Yesterday, the ITV program ‘This Morning’ featured a discussion about whether children should be excused from PE with a note from their parents, or whether it should be brought in that a Drs note is required. During the phone in section, a member of the public, Sarah, spoke about how her child has hypermobility & has problems with aching legs & is subsequently up during the night as a result after PE lessons. So in this impromptu post I wanted to discuss my thoughts on This Morning’s Should Schools Ban PE Sick Notes? feature & explain the concerns I have regarding comments about hypermobility from Dr. Dawn Harper.
My first concern, comes from what the viewer herself said. She commented that her son has hypermobility. This is where an individual has a larger than average range of movement in their joints, but it is not detrimental to the person’s health. However, the viewer also mentioned that her son experiences pain as a result of his hypermobility. To me, this would indicate one of the hypermobility syndromes, whether it be Ehlers-Danlos Syndrome, Hypermobility Type or one of the other hypermobility syndromes listed below.
There is a lot of confusion among the terms used for this condition & it is entirely possible that the viewer has not been given correct information as to her son’s condition or she has not understood the information she has been given. The most commonly used terms for this condition are:
1. Hypermobility (not an accurate term, but it is still used)
2. Joint Hypermobility Syndrome
3. Benign Hypermobility Syndrome (suggesting that it does not affect the person, which is incorrect. This terminology is being phased out)
4. Hypermobility Syndrome (this definition is more of an umbrella term for connective tissue disorders that affect the collagen, including Marfan’s Syndrome, Osteogenesis Imperfecta, Sticklers Syndrome, Psedoxanthoma Elasticum or one of the EDS Types)
5. Ehlers-Danlos Syndrome (in this case usually hypermobility type, though all the types of EDS have hypermobility as a major clinical factor)
Let’s now turn to comments on this by the Dr. who was present as part of the discussion, Dr. Harper. Her response to the Sarah’s comment about her son was that “you might also refer to it as double jointedness… that can be predisposed to achy joints, but equally it can mean that you’re really good at things like gymnastics… To say that your son should be excused from PE or excused from doing PE would not be in his best interests in his long term health.” Firstly, being ‘double jointed’ is an outdated terminology that is not used in clinical diagnostics anymore. This is partly because it does not differentiate between those that are not affected in their daily lives & those that are. Also, yes, many people who have one of the hypermobility syndromes are good at things that require them to bend, such as gymnastics. However, there are many risks involved in ‘bendy activities’ for the individual with one of the hypermobility syndromes. Generally, we have poor proprioception. This means that we are unable to gauge where our bodies are in relation to things around us. This can result in bumping into things & also hyperextension, as we are unaware how far our limbs are from our bodies. A person with one of the hypermobility syndromes has stretchier ligaments, meaning that it is much easier to overstretch & cause things like sublease or dislocations. So yes, some people with one of the hypermobility syndromes will be good at ‘bendy’ sports, but they carry greater risks. I myself was good at pole fitness. However, I sublaxed my shoulder as a result of this & have been left with lasting damage that has been one of the contributing factors to my having to give up playing my oboe & pursuing a career as a professional musician! There are also a number of people for whom these activities are just not possible, because of the pain & damage they will cause or because of injuries they have sustained in the past. I am also shocked that a Dr. would that PE would be in the best interest of a child’s long term health without either a full medical history (because the hypermobility syndromes are complex) or examining the individual. I have sustained lasting injuries as a result of physiotherapy that was supposed to help my hypermobility (which was not at that point diagnosed as EDS, but suspected). That was from people who should have known better. How is a PE teacher supposed to make a judgement about what is suitable for a child with a hypermobility syndrome if a trained physio can’t?
