Prevalence and features of joint hypermobility among adolescent athletes

Objective: To determine the prevalence of joint hypermobility in a group of adolescent, interscholastic athletes. Design: Cross-sectional; descriptive or observational. Setting: Free preparticipation physical examinations for sports. Subjects: Two hundred and sixty-four athletes (150 male, 114 female; average age, 15.5 years) comprised the entire set of athletes who came to our clinic for free physical examinations. Intervention and Main Outcome Measures: We screened 264 athletes using the widely accepted Carter-Wilkinson-Beighton method, which examines range of motion at the knees, trunk, fingers, thumbs, and elbows bilaterally and employs a 0 to 9 scoring scheme (5 = hypermobile). We also used an ''injury allowance,'' whereby if an athlete screened positive for only one side of a bilateral test but had a history of injury to the corresponding side, he or she was given an injury allowance point. Results: Thirty-two scored 5 or higher, with another 2 screening positive for hypermobility by the injury allowance, for a total of 34 hypermobile athletes (12.9%). There was a highly significant difference between sexes (P < .001), with 25 female (22%) and 9 male subjects (6%) testing positive. Conclusions: The overall prevalence of hypermobility and the significant sex difference found in this group of adolescent athletes were similar to nonathlete populations of comparable age. Research on nonathletes has been relied on by many to recommend that hypermobile persons avoid strenuous physical activity; however, research on athletes is less than conclusive. Given that a significant segment of young athletes, especially females, may be hypermobile, prospective studies are warranted to investigate this question before we can justify depriving hypermobile youths of the many known benefits of regular or strenuous exercise.