Abstract

Joint hypermobility is largely understood as a dysfunction of collagen fibers within connective tissues, allowing for a range of motion markedly increased over validated normal values. The ulnar collateral ligament (UCL) of the elbow provides stability to the elbow during valgus stress and, thus, has great significance in overhead throwing sports due to its susceptibility to injury. Our cross-sectional study explored the relationship between the length and width of the anterior bundle of the ulnar collateral ligament of the elbow and joint hypermobility. Two hundred and eighty-four undergraduate students completed a Beighton score assessment. Ultrasound images of the participants’ UCL were obtained in both arms at rest and under gravity induced valgus force. Sixty-one participants reported hypermobility in at least one elbow joint, and hypermobility in one elbow joint was correlated with hypermobility in the other. There were moderate correlations between UCL thickness and joint gapping between left and right elbow joints. However, there was no significant difference in UCL anterior bundle thickness or medial elbow joint gapping at rest or under valgus stress between those with and without hypermobile elbow joints. The thickness of the anterior bundle of the UCL and humeroulnar joint gap at rest moderately correlates to corresponding thickness and width under valgus stress. There is no significant difference in UCL anterior bundle thickness or joint width in people with elbow hypermobility and those without.

Highlights

  • Joint hypermobility is typically defined as the ability for a joint to move beyond the normal range of motion[1]

  • The thickness of the anterior bundle of the ulnar collateral ligament (UCL) and humeroulnar joint gap at rest moderately correlates to corresponding thickness and width under valgus stress

  • There is no significant difference in UCL anterior bundle thickness or joint width in people with elbow hypermobility and those without

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Summary

Introduction

Joint hypermobility is typically defined as the ability for a joint to move beyond the normal range of motion[1]. The Beighton score as a method for determining joint hypermobility was described by Beighton, Solomon and Soskolne[2] in 1973. While many people with joint hypermobility remain free from clinical symptoms, such as musculoskeletal injuries or pain[4,5], others suffer from joint hypermobility-related disorders ranging from hypermobile Ehlers-Danlos Syndrome (hEDS) to Hypermobility Spectrum Disorders[6,7]. Joint hypermobility in patients with Heritable Disorders of Connective Tissue (HDCTs) has long been understood as a dysfunction of the connective tissue on the cellular level[8]. It has been hypothesized that asymptomatic forms of joint hypermobility, such as GJH, are less severe variants of the same dysfunction. Joint hypermobility has been addressed as a decrease in the diameter of collagen fibrils due to heritable gene mutation[8]

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