On a more general note, whether the child in question has hypermobility (with no other symptoms) or has one of the hypermobility syndromes, it surprised me that the distinction wasn’t made between the two in order to let viewers know that there is a difference between general hypermobility that does not negatively impact a persons life to one of the hypermobility syndromes. By doing this Dr. Harper would also have provided the mother with information that could potentially have a positive impact on the way her son is treated. He might have been told he is hypermobile, but may have one of the hypermobility syndromes & not received a diagnosis yet, as so many of us fight for many years to gain these. This information may have allowed the mother to pursue a further diagnosis. If he has a hypermobility syndrome diagnosis it would have educated the mother as to the distinction, helping her provide better care for her son when she speaks to other professionals involved in her son’s care, including his school.
I was shocked when I came across the following on Twitter last night:
I would like to make a number of comments about this tweet. Firstly, it sounds like Dr Harper had one of the hypermobility syndromes & isn’t just hypermobile if she also experiences dislocations. If she understands hypermobility as a condition that can cause dislocations, why has she not made the distinction between the general hypermobility & the hypermobility syndromes, both on This Morning & in her tweet? A Dr. who doesn’t use correct terminology? That can’t be beneficial to anyone! It contradicts what Dr. Harper said on This Morning & just goes to strengthen my argument further. Why say that being excused from doing PE would not be in Sarah’s son’s best interests in his long term health if she understands the risks & doesn’t know the specifics of the child’s condition?
This feature on This Morning has been damaging to the community of people living with hypermobility syndromes. It is already hard for us to gain understanding from the general population. I’ve had friends shouted at for parking their cars in disabled parking spaces with their blue badges on show & their crutches holding them up. A number of friends who are part time wheelchair users because of the condition get derogatory comments made to them because people don’t understand the varying nature of the condition. By not differentiating between general hypermobility & the hypermobility syndromes, the comments made by Dr. Harper will add fuel to the opinions of mis informed individuals!
From my own experience of multiple chronic illnesses, I don’t think that a Dr.s note should be required for a child to not take part in PE & I don’t think that if a child is not well enough to do PE they shouldn’t be in school. However, that is a discussion for another blog post, as I know that chronic illness & general coughs & colds are very different. I also don’t want to take away from the way in which EDS & other hypermobility syndromes have been portrayed to the general public by ITV’s This Morning.
For more information on each of the hypermobility syndromes, as well as co-morbid conditions & information on management of the hypermobility syndromes, please check out the Hypermobility Syndrome Association‘s website.
Did you watch This Morning’s Should Schools Ban PE Sick Notes? What did you think of it? Do you have one of the hypermobility syndromes? How did this feature make you feel?
Find me on:
Bloglovin’ | Twitter | Instagram | Pinterest | Snapchat | Google+
You can also sign up for my newsletter!
Had a couple of interesting chats on Twitter about this last night.
What I hate most about Dr. Harper’s response was the fact that yes – flexibility in growing children is not uncommon and should not be sensationalised because it isn’t singularly indicative of a serious underlying problem…this comment needs further justification…stay with me…
BUT she was wrong in her advice to this particular parent whose child also appears to be suffering an abnormal amount of pain and discomfort as well – any doctor or therapist worth their salt should be advising further investigation – because checking for an underlying condition is not only about looking after said child in the present – it can have SERIOUS impact on their quality of life in the future.
At the end of the day, we are talking about a subset of problems that at their worst can be life endangering and life limiting (if not *just* dramatically life impacting.)
But also, this woman is advocating the refusal to listen and respond proactively to your child – if you stop affording credit to your child’s input, they will eventually stop trying to bring your attention to their issues at all – this has overwhelming implications for both the relationship and their quality of life in the future. Even if in this one circumstance there is no real problem, a parent who takes on this woman’s advice as a permanent blueprint is literally gambling with their child’s future state of mind and the risk that they may well miss something important down the line on the basis of a doctor on telly’s instruction.
It was a terrible way to present an issue that needed reams more context and a much much bigger allotment of time for further discourse and much closer inspection!
