| What We Treat
Hypermobility Spectrum Disorders
Bendy joints, frequent sprains, and pain that moves around? Hypermobility is common and often unremarkable — but when it comes with pain and instability, it needs a specific approach.
Overview
What Is Hypermobility?
Joint hypermobility means joints move beyond the usual range. It is common, present in a substantial minority of the population, and frequently causes no problems at all — it can even be an advantage in dance, gymnastics and music. A hypermobility spectrum disorder is diagnosed when hypermobility is accompanied by symptoms such as pain, recurrent injuries or instability, and other conditions have been excluded. Hypermobile Ehlers-Danlos syndrome sits at the more involved end of the same spectrum.
Use the buttons to see the main areas that need addressing.
Joint Symptoms
Recurrent sprains and subluxations, joints that feel unstable or give way, and pain that moves between joints. Symptoms often worsen with fatigue and improve with strength. Strengthening through the full available range is the mainstay of management.
Symptoms
How It Tends to Feel
Hypermobility spectrum disorders present with a characteristic mix of joint and systemic features:
Joints That Move Too Far
Ability to bend joints beyond the usual range, often noticed since childhood.
Recurrent Sprains and Subluxations
Joints partially slipping out and back, particularly shoulders, kneecaps and fingers.
Pain That Moves Around
Widespread or shifting joint pain rather than one consistently painful area.
Fatigue
Often the most disabling symptom, and frequently more limiting than the pain itself.
Poor Balance or Clumsiness
Reduced joint position sense makes coordination and balance harder.
Worse After Activity
A tendency to overdo things on good days and pay for it afterwards — the boom-and-bust pattern.
Causes & Risk Factors
What Drives It
Hypermobility is largely inherited, and symptoms arise from the interaction between joint laxity and the demands placed on the body.
Genetic Connective Tissue Variation
Differences in collagen structure are inherited, which is why hypermobility often runs in families.
Reduced Muscular Support
Where ligaments provide less passive stability, muscles must work harder — and weakness has a disproportionate effect.
Reduced Proprioception
Joint position sense is measurably reduced in hypermobile people, contributing to injury and instability.
Deconditioning Cycle
Pain leads to reduced activity, which reduces strength, which increases symptoms — a cycle that is very common and very breakable.
Hormonal Influences
Symptoms frequently fluctuate with the menstrual cycle and during pregnancy, reflecting hormonal effects on connective tissue.
The Approach
How Management Differs
The principles aren’t exotic, but the execution needs care. Progressions are slower, ranges are controlled, and pacing matters more than in most conditions.
Understanding
Get the framework right
- A clear explanation of what hypermobility is and, importantly, what it isn’t
- Establishing a realistic baseline of activity that doesn’t provoke flares
- Identifying the boom-and-bust pattern if it’s present
- Screening for features that warrant specialist referral
Tap through the stages. Slower progressions and better pacing are the main adaptations.
How We Can Help You
Treatment & Management
Management is about building active control where passive stability is reduced — and doing it patiently enough that the programme is sustainable.
What the evidence says
Exercise-based interventions have the strongest evidence for symptomatic joint hypermobility, with trials showing improvements in pain, function and quality of life. Programmes emphasising strengthening and proprioceptive control outperform generic advice.
There is no evidence that hypermobile joints need to be protected from loading — the opposite is true. Progressive strengthening is safe and effective, though progressions generally need to be smaller and more gradual than in the general population.
When to Seek Help
Red Flags — Don’t Ignore These
Hypermobility itself is benign. Some features warrant specialist assessment:
⚠ Seek medical assessment if you notice:
- A family history of aortic aneurysm, sudden cardiac death, or bowel or uterine rupture (needs specialist genetic assessment)
- Unusually fragile skin, poor wound healing, or widened scars
- Recurrent joint dislocations requiring reduction
- Marked dizziness or fainting on standing, or persistent digestive symptoms
- Neurological symptoms including new numbness, weakness, or changes to bladder or bowel control
Most hypermobility is benign. A family history of vascular or organ rupture, or unusually fragile skin, warrants assessment for rarer types of Ehlers-Danlos syndrome via your GP.
Common Questions
Frequently Asked Questions
Should I avoid exercise to protect my joints?
No — and this is the most important thing to get right. People with hypermobility are frequently under-loaded rather than over-loaded. Muscular control is what compensates for reduced ligamentous stability, so building strength is directly protective.
Should I stretch?
Generally, less than you might think. Hypermobile joints already have plenty of range, and stretching into end range can increase instability and irritation. Building strength and control through the range you have is far more useful.
Is this the same as Ehlers-Danlos syndrome?
They sit on a spectrum. Hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome share the core features and the same management approach, differing in specific diagnostic criteria. Rarer types of EDS involve vascular and skin fragility and need specialist assessment.
Why am I so tired?
Fatigue is one of the most commonly reported symptoms, and it’s genuine. Holding hypermobile joints stable requires more continuous muscular work, and disrupted sleep from pain compounds it. Building endurance and improving pacing both help substantially.
Build Control, Not Protection
A programme that builds the strength and control hypermobile joints need — progressed carefully enough to be sustainable.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.