Updated: Apr 27
If you’ve ever had a joint sublux or dislocate, you will know how painful this can be. In this article I’m going to share my thoughts on this complex issue that so often impacts the lives of people living with hypermobility or a connective tissue disorder like Ehlers-Danlos Syndrome. We are also sharing ourpractical approach on how to prevent subluxation.
First, let’s clarify the difference between a subluxation and a dislocation. Subluxations are much more common. It means that the two bones that form a joint will partially separate from each other and then return to their normal position. It’s also known as a partial dislocation. A full dislocation is when there is a complete separation between the two bones. Both of these scenarios can be very painful and stressful. Some people experience subluxations occasionally, but for some it is a daily occurrence.
When a joint does sublux, the body is going to attempt a few strategies of its own to attempt to stabilizethe joint. It’s going to give out some pain signals to stop you from moving that joint anymore. It will cause joint swelling to protect the joint and muscle spasms to protect the surrounding area.
The problem with living with frequent subluxations is that it is likely to create fear around movement in general. This is perfectly normal – if we think we are going to sublux, we are not going to move as muchand we will start to avoid actions that we think will cause a subluxation. A fear-avoidance strategy, however, leads to more stress and anxiety in general, together with a decreased muscle tone. Muscle tone is built by regular and appropriate exercise. Research has shown that movement is essential to a hypermobile body. If our muscle tone is not as strong as it could be, it seems to make sense that subluxations could happen more frequently. Due to lack of muscle tone, our postures lean towards what we call ‘hanging in our joints’ as opposed to engaged, resilient muscles supporting the joints. If I’m literally ‘hanging’ in my joints (and believe me, I used to) it makes sense that joints are potentially at greater risk of movement coupled with the force of gravity, pulling them out of alignment.
We end up in a vicious cycle avoiding the very thing that could help prevent subluxations in the future. Sowhat can we do to help prevent these happening in the first place? Here are our thoughts on what could be causing them:
1) Poor muscle tone and posture (as outlined above). Awareness of whole body alignment is going to be key.
2) Moving too fast with lack of control. For example, ever decided to throw a ball for your dog and then feel that shoulder joint ‘pop out’? Nothing wrong with throwing a ball, but we need to prepare the tissue to support this action.
3) Moving with too much load that the joint can’t cope with (because it does not have the surrounding muscle tone to support it). A classic example would be carrying a heavy shopping bag that is pulling downwards on the shoulder joint. The force of gravity is a big influence on subluxations – but gravity can also help you prevent them when used appropriately.
4) Moving into your end range with lack of control or awareness. Imagine reaching high up into a cupboard and not noticing your joints have locked out in the knees or elbows. Locking joints puts excessive strain on the joint: it could be another cause of subluxation.
5) Twisting actions without awareness. We often hear of hips subluxing when people get out of their cars. If the muscles surround the pelvis were more toned, could this help prevent a subluxation?
6) Accident or trauma to the joint could cause a subluxation.
7) Joint shape or surface – some people are born with shallower joint capsules. This is going to make them more prone to subluxation, but again strength in the surrounding area will help
You’ll notice a theme in all of these is movement, which brings us back to: how can we move correctly without subluxing a joint and causing more pain? The answer can be given by the right physical therapist who understands your unique situation. At Actify we “empower you through movement.” We literally heal patients by teaching and correcting the best movement patterns for your individual situation. In addition, our founder has EDS herself and is an expert on treating people with EDS through movement.
Are you interested in learning how you can help prevent subluxations, based on a unique movement program designed just for you? Click here to schedule a free phone consultation with our EDS specialist to learn how we can help you get back to doing what you love, without constant joint subluxations and pain.