I completely agree with everything you’ve put here! I just don’t understand why she didn’t get more information from the caller & state that there is a difference between general hypermobility & the hypermobility syndromes. Her tweet is totally contradictory. I can understand that she was ‘thinking on her feet’ to respond to the call, but then to tweet what she did, contradicting herself. I can’t get my head round it if I’m honest! I just hope the mother is switched on & doesn’t take Dr. Harper’s advice at face value, though I’m sure it will have had the impact you described on some children who’s families were watching. Which is the last thing they need! Xx
I completely agree with everything you’ve put here! I just don’t understand why she didn’t get more information from the caller & state that there is a difference between general hypermobility & the hypermobility syndromes. Her tweet is totally contradictory. I can understand that she was ‘thinking on her feet’ to respond to the call, but then to tweet what she did, contradicting herself. I can’t get my head round it if I’m honest! I just hope the mother is switched on & doesn’t take Dr. Harper’s advice at face value, though I’m sure it will have had the impact you described on some children who’s families were watching. Which is the last thing they need! Xx
I don’t think it should be P.E compulsory at all. I’m sick of schools acting like they’re the be all and end all of decisions. Maybe some people may not want to tell everyone they have a medical reason they can’t participate an they just want to quietly sit out and not make a fuss, and it can’t be comfortable having to go to greater lengths than a note to be understood.
Also, Some people just don’t like P.E or doing sport in front of other people. Sport is not a nice experience in school. Why do schools think they can have free reign over parents these days?! Packed lunches, haircuts and P.E notes.. was bad enough when I left school in 2012 but I feel sorry for the kids growing up now!
Natasha Kendall | Beauty and Lifestyle
I think having PE as a compulsory subject is good in that it gets children active & some may not have had the opportunity to partake in sports outside of school. I don’t think any school should be able to override a parent who is trying to protect their child. They could bring in something similar to the absence fine that parents face if their child misses a certain amount of school without a valid reason. Then parents would be less likely to write letters when their child doesn’t need them & children would hopefully be less likely to skip PE too. It would take into account the various medical reasons a child may be unable to participate in PE without putting extra pressure on schools to be accountable for additional illness or injury to a child who shouldn’t be doing PE. When I was very poorly I didn’t have a diagnosis but my school were extremely supportive, both in terms of PE & support round the school. Xx
I think having PE as a compulsory subject is good in that it gets children active & some may not have had the opportunity to partake in sports outside of school. I don’t think any school should be able to override a parent who is trying to protect their child. They could bring in something similar to the absence fine that parents face if their child misses a certain amount of school without a valid reason. Then parents would be less likely to write letters when their child doesn’t need them & children would hopefully be less likely to skip PE too. It would take into account the various medical reasons a child may be unable to participate in PE without putting extra pressure on schools to be accountable for additional illness or injury to a child who shouldn’t be doing PE. When I was very poorly I didn’t have a diagnosis but my school were extremely supportive, both in terms of PE & support round the school. Xx
Well said Tania. I agree with your points. I think the advice given should have been for the parent to seek advice from the child’s GP. I don’t think it is right at all to state what she did and to muddy the waters as a result.
Thanks Donna! I’m really shocked that the parent clearly indicated that there was a more underlying problem & the Dr. gave out generalised (incorrect) advice without suggesting seeking further medical advice. I just hope the mother doesn’t take what was said as being correct, though I sure some individuals with one of the hyypermobility syndromes will be experiencing negative repercussions from family members who have watched the program & now think there’s nothing wrong with them! Xx
Thanks Donna! I’m really shocked that the parent clearly indicated that there was a more underlying problem & the Dr. gave out generalised (incorrect) advice without suggesting seeking further medical advice. I just hope the mother doesn’t take what was said as being correct, though I sure some individuals with one of the hyypermobility syndromes will be experiencing negative repercussions from family members who have watched the program & now think there’s nothing wrong with them! Xx
Great post :) I completely agree. Watching the entire discussion about sicknotes for P.E. made me annoyed. I feel like they were very quick to answer about the importance of fitness and exercise in schools, rather than fully taking into account what the callers were actually saying. I didn’t like the comment that if your child is not well enough to do P.E. then they are not well enough to be in school! I suffer from asthma, so it was really stressful, physically draining and often painful for me to participate in lessons that required a lot of running so I believe it would have been in my best interest health wise to allow me not to do cross country and other related activities because it would exhaust me for the rest of the day which would affect my concentration in class, I was still well enough to be at school.
