Hypermobility and ACL.

First of all, as always the link of the research we are discussing today.

https://pubmed.ncbi.nlm.nih.gov/31798951/

In recent readings, I've learned more about how hypermobility can affect other injuries or their recovery. This, along with my particular interest in knee injuries, led me to the above article and to analyze how I am incorporating it into my practice.

According to the systematic review, and I am copying directly from the conclusion: "In men, GJH was associated with an increased risk of unilateral ACL injury. Moreover, GJH was associated with greater postoperative knee laxity and inferior patient-reported outcome". In other words, there is an inherent link between hypermobility and post-operative recovery from an ACL reconstruction.

My question is: Can we apply this to other injuries and operations? Are we required to test for hypermobility when rehabilitating someone after tendon and ligament surgery? The answer is clinical history and common sense. Hypermobility tends to affect systemically connective tissues (ligaments and tendons) increasing their flexibility, sometimes to the extent of becoming lax; so we can assume that this same principle would be applicable to other structures and not only to the ACL. According to this, we should be adapting our exercise programs to patient requirements, if someone shows signs of hypermobility, then maybe we should restrict stretches and emphasize strengthening and proprioceptive exercises.

Personally, what I have learnt after reading and analyzing this piece of research is to be aware of the impact that hypermobility can have in the recovery process and how adapting our treatment accordingly can prevent re-injury and optimize rehabilitation.