Hypermobility and Physiotherapy

Living with hypermobile joints can often leave you feeling as though your body is at odds with itself. You might feel perfectly fine one minute, only for a routine movement to trigger joint aching, weakness, or sudden fatigue. It is common to be dismissed as merely “very flexible” – yet that extra mobility can lead to persistent discomfort and injury.

Generally, you’re born with hypermobility, even if symptoms or a diagnosis come later. While it is often recognised during childhood or adolescence, many people are not diagnosed until adulthood. Regardless of when the diagnosis is made, the core principles of treatment remain the same, with a focus on improving strength, stability, movement, and symptom management.

If your teenager or young adult has hypermobility, you’ve likely seen them cope with daily pain, fatigue, repeated injuries, and the challenges these symptoms can create at school, work, or socially. As a parent, it can be difficult to watch them struggle – especially when the wider impact of hypermobility beyond the joints is still not fully recognised by many healthcare professionals.

Having flexible joints is common, but when hypermobility causes symptoms throughout the body, it falls into specific clinical categories:

• Asymptomatic Hypermobility: Having joints that move beyond the normal range without causing pain, instability, or injury. Many people (including dancers and athletes) are hypermobile and experience no negative side effects.
• Hypermobility Spectrum Disorder (HSD): Diagnosed when hypermobile joints cause symptoms – such as pain, frequent sprains, or dislocations – that impact daily life, but do not meet the full criteria for a systemic genetic disorder.
• Hypermobile Ehlers-Danlos Syndrome (hEDS): A heritable connective tissue disorder where joint hypermobility is accompanied by wider, systemic body symptoms. Because there is currently no single genetic test for hEDS, it is diagnosed clinically by evaluating your symptom history and ruling out other conditions.

Why Does Hypermobility Affect More Than Just Joints?
Hypermobility stems from variations in collagen – the protein that acts as the body’s structural “glue”. Because collagen is present in connective tissues throughout the entire body, hypermobility can affect much more than just your arms and legs.

Common symptoms include:

• Joints & Muscles: Persistent joint pain, stiffness, frequent sprains or strains, joint subluxations (partial dislocations), and poor balance or coordination.
• Wider Body Symptoms: Fatigue, easy bruising, stretchy or fragile skin, dizziness upon standing, and digestive or bladder issues.

How Physiotherapy Helps
There is no “cure” for hypermobility, but you do not have to live in constant fear of injury or pain. The primary goal of physiotherapy is not to increase flexibility, but to build joint stability and muscle strength.

When your ligaments are naturally looser, your muscles have to work harder to hold your joints in place. A targeted physiotherapy program trains those supporting muscles to protect your joints effectively.

At ESIC, our strategies for managing hypermobility include:

• Targeted Strength & Stability: Progressive exercises (such as core work and Pilates) to strengthen the deep stabilising muscles around vulnerable joints.
• Proprioception Training: Improving your body’s awareness of joint positioning to prevent accidental overextension.
• Pacing & Load Management: Learning how to exercise and move without triggering pain flare-ups or fatigue.
• Posture & Ergonomics: Optimising daily habits and footwear to reduce unnecessary strain on your body.

Take Control of Your Movement
You shouldn’t have to live on high alert, second-guessing every step or giving up the activities that bring you joy for fear of another flare-up or injury.

Living with hypermobility means living with an unpredictable body: it can be exhausting, confusing, and frustrating. At ESIC, our team supports you in building lasting strength and body confidence. Rather than trying to ‘fix’ hypermobility, we help you understand your joints, manage your symptoms, and take back control.