Written By Rich Saxton
A recent BBC article discussed the wider symptoms of hypermobility, but what is it?
Got a party trick? Can you bend your fingers further than your friends? Maybe you’ve always been told you’re “double-jointed”. But what does being extra flexible actually mean?
What is hypermobility?
Joint hypermobility simply means that some of your joints can move through a larger range than is typical.
You might be able to bend your thumb towards your forearm, straighten your elbows or knees further than your friends, or place your hands flat on the floor without bending your knees.
This increased movement is partly related to differences in the connective tissues in our bodies. Connective tissue helps support and hold structures such as our ligaments, tendons, muscles, skin and joints together.
Being hypermobile is relatively common, and being flexible does not automatically mean that you have a medical condition or hypermobility syndrome.
You may even have been told that you are “double-jointed”. Technically, you don't have extra joints, you simply have joints that can move through a greater range.
Is hypermobility a bad thing?
Not necessarily!
Many people with hypermobility have no problems at all and may never realise that their joints are more mobile than average.
For some people, however, increased joint movement can be associated with symptoms such as:
Joint or muscle pain
Recurrent strains and sprains
Feeling that a joint is unstable
Joint dislocations or subluxations (partial slipping of a joint)
Reduced balance or coordination
Recurrent soft-tissue injuries
It's important to remember that hypermobility itself isn't necessarily the problem. In many cases, the key factor is how well you can control and load your joints.
Hypermobility exists on a spectrum
Hypermobility isn't simply an “all or nothing” situation.
There are different presentations, ranging from people who are naturally very flexible but have no symptoms, through to people who experience significant symptoms associated with their hypermobility.
There are also specific medical conditions in which joint hypermobility can be a feature, including some forms of Ehlers-Danlos syndrome and Marfan syndrome.
At Run Serve Health, we look at your symptoms, medical history, family history and movement patterns and consider whether there are any features that may warrant further assessment by your GP or another healthcare professional.
How is hypermobility assessed?
One commonly used screening tool is the Beighton Score. This assesses flexibility at several joints and gives a score out of nine.
One point is awarded for each of the following:
Little finger bending backwards beyond 90° — right and left
Thumb bending to touch the forearm — right and left
Elbow extending beyond a straight position — right and left
Knee extending beyond a straight position — right and left
Being able to place both palms flat on the floor with your knees straight
A higher Beighton score indicates greater generalised joint hypermobility.
However, the Beighton Score is not a diagnosis by itself. Someone can have a high score and have no symptoms, while someone with significant symptoms may not necessarily score highly.
That's why a thorough assessment looks beyond flexibility alone.
What about the Brighton Criteria?
The Brighton Criteria have historically been used alongside the Beighton Score to help identify people who may have benign joint hypermobility syndrome.
They consider factors such as:
Generalised joint hypermobility
Joint pain
Previous dislocations or subluxations
Recurrent soft-tissue injuries
Features such as unusually stretchy skin
However, our understanding and classification of hypermobility-related conditions has evolved, and modern assessment considers the whole clinical picture, rather than relying on a single score.
Are there benefits to being hypermobile?
Absolutely!
Having greater joint movement can be an advantage in certain activities and sports.
Gymnastics, dance and some aspects of cricket, for example, may benefit from having a large range of movement. Greater flexibility can allow athletes to achieve positions or movements that others may find difficult.
The important factor is control.
Being able to move through a large range while maintaining good strength, coordination and control can be a real asset.
What can physiotherapy do for hypermobility?
If your hypermobility is causing symptoms, physiotherapy can play an important role in helping you understand and manage it.
Treatment may include:
Strengthening the muscles around hypermobile joints
Improving joint control and coordination
Developing balance and proprioception
Gradually increasing your tolerance to exercise and loading
Helping you manage recurrent injuries
Understanding how to modify activities when needed
Building confidence with movement and exercise
The aim isn't necessarily to make you less flexible. Instead, we want to help you become stronger, more controlled and more confident within your available range of movement.
Think you might be hypermobile?
Being flexible doesn't automatically mean something is wrong so there is no need to panic if you recognise yourself in this blog.
If you're experiencing recurrent injuries, joint pain, instability or you're simply unsure what your hypermobility means, a physiotherapy assessment can help you understand what's going on.
At Run Serve Health, we can assess your movement, strength and symptoms, look for any features that may require further medical investigation, and help you develop an exercise and management plan that's right for you.
And remember, being hypermobile isn't necessarily a disadvantage. With the right strength and control, your flexibility could actually be an advantage.