GHS (generalized hypermobility syndrome) and foot loading.

GHS: Generalized Hypermobility Syndrome

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We have all seen these types of clients/patients. They have joints that have more than ample full range. It is easy for them to hyperextend their elbows and knees. They can fold over and touch their toes, everything seems lax and flexible. What they need is help gaining more control of their joints. But what about their gait ? Albeit a focal study, finally someone has looked at how these people interface the ground,

The forefoot region received higher loading in GHS clients.
So what could this mean? Does it mean they have challenges transitioning from rearfoot to forefoot? Does it mean their center of pressure is more foreward biased ? Does it mean they have to impart heavier loads through the forefoot during gait to feel stable? Are they premature heel raisers thus showing the forefoot bias increase? There are many questions here, too broad for this study, but they are the keys to understanding how the GHS body interprets movement. Regardless, it is highly suspect that these clients dominate their gait with the calf muscle complex doing plenty of extra work. We suspect they will be toe clenchers/grippers ( ie, have increased toe flexor dominance) and this can have long term impact on things like metatarsal loads, neuroma formation, bunions, lumbrical weakness, fat pad displacement, hammer toes and many other related issues that occur with premature or excessive forefoot loading. They may even have a little of that vertical bouncy gait we often discuss. We will keep our eyes open for this stuff and keep you in the loop.

J Back Musculoskelet Rehabil. 2018 Nov 2. doi: 10.3233/BMR-170973. [Epub ahead of print]
Generalized hypermobility syndrome (GHS) alters dynamic plantar pressure characteristics.
Simsek IE1, Elvan A1, Selmani M2, Cakiroglu MA2, Kirmizi M2, Angin S1, Bayraktar BA3.