Helen McCormack talks to BAPO in "Focus On" Webinar


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  • Senior Orthotist Helen McCormack

Our senior orthotist, Helen McCormack, was invited to join The British Association of Prosthetists and Orthotics (BAPO) in one of its ‘Focus On’ webinars with the topic area of Hypermobility Management being discussed.

Helen spoke to an online audience of health professionals to raise awareness on a topic that is often misdiagnosed. Helen has been invited to continue the conversation at the BAPO national conference in October.

Hypermobility spectrum disorders (HSD) are a group of conditions related to joint hypermobility (JH). HSD are intended to be diagnosed after other possible answers are excluded, such as any of the Ehlers-danlos syndromes (EDS), including hypermobile EDS (hEDS). HSD, just like hEDS, can have significant effects on our health.

Indeed, Hypermobility and EDS is the topic of next year’s FORTH Conference, which will take place at Newcastle-Gateshead Hilton Hotel on 22 January.

Helen, said: “The aim of the BAPO webinar was to address what we already understand about these symptoms.

“As an orthotist, I first had exposure to hypermobility whilst undergoing university placements and really recognised the stigma attached to it.

“There are many obvious difficulties in diagnosing patients with Hypermobile EDS. Symptoms are wide-spread and can include extreme tiredness, joint pain, digestive problems such as heartburn constipation, dizziness, and many more, which is why pinpointing a diagnosis and treatment can be difficult.

“There are two key issues and they include lack of awareness and a lack of education. Early intervention is crucial with patients often being referred to a range of professionals including podiatry, occupational therapy, physiotherapy as well as ourselves, before a diagnosis is agreed upon.

“Historically, there have been issues over how best to treat patients with hypermobility and EDS. Early on in my career I came across a number of cases, one of which was the treatment of a 10-year-old girl. Rheumatologists diagnosed her with EDS but the physios disagreed and didn’t want to treat her for this. The problem being that EDS can exist by itself and as part of a more complex condition.

“After years of extensive research, the question still remains... How do you treat hypermobility and EDS? I have come to the conclusion that you can’t - but you can manage each case.

“In adults it can lead to osteoarthritis, premature arthritis and in children there can be issues with mobility when crawling and walking. Via a case study, Kim Claydon, hypermobile syndrome association (HMSA) charity coordinator, joined us on the webinar and discussed her journey with hypermobility.

“It took 11 years from initial symptoms following a car accident when Kim was aged 19 to diagnose her condition. Kim sufferers from a number of health problems including dislocations, slow wound healing, chronic fatigue and chronic pain, IBS and more.

“During the last 11 years, Kim detailed how her pain was dismissed and living with an undiagnosed case she faced a variety of difficulties. It was a chance meeting with an orthotist which led to her diagnosis and by this point she was struggling to walk. The orthotist she met instantly recognised that she was hypermobile and recommended orthotics for her shoes, which Kim still uses today. Getting her feet aligned really helped her to move and walk better and improved the quality of her life.

“Although we cannot cure hypermobility, by working together as an industry, we can treat and manage the condition whilst understanding the needs of an individual.

“Physically, we aim to reduce overloading of the joints and manage and improve the condition, by working with other professionals such as physios, to reverse acute pain and dislocation, promote strengthening, intensity and frequency and get patients to a point where they are strong enough to be taken off equipment, such as braces.

“Charting activity is one way of assessing how patients are managing. Education on the subject area within schools is crucial as is informing parents of practical tips for care. For example, small things, such as skin care routines, can really boost a patient not just physically but mentally.

“Essentially the key messages for health professionals are to know common associations, ask the correct questions, which is as simple as knowing if a patient has always been double jointed, when to refer for genetic testing and what we, as health professionals, can do to support a patient. This can include making a diagnosis, referring for podiatry assessment, addressing signs of anxiety and depression, reviewing their progress and providing support.”