Classifying joint hypermobility: a comparison of three current classification systems

Background/aims: Joint hypermobility is an excessive range of motion in one joint and is related to increased injury risk and performance adaptations within sports and dance. Joint hypermobility classification lacks consistency across the literature which may hinder effective management. The aim of the study was to compare the prevalence of joint hypermobility across sex and sport-specific participation using three different classification systems. Methods: Joint hypermobility was assessed in 286 subjects composed of rugby players, netballers, dancers and female and male controls. The Beighton Score was used to measure joint hypermobility in the 5th Metacarpal joints, thumbs, elbows, knees and lumbar spine. Scores were subsequently categorised using three different joint hypermobility classifications previously reported by Beighton et al (1973), Boyle et al (2003) and Stewart and Burden (2004). Findings: The prevalence of “not hypermobile” varied considerably between classifications and this difference was greatest in female netball players and at its lowest in male rugby players. Within the “not hypermobile” category an additional 33 females and 5 males were “not hypermobile” with the Beighton et al (2005) and Stewart and Burden (2004) criteria which may highlight a sex consideration when assessing low Beighton scores. In the “distinct hypermobility” female subjects demonstrated sensitivity to classification system, which was most prominent in dancers. Conclusions: There may be a need for separate sex categories and the female dancer classification may require further categorisation to identify extremes of joint hypermobility more effectively which may aid injury prevention strategies.