What Is Hypermobility?

When you hear the term “hypermobility,” you might imagine someone showing off their ability to twist, bend, or contort their body in ways that seem almost magical. But hypermobility, in a medical sense, is so much more than just a cool trick or talent. This physiological symptom impacts the way the body’s connective tissues support and stabilize the joints.

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For some, hypermobility may be relatively harmless and might even feel like an advantage. For others, it can cause pain, fatigue, and a slew of other challenges that affect their quality of life. So, what is hypermobility anyway, and why does it matter?

The Basics of Hypermobility

Picture your joints as hinges, designed to open and close within a normal range. In those of us with hypermobility, these hinges open a little wider and bend a little farther than they should. This increased range of motion typically stems from an unusual elasticity in the connective tissues—ligaments, tendons, and cartilage—that are supposed to provide stability and limit excessive movement.

While hypermobility obviously impacts flexibility, it’s about how the entire musculoskeletal system responds to these looser, stretchier tissues. Some people can move with ease and grace. For others, this creates instability, discomfort, and vulnerability to injuries like sprains and dislocations.

What’s Happening in the Body?

The connective tissues in our body rely heavily on collagen, a structural protein that gives them strength and elasticity. In people with hypermobility, the collagen may be a bit different: less firm, more elastic, or less able to resist tension. This means the tissues stretch more than usual, allowing the joints to move beyond their typical range.

But there’s a tradeoff here, too. While elasticity allows for greater movement, it can also reduce the structural integrity of these tissues. Over time, this can lead to joint instability, micro-tears in the tissues, and even premature wear and tear.

Factors that Contribute to Hypermobility

• Genetics: If you have hypermobility, there’s a good change it runs in your family. certain inherited traits affect the structure and behavior of connective tissues, making hypermobility more common within families.
• Hormonal Influences: Hormones like estrogen can also influence connective tissue elasticity. This is one reason why women (or AFAB individuals) are more likely to be hypermobile than men are.
• Age: Children and teenagers are naturally more flexible because their connective tissues haven’t fully matured. As we age, collagen becomes less elastic, and hypermobility often diminishes.
• Activity Level: Athletes, gymnasts, and dancers may develop extreme flexibility through training, but this doesn’t necessarily mean they’re hypermobile in the clinical sense.

Hypermobility or Something More?

It’s important to differentiate between general hypermobility and conditions like hypermobility spectrum disorder (HSD) or Ehlers Danlos Syndrome (EDS). While someone who is hypermobile might only notice extra flexibility, those with HSD or EDS often experience chronic pain, fatigue, frequent injuries, and other system symptoms that require specialized care.

The Physical Challenges

For those of us with hypermobility, the extra range of motion in our joints come at a cost. Loose, stretchy connective tissue can’t always provide the stability joints need to stay aligned and supported during movement. As a result, hypermobile joints are more prone to:

• Injuries: Sprains, strains, and dislocations are common when joints move beyond their intended limits.
• Chronic Pain: Muscles often work overtime to compensate for joint instability, which can lead to soreness and fatigue. Pain can also come from wear and tear on the joints over time.
• Fatigue: The extra effort it takes to stabilize hypermobile joints can leave people feeling exhausted, even after what might seem like simple activities.

Systemic Symptoms

In more complex cases, the effects can extend far beyond the joints. Some hypermobile people experience systemic symptoms, including:

• Digestive Issues: Conditions like irritable bowel syndrome (IBS) are more common in individuals with hypermobility.
• Cardiovascular Symptoms: Blood pressure regulation can be an issue, with some people experiencing dizziness or fainting due to conditions like Postural Orthostatic Tachycardia. Syndrome (POTS) or other forms of dysautonomia.
• Skin Changes: Skin may also be more elastic, fragile, or prone to bruising, especially in conditions like EDS.

The Emotional Toll

The challenges of hypermobile don’t end at the physical symptoms, either. Many of us struggle with feelings of frustration or isolation, especially if their symptoms are dismissed or misunderstood. Being labeled as “just flexible” trivializes these conditions, delaying proper diagnosis and care.

Managing Hypermobility

Hypermobile life calls for finding ways to balance the body’s flexibility with its need for stability and support. While there’s no one-size-fits-all solution, effective management often involves a combination of different strategies meant to empower you with the tools and knowledge you need to reduce pain, prevent injuries, and feel more confident going about everyday life.

Strengthening Stability

One of the best ways to manage hypermobility is through targeted movement that strengthens the muscles supporting the joints. Core stability exercises, for example, can help provide a solid foundation for the body, reducing strain on hypermobile joints.

Low-impact activities like Pilates, yoga (with modifications), and swimming are particularly effective. These exercises not only build strength but also promote body awareness, helping you avoid movements that could overstress your joints.

Physical Therapy

PT plays a vital role in managing hypermobile, by focusing on building strength, improving movement patterns, and preventing injuries. A skilled physical therapist can design a personalized program tailored to the unique needs of someone with hypermobility. These programs often emphasize strengthening the muscles around these joints to provide much-needed stability.

In addition to strength training, physical therapists may focus on posture and body mechanics, teaching individuals how to move efficiently without overloading their joints. They may also provide education on avoiding harmful movement patterns, such as overextending or hyperextending joints during daily activities.

Pain Management

For those of us who deal with chronic pain, a holistic approach is often the most effective. Managing pain might include medications to address inflammation or reduce discomfort, but the emphasis is typically on long-term strategies.

Physical tools such as braces, orthotics, or kinesiology tape can also provide external support to joints, especially during activities that put extra strain on the body. These supports help stabilize the joints and alleviate some of the workload on muscles. Additionally, lifestyle changes such as pacing activities, incorporating rest breaks, and learning to recognize the body’s limits are essential.

Dispelling the Myths

One of the most common misconceptions about hypermobility is that it’s always an asset. While it’s true that increased flexibility can be beneficial for certain activities, hypermobility often comes with hidden challenges that aren’t immediately visible.

Another myth is that hypermobility is always obvious. While some people display impressive flexibility, others may not appear hypermobile at all. Instead, their symptoms might include pain, fatigue, or instability, which aren’t exactly easy to spot from the outside.

Hypermobility is a unique condition that affects everyone differently, from those who live without symptoms to those who face chronic challenges. The key to living well while hypermobile is understanding your body’s needs and finding ways to support its strengths while addressing its vulnerabilities.

If you suspect you may be hypermobile, don’t hesitate to consult a healthcare provide familiar with the condition, such as those listed in The Ehlers Danlos Society’s healthcare professional directory.