Whole Body Vibration Therapy: Benign Joint Hypermobility Syndrome (BJHS)

As a Physical Therapist, I often encounter individuals who suffer from more complex and often painful conditions.

These individuals, whether it is their joints (Rheumatoid Arthritis), their tendons or bursae (Connective Tissue Rheumatism), their muscles (Regional Myofascial Pain Syndrome) or their whole entire body (Fibromyalgia), struggle day in and day out with nowhere to turn.

Since I have utilized Vibration Therapy to treat these patients, one thing has been clear; the ability they have to push their bodies physically while reducing their pain is unlike any other intervention. Vibration Therapy as well as Vibration Training, when done correctly and safely, is a highly beneficial exercise program with little to no negative musculoskeletal stress.

Due to the unique complexities of the issues mentioned above, they are deserving of their own articles. My goal with this article however, is to raise awareness to another condition that in itself is a problem and can benefit from Vibration Therapy. A condition that has an increasing amount of connectivity to each of the above mentioned conditions…..

“Benign Joint Hypermobility Syndrome (BJHS)”

Definition:

This medical diagnosis, inaccurately termed “benign” usually takes anywhere from 2 – 5 years to be identified and properly diagnosed. It is defined as “the occurrence of musculoskeletal pain in and around hypermobile joints (otherwise referred to as joints with “loose” or “lax” ligaments) in the absence of systemic rheumatological disease”. The latter portion, I believe, is inaccurate as a general rule however, and time will likely prove this point.  So how exactly does BJHS become problematic and how does Vibration Therapy help?  It all starts and ends with communication.

Lost In Translation:

By nature, the function of ligaments is to provide stability to our joints. This stability allows the primary movers of our joints, the muscles, to carry out their functions efficiently. Surrounding all muscles and ligaments, and connecting everything together, is fascia. Within the ligaments, muscles, and fascial tissue are “reporting stations” (aka joint receptors) whose vital function is to relay the information relating to these specific tissues to our brain. This communication system is called Proprioception. This crucial information traveling to the brain determines the nature of the information going away from the brain. It is a two way street of dependency and includes not only messages to and from the connective tissue, but to and from other vital body functions. This information also dictates the release of nutrients and neuropeptides. Neuropeptides control our mood, energy levels, pain and pleasure reception, body weight, and ability to solve problems; they also form memories and regulate our immune system.

When these systems, as a result of hypermobility and the resulting movement dysfunction, become inefficient, the information systems become altered. This leaves us, with a reversal of roles (tight muscles and fascia around loose joints), and both an alteration in the transmission of the nutrients and neuropeptides as well as detrimental changes in circulation and oxygen supply. For the muscles fortunate enough to maintain their normal function, they inevitably compensate, become overworked, and develop internal dysfunction (Ever heard of a “trigger point”? That is internal dysfunction of a muscle).  Finally, to complete the downward spiral, with all of the above considered, the end result is unavoidable stress to the joints and their internal structure.

Re-establishing Communication and Function via Vibration:

To effectively treat BJHS you must selectively harness the mechanical energy of the platform to create proper restorative changes to “the system”. This can be accomplished in several ways:

• Increasing Local Circulation – Utilizing the muscle spindle (a reporting station) and the stretch reflexes it creates, we can rapidly restore local blood flow. In BJHS, this is crucial for restoring oxygen supply to the muscles so that trigger point (aka “knots’) reduction can occur. With reduced internal muscle tension, the muscle’s efficiency is restored, and there is improved permeability of the tissue to nutrients and fluids, including water. Water, a vital component of fascia further allows for improved connective tissue mobility. With better circulation and improved tissue mobility, tissue healing occurs more rapidly and restricted areas where nerves perforate the connective tissue are released. This all contributes to the mechanism by which we experience pain relief.
• Improving Muscular Stability – Through excessive stimulation of the muscle spindle, we can increase the tone (resting tension level) of the muscle. Normally known for aesthetic benefits only, in BJHS, this assists in creating muscular stability for a joint that is unsupported by its ligaments. Being that excessive mobility is where this syndrome originates, this benefit gets to the “root” of the problem and is the most crucial component of restoring normal function and eliminating pain.
• Improving Muscle Flexibility – For those muscles that have become shortened in an attempt to stabilize the joints, we can now utilize selective stretching positions on the platform to normalize their length. In this case, we utilize vibration and the overwhelming sensory feedback that it provides to “hush” the muscle spindle so that a rapid increase in length of the muscle is achieved. This must be done slowly and carefully to avoid harming the tissue.
• Improving Lymphatic Mobility – Although this is not specific to BJHS, the rapid amount of muscle contractions created by the vibration platform assists lymphatic system mobility. By stimulating the millions of one-way valves in this system, Vibration Therapy further improves the diffusion and movement of fluid between the cells. Better fluid movement means better cell health and improved tissue repair rate.
• Restoring Normal Communication – Finally, through stimulation of the proprioceptive system and its reporting stations that have been discussed in length already, we are able to improve body communication; this includes the speed, accuracy, and appropriateness of the information that is transferred between the body and the Central Nervous System. This restoration process, deserving of its own 100 page article, is the final step in maximizing the therapeutic applications of Vibration Therapy for BJHS.

Written by Gabriel Ettenson, MSPT

Gabriel is a Physical Therapist in NY, NY

You may contact him at equilibriumpt.com