Assessing Hypermobility Assessment starts when the client walks in the door. Look for a loose-limbed gait or a tendency to turn the body by lateral rotation at the hip rather than through the spine. The loosened ligaments that allow a fallen arch may have loosened counterparts elsewhere in the body. When taking the client's history, look for a pattern of joint dislocations, especially one that involves multiple joints. Look also for other indications that may implicate connective tissue, such as heart-valve problems and generalized joint pain.
Visual assessment continues when the client is on the table.
Look for signs of bruising or unusually loose skin. Hypermobility at one joint on one side is likely to come from injury or repetitive motion at that joint. Bilateral hypermobility at multiple joints indicates a systemic cause. If you see evidence of the latter, you might tell the client that hypermobility is not necessarily a sign of anything wrong but that her primary health care provider might want to know about it. In general, beware of stretching an already hypermobile joint.