Joint hypermobility exists on a spectrum from increased mobility in a single joint to being a feature of a syndrome or systemic condition. It’s important to remember that people with hypermobility may not necessarily have a connective tissue disorder or syndrome. Some people are simply hypermobile but do not have any symptoms that impact their daily lives.
How common hypermobility is can also vary depending on how it is assessed, physical fitness, age, sex, race, population, and more. It is estimated that that between 5-40% of children have joint hypermobility, and 10-20% of adults.
Children are often hypermobile. Diagnosis of any other condition like Ehlers-Danlos Syndrome would not be investigated earlier than age 6 in hypermobile children. Many children grow out of hypermobility as they grow.
Types of joint hypermobility and causes
There are currently 4 types of joint hypermobility recognized (1)
- Localized joint hypermobility (LJH): LJH affects a single small or large joint and may be bilateral (e.g. both wrists)
- This could be inherited or acquired from disease, joint injury, surgery, or training
- Peripheral joint hypermobility (PJH)
- Hypermobility in the hands and feet (without large joint involvement)
- This is found commonly in children
- Generalized joint hypermobility (GJH)– Joint hypermobility at multiple sites
- Joint hypermobility at the four limbs
- This is more often congenital or inherited
- Acquired forms do exist including inflammatory diseases, degenerative joint conditions, or endocrine disorders
- Historical joint hypermobility (HJH)
- Adults who have presumably lost their GJH
Several genetic conditions can be associated with joint hypermobility. Some of these include:
- Hypermobile Spectrum Disorder (HSD)
- Ehlers-Danlos Syndrome (EDS)
- Marfan syndrome
- Loeys-Dietz syndrome
- Beals syndrome
- Several types of skeletal dysplasia (abnormal development of bones, joints, and cartilage)
The Zebra Club
Hypermobility safe, affordable and effective movement, education and community in the comfort of your own home.
The Zebra Club is a programme based on the Integral Movement Method. In this programme I will carefully guide you through safe exercises to manage your pain.
Learn moreIdentifying symptoms and effects of hypermobility
Joint hypermobility can be a symptomless condition but can also be associated with much more widespread symptoms as is the case with EDS.
Some possible symptoms and manifestations of joint hypermobility include:
- Joint instability
- This can be due to the laxity of the tissues surrounding the joint. This can be inherited or acquired. Remember, instability is not the same as hypermobility, a joint can be hypermobile and move beyond its range of motion but still be stabilized by muscles and tendons.
- Joint injury or trauma
- This may be due to excessive joint injury and accumulated micro-injuries that may predispose a joint to early arthritis.
- Pain
- Occasional and recurrent pain
- Chronic pain (pain lasting longer than 3 months)
- This can lead to pain sensitization
- Impaired proprioception
Diagnosing joint hypermobility
Joint hypermobility is more of a descriptor rather than a diagnosis. However, if you have more extensive and body-wide concerns such as digestive issues, easy bruising, frequent sprains and subluxations, chronic pain, delayed wound healing, and more – in addition to joint hypermobility, it would be worth being assessed for a connective tissue disorder such as hypermobile Ehlers Danlos Syndrome (hEDS) or hypermobile spectrum disorder (HSD).
A note on HSD
In 2017, the diagnostic criteria for EDS, and specifically hEDS, was made more strict to assist in research in finding genetic markers, categorizing it as a body-wide and inherited connective tissue disorder. This led to the categorization of HSD, which includes joint hypermobility that still has clinical symptoms (symptomatic hypermobility) but may not fit into the strict hEDS diagnostic criteria.
HSD is the diagnosis when people with “symptomatic joint hypermobility do not have a rare type of EDS and do not meet the criteria for hEDS.” In practice, many people with HSD have just as many symptoms of hEDS and can be treated the same.
There are 4 types of HSD
- Generalized HSD (G-HSD)
- Generalized joint hypermobility or hypermobility throughout the body. This is likely the category that many who do not meet the strict hEDS diagnosis fall into.
