Decoding Double Joints in the Shoulder: An In-Depth Exploration

The hypermobility of the shoulder joint may result from the following factors: 

• Genetics: Hypermobility may run in families suggesting a genetic predisposition ⁽⁵⁾. Individuals with a family history of hypermobility may be more likely to have double-jointed shoulders.
• Connective Tissue Disorder: Ehlers-Danlos syndrome is characterized by hypermobility due to abnormalities in collagen, a protein that provides structures to connective tissues ⁽⁴⁾. It affects ligaments and tendons in the shoulder joints.
• Muscular Imbalance: Weakness or imbalance in supporting muscles around the shoulder joints may contribute to increased joint mobility.
• Joint Capsule Laxity: If the joint capsule is naturally lax or becomes stretched, there may be increased joint flexibility.
• Hormonal Changes: Fluctuations in hormones, such as those occurring during puberty or pregnancy, may affect the elasticity of connective tissue ⁽⁶⁾. This may contribute to increased joint mobility.
• Injury of Trauma: Past injuries or partial dislocation of the shoulder joint can lead to increased laxity in the ligaments and contribute to hypermobility.
• Occupational or Recreational Factors: Participation in sports or activities demanding extreme flexibility in the shoulder joint may contribute to increased joint mobility.
• Nutritional Factors: Inadequate nutrition intake, particularly deficiencies of certain vitamins and minerals essential for maintaining joint health, may contribute to joint laxity.
• Neuromuscular Condition: Certain neurological conditions may impact the control and coordination of muscle, potentially leading to joint hypermobility ⁽⁷⁾.

A proper evaluation and diagnosis are needed if someone experiences joint hypermobility or double-jointedness, as it may be associated with underlying medical conditions or pose a risk of joint instability and injuries.

Increased joint mobility is the main feature of double-joint shoulders. Some of the problems associated include:

• Joint Instability: Increased joint mobility may lead to joint instability. This may lead to higher susceptibility to dislocations or subluxations, where the joint partially comes out of its normal position.
• Recurrent Dislocations: There may be repeated shoulder dislocations as the joint is more prone to slip out of place.
• Soft Tissue Injuries: Excessive mobility of the joint may contribute to increased stress on the surrounding soft tissues, including ligaments, tendons, and muscles. This makes them more prone to injuries such as strains and sprains ⁽⁸⁾.
• Muscle Imbalances: Hypermobility of joints may be associated with muscle imbalances. Weakness or lack of coordination in certain muscle groups can contribute to difficulties in stabilizing shoulder joints.
• Pain and Discomfort: Joint hypermobility can lead to pain and discomfort, especially when increased range of motion is not well-controlled or if the joint is frequently moving beyond normal limits.
• Impaired Functionality: Some individuals with hypermobility may experience limitations in daily activities and functional movement due to difficulties in controlling and coordinating joint movements.
• Increased Risk of Overuse injuries: Individuals with hypermobility may be at risk of overuse injuries as the joint may be subjected to repetitive stress without adequate support and stability.
• Postural Issues: Hypermobility of the shoulder may contribute to postural problems, affecting the alignment of the spine and potentially leading to discomfort or pain in other areas of the body.
• Development of Osteoarthritis: Over time, increased stress on the joint and soft tissue may contribute to the development of osteoarthritis in the shoulder.
• Functional Limitations in Sport and Activities: Hypermobility may affect the ability of an individual to participate in certain sports activities that require controlled and stable shoulder movement.

Treatment of double joint shoulders or hypermobility in the shoulder involves a comprehensive approach aimed at improving joint stability, preventing injuries, and enhancing overall shoulder function. 

Various strategies include ⁽⁹⁾: 

• Physical Therapy: A tailored exercise program is designed by a physical therapist to strengthen the muscles around the shoulder joint. This can help improve stability and control, and reduce the risk of dislocation and injuries.
• Strengthening Exercises: Exercises targeted for rotator cuff muscles and other muscles supporting the shoulder can help enhance stability. Resistance training helps in building strength and controlling hypermobile joints.
• Proprioceptive Training: Proprioceptive training focuses on improving joint awareness and control. These exercises help individuals sense and control the joint position and reduce the risk of accidental overextension.
• Range of Motion Exercises: Controlled range of motion exercises may help maintain flexibility while preventing excessive joint movements that may lead to instability.
• Postural Training: Addressing any postural issues is important to ensure proper alignment of the shoulders and reduce the risk of strain on surrounding tissues.
• Joint Protection Techniques: Learning techniques to protect joints during daily activities can be beneficial for individuals with double joints. This may include avoiding extreme range of motion or using adaptive strategies.
• Orthopedic Supports: In some cases, orthopedic support such as braces or taping may be recommended for additional stability to the shoulder joint.
• Education and Awareness: Educating individuals about the condition including the potential risk and proper management strategies can help empower them to make informed choices and reduce the likelihood of injuries.
• Avoiding Overuse: Individuals with double joints in the shoulder should avoid repetitive stress as it may lead to overuse injury. Adequate rest should be incorporated.
• Medical Interventions: In severe cases where conservative measures are not sufficient, joint stabilizing surgeries may be considered. Based on individual circumstances, healthcare professionals may make a decision.

Regular follow-up with a healthcare professional including a physical therapist and orthopedist is important to develop a treatment plan.

Double joints in the shoulder, are often indicative of hypermobility or joint hypermobility syndrome. Having an understanding of it is crucial for effective management and prevention of associated problems. A person with double joints in the shoulder can be at an increased risk of chronic pain and certain shoulder injuries.

Certain factors including genetic factors, connective tissue disorders, and muscular imbalance increase the risk of double joint in the shoulder. It may further lead to problems including joint instability, soft tissue injuries, and muscle imbalance, and may potentially impact daily activities and sports participation.

Treatment of double joints in the shoulder involves comprehensive management involving physical therapy, strengthening exercises, proprioceptive training, range of motion exercises, postural training, and joint protection techniques. Lifestyle techniques may involve avoiding overuse, maintaining a balanced activity level, and being aware of joint protection techniques. These may contribute to long-term joint health.

Management of double joints in the shoulder involves not only addressing immediate concerns but also promoting long-term joint health. By implementing a multifaceted and individualized approach, individuals with hypermobility can navigate the challenges associated with increased joint flexibility and lead active and fulfilling lives.