Joint Hypermobility Syndrome
Excessively flexible joints that cause pain and injury
Quick Facts
- Type: Connective tissue / musculoskeletal condition
- Main feature: Joints that move beyond the normal range
- Common symptoms: Joint pain, sprains, dislocations, fatigue
- Management: Exercise, physical therapy, pain control
Overview
Joint hypermobility means that some or all of a person's joints can move further than normal. Many people with hypermobile joints have no problems at all and may simply be "double-jointed." Joint hypermobility syndrome is diagnosed when this extra flexibility is associated with symptoms such as ongoing joint pain, frequent sprains, or joints that dislocate easily, without another condition that better explains them.
The flexibility comes from differences in connective tissue, the material that gives ligaments and other structures their strength and stretchiness. Hypermobility often runs in families and tends to be more noticeable in childhood, lessening with age. While the syndrome is generally not dangerous, the symptoms can affect daily life and activity. Care focuses on protecting the joints, building muscle support, and managing pain. In some people, very flexible joints are part of a broader inherited connective tissue disorder, which is why a careful evaluation is helpful.
Symptoms
Symptoms vary widely and often center on the joints but can involve other parts of the body.
- Joint pain and stiffness, often after activity or at the end of the day
- Joints that sprain, partly slip, or dislocate easily
- A tendency to clumsiness or poor balance
- Muscle pain and fatigue
- Soft, stretchy skin or easy bruising in some people
- Digestive symptoms, dizziness on standing, or anxiety in some individuals
Children may be late to walk, tire easily, or have aching legs (sometimes called growing pains). The pattern and severity differ greatly from person to person.
Causes
Joint hypermobility syndrome is caused by differences in connective tissue that make ligaments and joint capsules more lax than usual.
- Genetics: Hypermobility commonly runs in families and is often inherited.
- Connective tissue makeup: Variations in collagen and related proteins make supporting tissues stretchier.
- Shape of the joints and bones: Differences in how the bones fit together can allow extra movement.
- Muscle tone: Lower muscle tone can contribute to a sense of looseness.
In a minority of people, hypermobility is part of a defined genetic condition such as a hypermobile connective tissue disorder, which a specialist can help identify when features point that way.
Risk Factors
- A family history of hypermobility or loose joints
- Younger age (flexibility is often greater in childhood)
- Female sex
- Certain ethnic backgrounds with naturally greater flexibility
- Inherited connective tissue conditions
Diagnosis
Diagnosis is based on assessing joint flexibility and symptoms and ruling out other conditions.
- Beighton score: A simple set of movements (such as bending the thumb to the forearm and over-straightening the elbows and knees) used to measure overall hypermobility.
- Medical history: Reviewing joint pain, injuries, family history, and other symptoms.
- Physical examination: Checking the joints, skin, and muscle strength.
- Tests to exclude other conditions: Sometimes used to look for inflammatory arthritis or a specific inherited connective tissue disorder when features suggest one.
Treatment
There is no cure, but symptoms can usually be managed well, and the main aim is to protect and strengthen the joints.
- Physical therapy: Targeted exercises strengthen the muscles around loose joints, improve stability, and reduce pain and injuries.
- Low-impact exercise: Activities such as swimming and cycling build fitness while protecting the joints.
- Pain management: Simple pain relievers, heat or ice, and pacing of activity help control discomfort.
- Joint protection and supports: Good technique, supportive footwear, and occasionally braces or taping for unstable joints.
- Education and self-management: Learning to avoid overextending joints and to balance activity and rest.
Most people manage well with these measures, and staying active is generally encouraged rather than avoiding movement.
Prevention
- Strengthen the muscles that support flexible joints with regular exercise
- Choose low-impact activities and use good technique
- Avoid pushing joints to the extreme end of their range
- Warm up before sport and pace activity to limit fatigue
- Use supportive footwear and protective taping for vulnerable joints
When to See a Doctor
See a doctor if very flexible joints are causing ongoing pain, frequent sprains or dislocations, fatigue, or difficulty with daily activities. An assessment can confirm joint hypermobility syndrome, rule out other conditions, and guide a strengthening program. Seek prompt care for a joint that dislocates and will not go back, severe pain or swelling after an injury, or new symptoms such as significant dizziness, fainting, or marked skin fragility, which may need further evaluation.
Frequently Asked Questions
Is being double-jointed the same as joint hypermobility syndrome?
Not exactly. Many people have hypermobile, or "double-jointed," joints with no problems at all. Joint hypermobility syndrome is diagnosed only when the extra flexibility is linked to symptoms such as ongoing joint pain, frequent injuries, or dislocations.
What is the Beighton score?
The Beighton score is a quick way to measure overall joint flexibility using a few movements, such as bending the thumb back toward the forearm and over-straightening the elbows, knees, and little fingers. A higher score indicates more widespread hypermobility and helps support the diagnosis.
Should I avoid exercise if I have hypermobile joints?
No. Staying active is encouraged. The key is choosing joint-friendly, low-impact activities and strengthening the muscles around loose joints, which improves stability and reduces pain and injuries. A physical therapist can design a safe program.
Can joint hypermobility syndrome get better over time?
Joints often become less flexible with age, and symptoms can improve as muscles are strengthened and activity is managed. While there is no cure, most people control their symptoms well with exercise, pacing, and joint protection.
Is joint hypermobility ever a sign of something more serious?
In most people it is benign. In a minority, very flexible joints are part of an inherited connective tissue disorder such as Ehlers-Danlos syndrome or Marfan syndrome. A doctor can look for features that suggest these conditions and refer for further evaluation if needed.
References
- MedlinePlus, U.S. National Library of Medicine. Hypermobile joints.
- Mayo Clinic. Joint hypermobility.
- The Ehlers-Danlos Society. Hypermobility spectrum disorders.
- National Health Service (NHS). Joint hypermobility syndrome.