- Peripheral HSD (P-HSD)
- Hypermobility in the hands and feet
- Localized HSD (L-HSD)
- Hypermobility is only present in a single joint or group of joints
- Historical HSD (H-HSD)
- History of generalized hypermobility throughout the body
Managing and treating joint hypermobility
There are many ways to manage joint hypermobility and reduce pain associated with hypermobility. Examples include:
- Physiotherapy or physical therapy can help build strength and stability around the joints.
- Joint protection strategies like avoiding high-impact sports or activities that may put strain on the hypermobile joints.
- Orthotics for shoes can help reduce foot pain and improve posture and joint alignment.
- Using braces or splints on hypermobile joints can help avoid strain and injury.
- Pain management: speaking to a health professional about pain medications may be helpful for many people.
- Posture and body mechanics: working with someone to improve overall movement patterns and an integrated posture can really help manage hypermobility.
- Occupational therapy can be very helpful as a hypermobility management plan.
Online Course
Strengthen your Hypermobile Core
Some 10-25% of individuals have some degree of joint hypermobility and for many it’s not just about being bendy – it can disrupt your day-to-day life in many ways you may have come to accept as ‘normal’.
Do you experience pain, fatigue, repeated soft tissue injuries or digestive issues? Does the thought of movement and exercise cause you anxiety and fear? Let me help you develop a strong, stable body in a healthy, safe way.
On this course, I demonstrate and explain every exercise, including ‘watch for’ points for the hypermobile body. You can work from the comfort of your home, at your own pace. When these exercises are practised regularly, your strength and stamina will grow.
You will:
- Learn more about a safe and effective movement programme
- Look at six key areas that are essential for a healthy hypermobile body and mind: Breath, Relaxation, Proprioception, Stability, Balance, Posture.
- Build confidence and learn to enjoy exercise
- Be coached by someone who can relate to your challenges
- Strengthen your core and feel stronger every day
Physical therapies and exercises
We know that appropriate exercise and movement practices that are adapted for hypermobility are important to the long-term management of symptomatic hypermobility.
My Integral Movement Method (IMM) for hypermobility has six guiding principles that allow for safe hypermobility exercise. These are Breath, Relaxation, Proprioception, Stability, Balance, and Posture.
Movement does need to be tailored for hypermobility. It needs to include isometric, eccentric, and concentric exercises. People with hypermobility sadly often do not do well with traditional physical therapy approaches and it does need to be adjusted.
Living with joint hypermobility: daily life and long-term strategies
You may need to adopt new strategies to manage symptomatic hypermobility.
If your child is struggling with hypermobility, please ensure their school is aware of the school toolkit. This can help provide schools with useful information on how to adapt school requirements.
Overall, it helps to learn as much about hypermobility as possible and ensure people are aware of your condition. We know the following can help with long-term management:
- Regular exercise
- this can be little and often. Check my YouTube channel for plenty of ideas and classes. I also offer The Zebra Club platform for a comprehensive program for hypermobility management.
- Pacing
- We may need to adjust our daily activities to ensure we do not overstrain joints or push through joint pain.
- Stress management
- we know stress can make many conditions worse. Pain is one of them, gentle breathing exercises or meditation can help.
- Emotional support
- Being able to connect with other people who have hypermobility can be really helpful. The Zebra Club offers a supportive online community.
Sources:
- Castori, et al. (2017) A framework for the classification of joint hypermobility and related conditions. American Journal of Medical Genetics.
- Nicholson, et al. (2022) International Perspectives on Joint Hypermobility: A Synthesis of Current Science to Guide Clinical and Research Directions. Journal of Clinical Rheumatology.
What clients say
I have Hypermobility Spectrum Disorder and since seeing Jeannie my posture has changed, my pain has reduced and the way I use my body is just different. If you are undecided about booking an appointment with Jeannie I would say definitely, do it, it’s an investment that you and your body deserve.
