Hypermobility and the hypermobility syndrome, part 2: assessment and management of hypermobility syndrome: illustrated via case studies.

Joint hypermobility syndrome (JHS) is a largely under-recognised and poorly understood multi-systemic hereditary connective tissue disorder which manifests in a variety of different clinical presentations. The assessment and management of patients with the syndrome is often complicated, requiring a comprehensive patient-centred approach and co-ordinated input from a range of medical, health and fitness professionals. The functional rehabilitation process is frequently lengthy, with education of the patient and family, sensitively prescribed and monitored physical therapy interventions and facilitation of lifestyle and behaviour modifications being the mainstay of the plan. Two typical but very different case studies are presented, each illustrating key aspects of the assessment and highlighting the variety of management strategies and techniques required by therapists to facilitate successful outcomes.