns might affect physical stability, while also considering how physical symptoms of hypermobility might feed back into neurological states, influencing attention and activity levels.

Hypermobility and ADHD

Graphic of a person reaching up with colorful swirls above, inside head outlines with 'ADHD', suggesting a connection between body movement, brain diversity, and ADHD.

Impact of Hypermobility on ADHD

Hypermobility can complicate the expression and management of ADHD, affecting physical coordination and increasing discomfort during activities requiring sustained attention.

How Hypermobility Affects ADHD Symptoms

Joint discomfort and instability can exacerbate ADHD symptoms by increasing restlessness, executive functioning, and discomfort, particularly in settings requiring stillness.

How ADHD Exacerbates Hypermobility Issues

Imagine Matt, a college student with ADHD and hypermobility. Due to ADHD, Matt often feels a need to move constantly, leading to frequent pacing, fidgeting, and engaging in sports without proper warm-up. This increased physical activity strains Matt’s already hypermobile joints, causing joint pain and increasing the risk of dislocations or injuries. Despite the discomfort, the compulsive need for movement makes it challenging for Matt to moderate activity levels, creating a cycle of physical stress and injury that exacerbates the hypermobility issues.

Management Challenges in Coexisting Conditions

Co-managing these conditions requires a careful balance of treatments addressing both the mental and physical aspects, often necessitating a multidisciplinary approach.

Self Care is Key:

  • Maintain a healthy lifestyle with a balanced diet and keep a healthy weight to support joint strength.
  • Follow sleep hygiene practices for better rest, like consistent sleep schedules and creating a comfortable sleeping environment.
  • Engage in low-impact activities such as swimming or cycling to stay active without overstraining joints.
  • Wear supportive shoes for ankle stability.
  • Apply heat to soothe sore joints and use ice on injuries to reduce swelling.
  • Rest and elevate injured joints for recovery.

Hypermobile Patients with ADHD

Prevalence of Hypermobility in ADHD Patients

Emerging data indicate a higher prevalence of hypermobility among those diagnosed with ADHD compared to the general population.

  • 50% of participants with a diagnosis of Autism, attention deficit hyperactivity disorder (ADHD), or tic disorder (Tourette syndrome) demonstrated elevated levels of hypermobility, compared with just 20% of participants from the general population.
  • One study reported generalized hypermobility in 32% of 54 patients with ADHD, compared to 14% of a comparison group (22). 
  • Another study reported the prevalence of GJH to be 74% in 86 children with ADHD, compared to 13% of a comparison group (23).
  • Individuals with Ehlers-Danlos syndrome were 5.6 times more likely to have an ADHD diagnosis than those without Ehlers-Danlos syndrome.

Importance of Studying the Relationship Between Hypermobility and ADHD

Understanding the connection between these conditions is crucial for developing more effective treatment strategies and improving patient care.

Clinical Implications of Hypermobility in ADHD Patients

This connection underscores the need for healthcare providers to screen for both conditions when symptoms of one are present, ensuring comprehensive care.

ADHD in Children and Hypermobility

A child performing a backbend on a riverbank, a display of physical flexibility that might be related to hypermobility, often discussed in the context of ADHD.

Relationship Between Hypermobility and ADHD in Children

In children, hypermobility and ADHD can significantly affect physical and educational development, necessitating early interventions and support. Kids with ADHD can become easily distracted, fidgety, and academically disengaged. They can exhibit lagging executive function skills that require targeted support. 

Effects of Hypermobility on Child ADHD Diagnosis and Management

Hypermobility may complicate the diagnosis and management of ADHD in children, affecting their academic performance and physical activities.

Treatment and Management Strategies

Medication and Psychological Support

A combination of medication for ADHD and physical therapy for hypermobility can be effective, alongside psychological support to address any emotional or mental health challenges.

Quality of Life and Coping Strategies

To manage a quality of life with comorbid conditions requires effective coping strategies and resilience. Strategies focusing on improving daily living and reducing symptoms can significantly enhance the quality of life for individuals with both conditions. 

💡Reduce ADHD Symptoms

💡Improve Executive Functions

💡Reduce pain

💡Improve muscle strength and fitness

💡Improve posture

💡Improve your sense of your body’s position and movement (proprioception)

💡Correct the movement of individual joints

Integrated Care Approaches

An integrated care model, involving a team of healthcare professionals, is essential for effectively managing the co-occurrence of these conditions.

💡Physiotherapy and exercise

💡Occupational therapy

💡Podiatry

💡Pain management

💡ADHD Coaching for young adults and parents

Physical Therapy and Exercise Recommendations

Specific exercises and therapy can strengthen muscles around joints, improving stability and reducing hypermobility symptoms. A wide range of exercise techniques can be used. You may be advised to follow an exercise program that includes strength and balance training, special stretching techniques and advice about pacing.

Future Directions in Research and Treatment

Technological Advancements and Innovations

Technological advancements and innovations in the study of the link between joint hypermobility and neurodivergence are focusing on areas like genetic sequencing to identify specific genetic markers, wearable technology to monitor joint movements and stress, and AI-driven data analysis to understand complex symptom patterns. These technologies aim to improve diagnosis, personalize treatment plans, and enhance our understanding of the physiological underpinnings of these conditions.

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Conclusion

In navigating the complexities of hypermobility and ADHD, it’s clear that awareness, understanding, and targeted care are essential. As we continue to explore the connections between neurodiversity and physical health, the role of technological advancements and integrated care approaches becomes increasingly significant. To those navigating these challenges: you are not alone. Resources and support are available, and further research promises new insights and solutions. 

Take the next step towards better ADHD awareness and management by contacting Effective Effort Consulting or scheduling a free screening call with Dr. Murphy. Let’s work together towards a more informed, supportive future.

FAQs

How do hypermobility and ADHD affect aging, and what long-term care plans are recommended?

As individuals with hypermobility and ADHD age, they may face increased challenges, including worsening joint pain and the potential for increased ADHD symptom severity. Long-term care plans often emphasize a holistic approach, focusing on maintaining joint health through physical therapy and managing ADHD symptoms with appropriate medication and cognitive strategies.

Can lifestyle changes impact the severity of symptoms in individuals with both hypermobility and ADHD?

Yes, lifestyle changes, such as a balanced diet, regular exercise tailored to joint care, and structured routines, can help manage and sometimes reduce the severity of symptoms associated with both hypermobility and ADHD. Mindfulness and stress management techniques can also play a crucial role.

Are there any specific occupational or physical therapy techniques beneficial for adults with ADHD and hypermobility?

Occupational and physical therapy can be highly beneficial, focusing on strengthening exercises that improve joint stability and ergonomic assessments to reduce strain during daily activities. Techniques that enhance fine motor skills, alongside strategies to improve executive functions,  focus and organizational skills, are also valuable.

What are the educational implications for children with hypermobility and ADHD?

Children with hypermobility and ADHD may struggle with academic skills like handwriting, homework, and notetaking. They may require tailored educational support to accommodate physical discomfort and learning challenges. This can include individualized education plans (IEPs), accommodations for seating and writing, breaks for movement, help with attention and planning, as well as specialized teaching strategies that cater to attentional needs. Collaboration between healthcare providers, parents, and educators is key to ensuring these children can thrive academically.