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Hvem er hypermobil?

Hypermobilitet betyder, at et eller flere led kan bevæges ud over det bevægeudslag, man normalt forventer. Når hypermobiliteten findes i flere led i kroppen, bruges betegnelsen generaliseret ledhypermobilitet (Generalised Joint Hypermobility – GJH).

Hypermobilitet er ikke nødvendigvis et problem i sig selv. Mange mennesker er hypermobile uden smerter eller begrænsninger. Det er derfor vigtigt at skelne mellem at have hypermobile led og at have symptomer eller en egentlig bindevævstilstand.

En af de mest anvendte kliniske metoder til at undersøge generaliseret ledhypermobilitet er Beighton Score.

Beighton Score

Beighton Score er en simpel klinisk screening af bevægeligheden i fingre, tommelfingre, albuer, knæ og ryg. Testen består af fem bevægelser, hvor fire undersøges på både højre og venstre side.

Der kan opnås maksimalt 9 point.

De fem Beighton-tests

1. Lillefinger
Kan lillefingeren passivt bevæges bagud mere end 90°?

• Højre: 1 point
• Venstre: 1 point

2. Tommelfinger
Kan tommelfingeren passivt føres ind mod underarmen, så den berører underarmen?

• Højre: 1 point
• Venstre: 1 point

3. Albue
Kan albuen overstrækkes mere end 10°?

• Højre: 1 point
• Venstre: 1 point

4. Knæ
Kan knæet overstrækkes mere end 10°?

• Højre: 1 point
• Venstre: 1 point

5. Foroverbøjning
Kan du med strakte knæ bøje dig frem og placere begge håndflader fladt på gulvet?

• Ja: 1 point

Total Beighton Score: 0–9 point.

Illustration created with ChatGPT.

Hvornår betragtes man som generaliseret hypermobil?

Grænseværdien afhænger blandt andet af alder. I den internationale klassifikation fra 2017 anvendes ≥5/9 hos mænd og kvinder fra puberteten til 50-årsalderen som grænse for generaliseret ledhypermobilitet. Det samme cut-off anvendes i nyere ACL-forskning.
Det er vigtigt at understrege, at Beighton Score er et mål for generaliseret ledhypermobilitet – ikke i sig selv en diagnose. En høj score betyder derfor ikke automatisk, at man har Ehlers-Danlos syndrom eller en anden bindevævssygdom.

Hypermobilitet og sport

At være hypermobil betyder ikke, at du skal undgå sport eller fysisk aktivitet.

Der er dog nogle situationer, hvor hypermobilitet kan være relevant. Forskning har blandt andet fundet en sammenhæng mellem generaliseret ledhypermobilitet og øget risiko for knæskader, herunder skade på det forreste korsbånd (ACL).

Et svensk prospektivt kohortestudie fra 2023 undersøgte 1.198 patienter efter ACL-rekonstruktion. Her blev en Beighton Score på ≥5/9 anvendt til at definere generaliseret ledhypermobilitet.

Inden for de første to år efter ACL-rekonstruktion vendte:

• 49,2 % af patienterne med generaliseret ledhypermobilitet tilbage til sport.
• 57,3 % af patienterne uden generaliseret ledhypermobilitet tilbage til sport.

Forskellen var statistisk signifikant.

Studiet fandt derimod ikke nogen signifikant forskel i tiden til return to sport blandt de patienter, der vendte tilbage.

Forskerne konkluderede samlet, at en mindre andel af patienter med generaliseret ledhypermobilitet vendte tilbage til knæbelastende sport inden for de første to år efter ACL-rekonstruktion.

Skal man være bekymret, hvis man er hypermobil?

Nej – hypermobilitet er ikke det samme som sygdom.

 

Who Is Hypermobile?

Hypermobility means that one or more joints can move beyond the range of motion that would normally be expected. When hypermobility is present in multiple joints throughout the body, it is referred to as Generalised Joint Hypermobility (GJH).

Hypermobility is not necessarily a problem in itself. Many people are hypermobile without experiencing pain or limitations. It is therefore important to distinguish between having hypermobile joints and having symptoms or an underlying connective tissue disorder.

One of the most commonly used clinical methods for assessing generalised joint hypermobility is the Beighton Score.

Beighton Score

The Beighton Score is a simple clinical screening tool used to assess joint mobility in the fingers, thumbs, elbows, knees, and spine. It consists of five movements, four of which are assessed on both the left and right sides.

A maximum of 9 points can be achieved.

The Five Beighton Tests

1. Little Finger
Can the little finger be passively extended backwards beyond 90°?

• Right: 1 point
• Left: 1 point

2. Thumb
Can the thumb be passively moved towards the forearm so that it touches the forearm?

• Right: 1 point
• Left: 1 point

3. Elbow
Can the elbow be hyperextended beyond 10°?

• Right: 1 point
• Left: 1 point

4. Knee
Can the knee be hyperextended beyond 10°?

• Right: 1 point
• Left: 1 point

5. Forward Bend
With your knees straight, can you bend forward and place both palms flat on the floor?

• Yes: 1 point

Total Beighton Score: 0–9 points.

Illustration created with ChatGPT.

When Is Someone Considered Generally Hypermobile?

The cut-off depends, among other factors, on age. In the 2017 international classification, a Beighton Score of ≥5/9 in men and women from puberty up to the age of 50 years is used as the threshold for generalised joint hypermobility. The same cut-off has also been used in recent ACL research.

It is important to emphasise that the Beighton Score is a measure of generalised joint hypermobility – it is not a diagnosis in itself. A high score therefore does not automatically mean that someone has Ehlers-Danlos syndrome or another connective tissue disorder.

Hypermobility and Sport

Being hypermobile does not mean that you should avoid sport or physical activity.

However, there are situations where hypermobility may be clinically relevant. Research has identified an association between generalised joint hypermobility and an increased risk of knee injuries, including anterior cruciate ligament (ACL) injuries.

A Swedish prospective cohort study from 2023 investigated 1,198 patients following ACL reconstruction. A Beighton Score of ≥5/9 was used to define generalised joint hypermobility.

Within the first two years following ACL reconstruction:

• 49.2% of patients with generalised joint hypermobility returned to sport.
• 57.3% of patients without generalised joint hypermobility returned to sport.

The difference was statistically significant.

However, the study found no significant difference in the time to return to sport among those patients who did return.

Overall, the researchers concluded that a smaller proportion of patients with generalised joint hypermobility returned to knee-strenuous sports during the first two years following ACL reconstruction.

Should You Be Concerned If You Are Hypermobile?

No – hypermobility is not the same as having a disease.