Everything You Ever Wanted to Know About Hypermobility*

*but were afraid to ask.

Last Saturday, I was at Grand Lake in northeast Oklahoma with my family. There was an incident on a boat, which can be blamed neither on alcohol nor weather nor some reckless yahoo on a Ski-doo. Sadly, there is no one to blame but me… but I stepped down off the dock crookedly, and I twisted my right ankle. It just rolled outward and popped, and I went down like a sack of concrete.

I’ve had ankle sprains before, but nothing ever like this. Within minutes, it was swollen to the size of a softball. I was able to climb to a sitting position, but just barely; mostly, I spent the day lolling on the aft seat while people brought me Advil and cold beverages and ice packs wrapped in towels. I didn’t swim, I didn’t go on the Waverunners, I couldn’t go up and down to the docks like everyone else.

Soon, the swelling got colorful. It’s been a fine rainbow of bruises, from aqua and blue to purplish-red. I hobbled around the rest of the weekend, doing the PRINCE treatment and trying to stay off it. By the second day, it didn’t seem to be improving, so I made an appointment with my family physician in Dallas.

They took one look at it and sent me for x-rays. The x-ray technician took…well, three very radioactive looks at it, and referred me to an orthopedic surgeon—for the x-ray revealed “a tiny chip suggesting avulsion-type fracture of the lateral malleolus.” But whether or not the ankle was cracked or broken was inconclusive on the films.

Without the ortho opinion, all they could tell for sure was that I was not allowed to go down to Fair Park last night to see Wicked at the Dallas Summer Musicals. (And I had so been looking forward to it. I was invited by a colleague to a private dinner at the Music Hall before the show, with a themed menu. Wicked Wedge of the West with blue cheese crumbles. I promise I’m not making this up.)

So I stayed home, sulking on the couch—Ace-bandaged and ice-packed and elevated. I played Dr. Google while looking over the x-ray report, and I learned that the lateral malleolus is the bottom-most point of the fibula (leg bone) and it makes the outer bony protusion that you think of as your ankle, and that fractures to it are fairly common. I learned that ankle sprains are the most common injury that basketball players experience.

In fact, I read so much last night that I was sure I knew exactly what would happen in my exam today. (Cue foreboding music.)

So today, I saw a very nice orthopedic surgeon specializing in foot and ankle, and an orthopedic PA. They reviewed my x-rays. And they wiggled my right foot around, and poked and prodded it in ways that were clearly very scientific. They appreciated my Technicolor cankle to appropriate degrees.

And the diagnosis was that I do not have a fracture—just a severe sprain. Which was the good news.

The bad news is that I have ligamentous laxity or hypermobility— the clinical term for a life-long condition that in the olden days we called “double-jointed.”

Which I had always believed was a good thing. When I was a kid, it was a cool trick that I could bend my fingers from just the top knuckle, or bend my thumb back to touch my forearm. When I was in dance and gymnastics, it was an asset that I was so flexible. As an adult, it has impressed my stepkid that I am still closer to doing the splits at 30-something, with no practice, than she is at 14, with weeks of stretching.

I’m bendy. Always have been. It impresses people in gym class. More limber. More flexible. What’s not to love about that?

But as Dr. D. was asking me pointed questions about what kinds of joint injuries I’d had as a child (loads of them), and did I notice my joints clicking and popping in normal range of motion (yes!), and how far back I could bend my fingers (freakishly far)… the light bulb was slowly dawning. When I showed him the bizarre way I can rotate my elbows, he was sure.

There isn’t a lot of research in the U.S. on hypermobility. It’s a very prevalent diagnosis in the UK and Europe, but allegedly American doctors don’t diagnose it or pay much attention to it. (Which I believe, since I’m a textbook case of it and yet it took my first adult visit to an orthopedic specialist at age 36 for anyone to notice)

Every major injury I’ve had in life can tie directly back to this hypermobility: The hamstring tear in 10th grade. The broken wrist in 7th grade. The shoulders that I can dis- and re-locate á la Mel Gibson in Lethal Weapon. And the near-annual right ankle sprain (although never this bad).

And there’s the rub: it’s never been this bad before. But those loosey-goosey joints that were fun when I was young and springy are now just… loose. The doctor described my right ankle ligaments as stretched out and not keeping my ankle in place as designed. In fact, in two weeks, if my ligaments haven’t done a suitable amount of internal repair work, the ortho wants to talk surgery.

My hypermobile ligaments are not snapping back like a fresh rubber band. They’re lying limp, and I’m injuring myself.

If there is a silver lining to the rainbow sprain, it’s that I got examined by this orthopedic specialist and got a reality check about my ligaments and joints. I have to change a few things in my life, if I don’t want hobbling and aching to be the new normal.

Very simply, I have to build up my muscular strength, so that my muscles and bones can do what my worn-out ligaments apparently cannot: protect my joints.

Otherwise, I’ll be dooming myself to a life of missing out on fun like family lake weekends, and the “Wicked Wedge of the West.”

And I think we can all agree what a tragedy that is.

2 Comments

Misty says: 24 June 2010 - 10:30 am

Yep. I have the same problem, and it seemed to get worse after I had a baby. I have an issue with a shoulder that just won’t heal - a small tear in the superspinatus tendon, and hypermobility/subluxation of all of the muscles around my left shoulder, which has resulted in chronic pain. I always thought when I was younger that the double jointedness just meant I had a cool party trick that let my bend my thumb to touch my wrist. I have this subluxation protocol for strengthening the shoulder capsule, but it’s minimal help.

Fingers crossed for quick healing and no surgery!

Tracy says: 24 June 2010 - 10:35 am

Ugh, Misty, that’s what I’ve read…. that I should expect it to get even more pronounced if I have a kid, since pregnancy tells the body to loosen tendons and ligaments even more for childbirth.

I figure at some point I’ll just collapse into a bag of bones. Y’all will have to prop me up like “Weekend at Bernie’s.”