Have you ever had friends tell you since you were little, "This guy is like a rubber ball, he can bend it any way he wants"? Maybe you can bend your toes back a lot more than others. Or maybe you feel like your knees are going backwards when you straighten them. This kind of excessive flexibility in joints, that is, in the joints, is what we medically call `joint hypermobility`. So is this a disease? Is this dangerous? You may be wondering how to test for this. That's what we're talking about today.
What is the Beighton Score?
Simply put, the Beighton Score is a simple test that measures how flexible, or bendable, your joints are. It's not a scary test that involves a big machine, blood draws, or anything else. It's just a few very simple activities that your doctor will do in person.
This test uses a 9-point scale. The higher your score, the more flexible your joints are. It's like grading an exam, but getting a higher score may not be a good thing. We'll talk about that later.
This test mainly focuses on these joints of yours:
- The base of the thumbs of both your hands
- Two elbows
- Two knees
- The middle joints of the little fingers
- Spine (spine)
Why is this baton test important?
This test is often done to help diagnose a condition called joint hypermobility syndrome , a common condition that affects about 3% of the general population, or about three in a hundred people.
But here's something important to understand. Not everyone who is very flexible has this condition. People like dancers and gymnasts have very flexible joints. It's a result of their training. But sometimes, this excessive flexibility can be a symptom of another underlying condition.
In particular, this condition can be associated with hereditary connective tissue disorders (HCTD). Simply put, connective tissue is like the 'gum' that holds our body's organs and tissues together and provides support. When this connective tissue weakens, joints begin to bend excessively. Some of these conditions include:
- Ehlers–Danlos syndrome (EDS)
- Marfan syndrome
- Osteogenesis imperfecta
Therefore, if your joints are excessively flexed and you are experiencing joint pain and frequent joint swelling, it is very important to see a doctor and talk about this.
How do you do this test? Let's see.
This test consists of two parts. In the first, your joints are moved into certain positions. In the second, you are asked some questions. All of this is done by your doctor. You should not try to do these things yourself at home.
| Maneuver | How points are given |
|---|---|
| Part One: Physical Activity (Total 9 points) | |
| Can you bend forward and place both palms fully on the ground without bending your knees? | If possible, 1 point . |
| Can you hyperextend your elbow beyond the normal straightness? | 1 point for each elbow (total 2 points) . |
| Can you hyperextend your knee beyond the normal range of motion? | 1 point for each knee (total 2 points) . |
| Can you bend your little finger back more than 90 degrees? | 1 point for each little finger (total 2 points) . |
| Can you bend your thumb back and rub it on the forearm? | 1 point for each big toe (total 2 points) . |
| Part Two: Questions about your past (Total 5 marks) | |
| Have you ever been able to place both palms on the floor without bending your knees? | "Yes" is 1 point . |
| Have you ever been able to bend your thumb and rub it on the underside of your hand? | "Yes" is 1 point . |
| When you were a kid, did you ever surprise your friends by bending your body in different ways? (e.g., could you do the splits?) | "Yes" is 1 point . |
| Have you ever dislocated your shoulder or knee more than once as a child or young adult? | "Yes" is 1 point . |
| Would you describe yourself as "double-jointed"? | "Yes" is 1 point . |
What to expect during the test?
This is a very simple, quick test. Your doctor will ask you to sit, stand, or lie down in bed. Then he will very gently touch your joints and have you do the activities mentioned above.
The entire test only takes a few minutes. The most important thing is that you won't feel any pain during this procedure . So there's no reason to be afraid.
This has no risks or side effects.
How do you understand the results of this?
You can know the results immediately. The doctor will do the activities with you, add up the scores, and tell you right there.
Joint hypermobility syndrome is usually suspected in the following cases:
- If you have a score of 4 or more on that physical activity scale and have had pain in 4 or more of your joints for more than 3 months.
- Or, if you answered 'yes' to 2 or more of the questions asked about the past .
But here's something you need to keep in mind: A high Batten score doesn't mean you have a serious condition like the Ehlers–Danlos syndrome we talked about earlier.
The Batten score is only one step in the journey to a diagnosis. It alone cannot tell you 100% whether you have a disease. Your doctor will consider many other factors, such as your symptoms and family history, and refer you for further tests if necessary.
Okay, my score is high. What do I do now?
If your Batten score is high, don't panic. The first thing to do is to talk to your doctor about it. He or she will explain what you need to do next. You can also ask him or her questions like:
- "Doctor, do I need to do any more tests?"
- "How do you treat this `joint hypermobility syndrome` condition?"
- "What can I do to improve the health of my joints and strengthen them? Are things like exercise good?"
- "How am I supposed to carry out my daily work with this situation?"
Your doctor will give you the advice you need, including possibly a referral for physiotherapy.
Take-Home Message
- The Beighton Score is a very simple, painless test that measures the flexibility of your joints.
- A high score means your joints are more flexible than normal. This condition is called `joint hypermobility`.
- Having flexible joints is not always a disease. Even very healthy people can have this condition.
- If you have a high score and symptoms such as long-term joint pain and frequent joint swelling, it is essential to see a doctor.
- This test is just the beginning of the journey to a diagnosis. It is not enough to diagnose serious conditions. Therefore, always discuss your results with your doctor.
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