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Hypermobility

Stabilising joints and building strength for active lives

About Hypermobility

Hypermobility refers to joints that move beyond their normal range of motion. Many children are flexible without any symptoms — this is known as benign joint hypermobility. When hypermobility causes pain, fatigue, instability, and functional difficulties, it is diagnosed as Hypermobile Ehlers-Danlos Syndrome (hEDS) or Hypermobility Spectrum Disorder (HSD). The condition is significantly under-recognised and under-diagnosed; estimates suggest up to 3% of the population may be affected (Hypermobility Syndromes Association, HMSA). Physiotherapy is the primary recommended intervention for managing hypermobility-related symptoms, with a focus on joint stability, proprioception, strength, and pain management rather than further increasing flexibility.

Hypermobility is more common in children and young people, in females, and in certain ethnic groups including South Asian and Afro-Caribbean populations. Symptoms typically peak in adolescence when joints are under significant load from growth and sport. Fatigue and pain can have a significant impact on school attendance, sport participation, and quality of life.

Information sourced from: Hypermobility Syndromes Association (HMSA), NHS, NICE

Signs & Symptoms

  • Joint pain — particularly in the knees, hips, ankles, wrists, and fingers
  • Recurrent joint sprains, dislocations, or subluxations
  • Chronic widespread pain and fatigue
  • Poor balance and proprioception (joint position sense)
  • Flat feet or other foot posture abnormalities
  • Difficulty with activities requiring sustained posture — writing, sitting in school
  • Muscle weakness, particularly of the core and stabilising muscles
  • Poor stamina and post-exertional malaise in more complex cases (POTS)
  • Anxiety, sleep difficulties, and reduced quality of life

How Physiotherapy Helps

  • Joint stabilisation and proprioception training
  • Progressive strength training targeting core, hip, and lower limb muscles
  • Pain education and management strategies
  • Pacing and fatigue management
  • Gait analysis and advice on footwear and orthoses
  • Return to sport planning and load management
  • Hydrotherapy — warm water can ease pain and facilitate exercise
  • Advice on activity modification and ergonomics for school
  • Education for families on protective strategies and self-management

What to Expect from Physio4Kids

1

A thorough assessment of joint mobility, strength, balance, and pain levels

2

A progressive strengthening programme that respects symptom fluctuation

3

Education about the condition and the importance of active self-management

4

Liaison with rheumatology, paediatricians, or pain teams as appropriate

5

Advice for schools on supportive adjustments and physical activity

6

Written reports for EHCP, paediatric rheumatology, or legal purposes

Ready to discuss Hypermobility support?

Our specialist physiotherapy team has extensive experience supporting children and young adults with hypermobility. Contact us today for a free initial conversation.