When it come to the discussion with Sarah about her son, I thought it was really not acceptable the way the Dr. made light of hypermobility, without even asking whether her son had a hypermobility syndrome. Sarah mentioned that there are lots of children with conditions that are invisible and I think it would have been a perfect opportunity for the Dr. to discuss invisible illnesses and also explain the difference between hypermobility and hypermobility syndromes. I thought it was a very bold statement to say that P.E would be in the child’s best long term health interest without knowing if some exercise could be very detrimental to his health and cause lasting damage :( I want them to bring her back on the show and have her discuss what hypermobility syndrome is!
I think school is going to become very difficult for children with physical and mental health problems who try their hardest to get through a day of school as it is, without the added stress of P.E, if sicknotes are not considered on an individual child basis.
http://www.raiin-monkey.blogspot.com
I completely agree with you, they definitely tried to make Sarah sound like she was being overprotective & didn’t listen to her properly. Her son may very well have one of the hyermobility syndromes but because of the difference in terminology she may have only been told he is hypermobile. The comment about his pain straight away raise concern in me. I also 100% agree with you that it is not necessarily the case that if a child is not well enough to do PE, they shouldn’t be in school. My basilar type migraine was at it’s worst when I was 13. I was not allowed to do PE because my symptoms caused me to loose consciousness & I was loosing a lot of weight. The extra activity would have made this weight loss even more drastic. I too would have struggled more in my lessons after PE had I been forced to take part. Getting through a day was hard enough as it was. Can they genuinely say that I should have had to miss out on the rest of my education as a result of this? I did get to the point where I was not well enough to be in school & for half a term before that & half a term after I was on 1/2 days. My school did everything they could to make sure I missed out on as little as possible & I am eternally grateful to them for that. I would love to see ITV’s This Morning doing a feature on the hypermobility syndromes, but after her comment on Twitter & the apology Dr. Harper issued still not using correct terminology, I don’t think she would be the best person to deliver this. I completely agree with you that if this is brought in across the board it will make school life much more difficult for children with physical & mental health conditions & I can see it causing an increase in absence from school. Xx
I completely agree with you, they definitely tried to make Sarah sound like she was being overprotective & didn’t listen to her properly. Her son may very well have one of the hyermobility syndromes but because of the difference in terminology she may have only been told he is hypermobile. The comment about his pain straight away raise concern in me. I also 100% agree with you that it is not necessarily the case that if a child is not well enough to do PE, they shouldn’t be in school. My basilar type migraine was at it’s worst when I was 13. I was not allowed to do PE because my symptoms caused me to loose consciousness & I was loosing a lot of weight. The extra activity would have made this weight loss even more drastic. I too would have struggled more in my lessons after PE had I been forced to take part. Getting through a day was hard enough as it was. Can they genuinely say that I should have had to miss out on the rest of my education as a result of this? I did get to the point where I was not well enough to be in school & for half a term before that & half a term after I was on 1/2 days. My school did everything they could to make sure I missed out on as little as possible & I am eternally grateful to them for that. I would love to see ITV’s This Morning doing a feature on the hypermobility syndromes, but after her comment on Twitter & the apology Dr. Harper issued still not using correct terminology, I don’t think she would be the best person to deliver this. I completely agree with you that if this is brought in across the board it will make school life much more difficult for children with physical & mental health conditions & I can see it causing an increase in absence from school. Xx