Information for Schools on Hypermobility (Bendiness) - children and young people

What to remember

Hypermobility (bendiness) is a description of joint movement. 'Hyper' means more and 'mobility' means movement. Ligaments offer stability to joints and in hypermobility, ligaments are more lax and joints have more flexibility.

There are a wide variety of symptoms that can be associated with bendiness and each child can experience these differently. Some children can be very bendy without much or any pain, whilst others experience more pain. Some children may only have one or two of the problems listed below.

School challenges associated with hypermobile joints:

Pain:

Affects concentration, memory, attention and mood.

Clumsiness:

This can be due to their lessened proprioception (this is the sense that tells you exactly where your joints are positioned) and reduced co-ordination. This can make the pupil prone to falling over or tripping

Tiredness:

Many pupils have trouble sleeping due to pain. They tire more quickly during activities due to their weaker muscles.

Mobility:

Walking long distances and climbing up and down stairs can be challenging.

Difficulty sitting still for long periods of time:

This is due to pain, reduced stamina and poor proprioception.

Difficulty participating in PE:

This is due to pain, reduced stamina and poor proprioception.

Hand writing:

Overly "bendy" body and finger joints can make it difficult to sit well at a desk and grip the pen correctly. Lots of writing may cause pain over long periods of time.

Posture:

Maintaining prolonged, unsupported seating positions can contribute to back and neck pain

What You Can Do To Help:

Children and Young people with hyper mobility may require extra support to achieve their best in school and some minor modifications may be appropriate from time to time. The aim is to encourage your pupil to self manage their symptoms, attend school and take part in activities as able.

Most pupils will have specific physiotherapy exercises to do. These will help them increase their strength and stamina over time. Some pupils may also receive occupational therapy and psychological input to help them manage their pain.

General advice:

Pacing: This means to start at a slow, achievable level and then gradually increase an activity in order to achieve a goal. They must not do too much activity in one day but spread it throughout the week and focus on building more stamina and fitness.

Pain management strategies:

Try to distract the pupil by keeping them busy when in pain so that they don't focus on it. Encourage the pupil to use any relaxation or mindfulness they have learnt, if they are struggling in class.

Practical Strategies for the classroom:

Good posture is important, particularly for prolonged periods in front of computers.

To reduce the load on their back, the use of a locker may be of benefit

Try and limit the amount of time pupils have to sit unsupported for prolonged periods on the floor. Try and correct any w-sitting (sitting with their knees together and feet to either side).

Allow your pupil to move around in class when necessary. This will give them a break and allow them to manage their pain by changing their body position.

Some pupils may also benefit from a writing slope (even an A4 folder will help) to encourage a more upright posture.

If your pupil struggles with handwriting, larger pens or pencils grips may be of benefit.

If pupils struggle with the volume of writing, it may be useful to provide alternatives such as written worksheets or a laptop to reduce the time initially writing. The disadvantage of carrying a laptop should not be forgotten.

Some pupils may have difficulty walking long distances during outings and this may require forward planning/pacing

Good, supportive shoes are important, especially during PE. This gives them extra support during balance and activities that require coordination. Some pupils may require wearing insoles in their shoes.

All pupils are encouraged to take part in PE to their ability. Short breaks and paced activities can be of benefit. It is better to exercise 3 or 4 times each week using short exercise periods than only once for a long time. Swimming and cycling should be encouraged.

It is vital that the pupil/family and school are clear in their understanding of the condition, and that a self-management programme is the most appropriate long-term treatment approach.

The fitter and stronger the pupil is, the better it will be for their hyper mobility and general wellbeing.

For advice call please call the Children & Young People's Professionals' Advice Line on 01383 674055