By Andrew Siyabalawatte, Oct 2022
What Is Hypermobility Syndrome?
Hypermobility syndrome is a condition where joints move beyond the normal range of motion, often leading to pain, instability, and fatigue.
While some people with hypermobile joints never experience discomfort, for others, this flexibility can cause long-term musculoskeletal problems and impact quality of life.
Understanding the difference between normal flexibility and hypermobility syndrome is essential for early diagnosis and effective management.
Normal vs. Joint Hypermobility
In a healthy musculoskeletal system, joints allow the body to move within a specific range of motion (ROM) without damaging the connective tissues or compromising joint stability. This balance is maintained by a combination of bone structure, ligaments, tendons, and muscles working in harmony.
Hypermobility syndrome, however, occurs when these structures-particularly the connective tissues-are overly elastic.
This can happen in isolation or as part of broader connective tissue disorders such as Ehlers-Danlos syndrome (EDS).
In nonsyndromic hypermobility syndrome, the increased movement is present without the systemic complications seen in syndromic forms.
Causes of Hypermobility Syndrome
Hypermobility syndrome can result from several factors, often working together-
Genetics – Certain connective tissue disorders are inherited and affect the structure of collagen, a protein that gives ligaments and tendons strength and elasticity.
Collagen abnormalities – Weak or overly elastic collagen fibers lead to lax ligaments and unstable joints.
Developmental factors – Children and adolescents naturally have more flexibility, but in some, this persists into adulthood.
Hormonal influences – Some research suggests that hormonal changes, such as increased relaxin during pregnancy, may temporarily increase joint laxity.
Lifestyle factors – Repetitive overstretching from dance, gymnastics, or yoga can worsen joint instability over time.
Joint Hypermobility and Pain
Joint Hypermobility is a frequent cause of chronic pain and fatigue, affecting at least 3% of the general population. Its tissues are characterized by being highly stretchy and soft to the touch, often described as “dough-like skin.”
Other commonly associated conditions include scoliosis, fibromyalgia, gout, rheumatoid arthritis, and digestive issues.
Associated Conditions and Complications
Hypermobility syndrome can appear alongside or increase the risk of several other health issues, including-
Scoliosis – abnormal curvature of the spine
Fibromyalgia – widespread musculoskeletal pain and fatigue
Gout – inflammatory arthritis caused by uric acid buildup
Rheumatoid arthritis – autoimmune joint inflammation
Digestive problems – such as irritable bowel syndrome (IBS)
Temporomandibular joint dysfunction (TMJ) – jaw joint pain and clicking
These conditions can complicate diagnosis, as symptoms may overlap. Early recognition is vital to prevent unnecessary suffering and to develop a personalized treatment plan.
Hypermobility Syndrome and Chronic Pain
Joint hypermobility is more than just being “double-jointed.” For many people, hypermobility syndrome causes chronic joint pain, muscle fatigue, and even frequent injuries. Studies estimate that at least 3% of the general population experience significant symptoms from hypermobility syndrome.
One hallmark sign is soft, velvety, or “dough-like” skin, which reflects the underlying connective tissue laxity. Alongside pain, people may also experience joint swelling, muscle spasms, and reduced endurance.
How Do You Know If You Have Hypermobility Syndrome?
The Beighton Scoring System is the most widely used method for assessing joint hypermobility. It is a nine-point test evaluating flexibility in the following areas:
Knuckle of the fifth (pinky) finger – both hands
Base of the thumb – both hands
Elbows – ability to hyperextend beyond normal
Knees – ability to hyperextend
Spine – ability to place palms flat on the floor with knees straight
Each positive finding scores one point, with higher scores indicating greater hypermobility.
Watch a demonstration here
Living With Hypermobility Syndrome
Living with hypermobility syndrome means balancing your body’s flexibility with strategies to protect and strengthen your joints. Without proper care, the extra movement in joints can lead to micro-injuries, early-onset osteoarthritis, and reduced mobility.
Simple lifestyle adaptations can make a big difference:–
Avoiding high-impact sports that stress joints
Using supportive footwear
Maintaining a healthy weight to reduce load on joints
Practicing low-impact exercise like swimming or cycling
While there’s no “cure” for hypermobility syndrome, effective management focuses on strengthening muscles, improving joint stability, and reducing pain.
Treatment Options for Hypermobility Syndrome
1. Physical Therapy and Exercise
Targeted exercise helps build the muscles that stabilize hypermobile joints. Therapists often focus on core stability, balance, and proprioception (body position awareness). Strengthening these areas reduces the risk of injury and helps manage pain.
2. Massage Therapy
Massage helps relax overworked muscles and improve blood circulation, reducing pain caused by compensatory tension. For people with hypermobility syndrome, gentle techniques are preferred to avoid overstretching tissues.
3. Osteopathy and Chiropractic Care
These treatments can help restore joint alignment, ease discomfort, and improve function—especially when combined with strengthening exercises.
4. Pain Management Strategies
Heat therapy, anti-inflammatory medication, and gentle stretching can provide relief during flare-ups. In some cases, doctors may recommend joint injections to control inflammation.
Preventing Long-Term Complications
While hypermobility syndrome cannot always be prevented, you can reduce the risk of worsening symptoms by-
Staying active with controlled, low-impact movement
Building muscle endurance through gradual resistance training
Avoiding repetitive overstretching in sports or pilates
Seeking early intervention when pain or instability appears
Hypermobility Syndrome at Back To Health Wellness
At Back To Health Wellness, we’ve helped many clients with hypermobility syndrome regain strength, stability, and confidence in their movement. Our integrated approach combines manual therapy with exercise-based rehabilitation to support long-term joint health.
If you suspect you have hypermobility syndrome or struggle with chronic joint pain, we can guide you through a personalized plan. Book a session with us today and take the first step toward a more stable, pain-free future.