Hypermobility Explained: When Flexibility Becomes a Medical Concern
by Dr. Grace Downs
What Is Hypermobility?
Have you ever been called “double-jointed”? Do your joints seem to bend further than most people’s? You may have joint hypermobility — a condition where the joints move beyond the normal range of motion. While some people with hypermobile joints experience no symptoms and may even thrive in dance or gymnastics, for others, hypermobility can be a source of persistent discomfort, instability, and chronic pain.
Hypermobility is not just about being flexible. For many, it’s linked to a broader set of symptoms that impact daily life — and that’s where the connection to chronic pain becomes more serious.
Hypermobility Spectrum Disorders and hEDS
Hypermobility can exist on its own, but when it comes with symptoms like joint pain, fatigue, digestive issues, or easy bruising, it may fall under a category called Hypermobility Spectrum Disorders (HSD) or hypermobile Ehlers-Danlos Syndrome (hEDS).
These are connective tissue disorders. In people with HSD or hEDS, collagen — a protein that helps give structure and stability to tissues — doesn’t work as effectively, leading to joint laxity, skin fragility, and a host of systemic symptoms.
Why Does Hypermobility Cause Chronic Pain?
There are several reasons why hypermobility can be painful over time:
Joint Instability: Loose joints are more prone to subluxations (partial dislocations), sprains, and overuse injuries. The muscles around them often have to work harder to maintain stability, leading to fatigue and soreness.
Muscle Tension and Compensation: When joints don’t provide stable support, muscles compensate. This often leads to chronic muscle tightness and spasms, especially in the neck, back, hips, and shoulders.
Nerve Sensitization: Repeated injuries and inflammation may cause the nervous system to become more sensitive, leading to a lower pain threshold — a process known as central sensitization.
Poor Proprioception: People with hypermobility often have difficulty sensing where their limbs are in space, which can result in clumsiness or repetitive strain, further contributing to pain.
Associated Conditions: Fatigue, sleep disturbances, headaches, chronic digestive concerns, and conditions like POTS (Postural Orthostatic Tachycardia Syndrome) and mast cell activation may accompany hypermobility and amplify the pain experience.
Living with Hypermobility and Chronic Pain
Managing hypermobility-related pain is complex and often requires a multidisciplinary approach. There is no one-size-fits-all solution, but many people find relief with the following strategies:
Physical Therapy: Not all exercise is created equal. Physical therapy focused on stabilization, core strength, and joint protection (rather than excessive stretching) can help.
Pacing and Activity Modification: Learning to listen to your body and pace yourself can help reduce flare-ups. This includes alternating between activity and rest and avoiding extremes of motion.
Pain Management: Heat, massage, gentle movement, and in some cases, medications or injections, may be part of a comprehensive pain management plan.
Sleep Support: Poor sleep can intensify pain. Creating a restful sleep environment and addressing insomnia or sleep disorders is an important part of managing symptoms.
Mental Health Care: Chronic pain takes a toll on emotional well-being. Psychological support, including cognitive behavioral therapy (CBT) or pain reprocessing therapy, can help you cope with pain and reduce its impact on daily life.
Community and Advocacy: Many people with hypermobility feel dismissed or misunderstood by healthcare providers. Finding a supportive community or knowledgeable clinician can make a huge difference.
The Bottom Line
Hypermobility isn’t just about being extra flexible — for many, it’s a chronic condition that affects physical and emotional health. The path to feeling better often starts with recognizing the condition, validating the pain, and building a supportive, integrative care plan. If you or someone you know lives with joint hypermobility and chronic pain, know that you're not alone and there is help available. Schedule a visit to talk through options.
See you in Clinic,
Dr. Downs
Helpful Resources:
The Ehlers-Danlos Society (https://www.ehlers-danlos.com/ )
Hypermobility Syndromes Association (https://www.hypermobility.org/ )
Books: Disjointed by Diana Jovin, Living Well with Hypermobility by Isobel Knight