Summary

The variation of generalized joint hypermobility rates by sport was previously undefined, this study identified standards for sport-specific GJH prevalence in a population of collegiate athletes.

Abstract

Background

Generalized joint hypermobility (GJH) is a clinical condition diagnosed by physical examination using the Beighton Score. Despite an increasing body of evidence regarding GJH and its association with skeletal injuries, there is a poor understanding of how the GJH prevalence varies by sport. The first step in understanding GJH and its importance in an athletic patient population, is to define how rates of GJH vary among athletes of different sports. The purpose of this study is to measure the Beighton score in a large cohort of collegiate athletes and identify standards for sport-specific GJH prevalence.

Methods

The Beighton scores were collected for 364 collegiate athletes in 16 different sports at a National Collegiate Athletic Association Division I program in the United States. The examinations were performed during the athletes' preseason physical by two orthopedic surgery residents with the use of a goniometer. Each patient’s demographics were recorded, including: age, gender, year in school, sport, height and weight. Athletes with Beighton scores of 4/9 or greater were diagnosed with generalized joint hypermobility. Binary logistic regression analyses were used to identify independent variables. A subgroup analysis was performed to identify independent variables among sports with both male and female athletes (tennis, cheer, diving, golf, soccer, swimming and basketball).

Results

364 athletes had a mean Beighton score of 2.7 (standard deviation (SD) ± 2.4). The mean Beighton score was different between the 16 sports (p < 0.001). The GJH prevalence was 30% overall and varied significantly among sports (p < 0.001). The rank order of GJH prevalence (%) in each sport and associated mean Beighton scores were: swimming (68%; 5.6 ± SD 2.6), soccer (53%; 3.4 ± SD 2.1), volleyball (47%; 3.4 ± SD 2.2), cheer (42%; 3.5 ± SD 3.1), fencing (40%; 3.4 ± SD 2.3), golf (38%; 2.8 ± SD 2.2), diving (33%; 3.8 ± SD 3.0), softball (33%; 2.3 ± SD 1.8), cross country (29%; 2.3 ± SD 2.3), lacrosse (28%; 2.3 ± SD 2.2), basketball (27%; 2.6 ± SD 2.4), tennis (23%; 2.2 ± SD 1.6), field hockey (15%; 2.3 ± SD 1.8), baseball (14%; 1.5 ± SD 1.7), American football (9%; 1.5 ± SD 1.5) and wrestling (7%; 1.4 ± SD 1.3). Female athletes had a higher average Beighton score (3.3, SD ± 2.5) compared to males (1.9, SD ± 2.0) (p < 0.001). The GJH prevalence also varied between female (42%) and male athletes (17%) (p < 0.001). Among sports with both female and male athletes, female sex (OR 3.44, 95% CI, 1.02 – 11.63, p = 0.047) and swimming (OR 8.01, 95% CI, 1.66 – 38.59, p = 0.0095) were independent predicators of GJH, while age (p = 0.51), height (p = 0.36) and weight (p = 0.28) were not.

Conclusion

Beighton score and the prevalence of GJH varied significantly between sports. Among sports with both female and male athletes, females and swimmers were independently associated with GJH.