Newly diagnosed, it was so refreshing to find a professional movement teacher, with full empathy, and a most impressive wealth of experience. Within the first two sessions, my typical tension and bracing eased markedly, facilitated largely through my first encounter with Reformer Pilates. Then, seeing The Zebra Club app launched and grow over recent years, gives myself and the other members, a real sense of support, validation, and hope, that we can finally use safe and targeted movement practices, to substantially improve our symptoms and quality of life.
Jeannie’s program offered me a pain-free alternative complete with her astute assessment skills and her unwavering empathy. After sessions with Jeannie, I felt like my body had received a healing balm. I was able to practice her exercises without causing a flare-up or causing additional pain. It was like nothing I had ever experienced before. Most importantly, Jeannie’s program gave me hope. Today, because of Jeanie’s program, I have moved into trying so many activities that I would not have previously been able to do.
Working with Jeannie has enabled me to overcome many years of chronic pain and frustration. Her mentorship has been invaluable, and I am so grateful to have movement solutions for pain and fatigue instead of relying on medications or trying to ignore it and power through. The Zebra Club community is also hugely supportive and helpful for tips and tricks for dealing with hypermobility. I'm so thankful for Jeannie and The Zebra Club and highly recommend it to anyone dealing with hypermobility and chronic pain.
From age 11, I have had chronic pain and frequent subluxations. Diagnosed with HSD at 17, every type of therapy I was sent to only made things worse. Discovering Jeannie and working with her has been an absolute game changer. Jeannie's intimate understanding of the EDS body from her wealth of personal and professional experience is very unique. Her x-ray-like vision in detecting and correcting dysfunctional body mechanics is incredible. I have learned how to walk without pain, naturally not lock my hypermobile joints, and activate muscles I didn't know I had. When I first started with Jeannie, I was housebound, but now I am able to attend college full time and work part time.
I have worked with Jeannie Di-Bon face to face for a number of years. Her approach offered me hope and progress where others had failed and has allowed me to recapture confidence and function in my life. Whilst I continue to be a work in progress her expertise has allowed me to find hope for the future where it has historically been lacking.
Discovering Jeannie was a game changer for me. Having struggled with varied physical health problems since my childhood I went on a self-diagnosis journey after I had a problematic pregnancy and birth with my first child - which compounded all my existing health issues. Jeannie has offered patience, guidance and a wealth of knowledge which have helped me to accept, understand and work with my body. Re-educating my nervous system with Jeannie’s guidance has been a slow and gentle process. I feel now I have the tools to take my pain management and future health into my own hands as I understand how my “different” body works and why my body has reacted in certain ways in the past.
Some related services that have also helped our clients with Hypermobility
Managing your pain starts with learning with what is the right approach for you. Discover a range of services that can help you manage Hypermobility & EDS.
The Zebra Club platform
Begin your journey to safe, healthy, hypermobility friendly movement with our app today.
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Strengthen your Hypermobile Core
On this course, I demonstrate and explain every exercise, including 'watch for' points in the hypermobile body. You can work from the comfort of your home, at your pace.
View courseFrequently Asked Questions
Learn more about EDS & Hypermobility
No, you do not necessarily have EDS if you have hypermobility. There are many presentations of hypermobility ranging from asymptomatic hypermobility, hypermobility localized to one joint, or more systemic conditions like Hypermobility Spectrum Disorder or EDS.
I always say it’s not the exercise that’s wrong, but the approach to exercise. The only exercise I don’t encourage you to do are those that cause you pain. Even then you may be able to change the approach and get back to doing exercise you love.
Walking is not bad for hypermobility, it can be great exercise. However, if walking is causing increased pain we can work on things like gait, posture, and stability to improve this.
Research has demonstrated and important role for physical therapy in hypermobility management. However, it is important to work with a provider who is aware of hypermobility like those trained in The IMM. Physical therapy and movement therapy can help with joint stability, reduce pain, and improve function. Treatment should be individualized and appropriate to each person individually.
