Joint Hypermobility: Causes, Symptoms, and Tips to Strengthen and Support Your Joints

If you can bend your thumb back to your wrist or effortlessly drop into the splits, that’s joint hypermobility in action. It means your joints move beyond the typical range of motion due to more flexible connective tissues. While this extra flexibility can be an advantage in activities like dance, yoga, and gymnastics, it can also contribute to joint pain, muscle fatigue, or frequent injuries for some people.

"You can definitely have the best of both worlds," says Aashini Govani, PT, DPT, a physical therapist at Hinge Health. "You can have joint hypermobility and no pain. But without enough strength and stability around those joints, some people — especially as they age or if they’re not regularly active — may be more prone to joint discomfort or injuries."

Some people with joint hypermobility may have concerns about how to exercise safely. Read on to learn more about what causes hypermobility, and get tips and exercises recommended by Hinge Health physical therapists to help you feel confident and safe to move. 

What Is Joint Hypermobility?

Joint hypermobility occurs when the ligaments that support a joint allow for more movement than usual. "Joint hypermobility quite simply means your joints move a little bit more than their typical range of motion," explains Dr. Govani. This can be seen in people who can bend their fingers backward, touch their palms to the floor without bending their knees, or easily perform deep stretches. “When people say they’re double-jointed, that’s typically joint hypermobility."

Hypermobility is often inherited and is more common in children and young adults. For many, it’s simply a part of how their body moves. But for others, it can lead to symptoms like joint pain, fatigue, or a sense of instability. In some cases, hypermobility is linked to conditions like hypermobility spectrum disorder (HSD) or Ehlers-Danlos syndrome (EDS), which affect connective tissue throughout the entire body.

Whether hypermobility is a concern depends on if and how it affects your daily life. While some people never experience issues, others may need to strengthen muscles surrounding the affected joints and find additional ways to support their joints and manage discomfort. 

Causes of Joint Hypermobility

Ever wondered why some people seem naturally more flexible than others? It’s due to a mix of genetics, biology, and lifestyle factors. 

• Genetics. Joint hypermobility is largely influenced by genetics. Some people are simply born with more flexible connective tissues than others, thanks to differences in the composition of collagen, a protein that provides structure and support to ligaments, tendons, and joints. When collagen is more elastic or loosely structured, it allows joints to stretch further.

• Daily activities. “Some people develop hypermobility from their regular daily activities,” says Dr. Govani. People who do a lot of gymnastics, yoga, or dance may develop hypermobility through repetitive stretching and training. “It’s also common in baseball and softball pitchers,” notes Dr. Govani. "They might develop hypermobility in their shoulder because they have to cock their arm all the way back to throw a good pitch." You can also develop hypermobility from habits like sleeping with your arms over your head or frequently standing with your knees locked. “It’s not that these are bad habits — just things that can contribute to hypermobility in people who are predisposed to it.” 

• Age. Children and young adults tend to be more flexible than older adults because their connective tissues are naturally looser. As we age, collagen stiffens, reducing joint mobility. “Kids tend to be less likely to be bothered by hypermobility,” notes Dr. Govani. “It’s usually as we get older that it tends to cause more discomfort, especially if you don’t have enough strength around a hypermobile joint.” 

• Connective tissue conditions. Some medical conditions, such as hypermobility spectrum disorder (HSD) or Ehlers-Danlos syndrome (EDS), affect the structure and function of collagen. When collagen is weaker or more elastic than usual, ligaments stretch more easily. This can lead to looser, less stable joints that can move beyond their typical range of motion.

• Muscle strength and control. Weak muscles surrounding a joint can contribute to excessive joint movement. When muscles don’t provide enough stability, the joints may rely more on ligaments for support, increasing the likelihood of hypermobility-related discomfort. 

• Hormones. Certain hormones, like estrogen and relaxin, can affect ligament laxity. This is why women may experience increased flexibility during pregnancy or certain phases of their menstrual cycle.

Symptoms of Joint Hypermobility

The symptoms of joint hypermobility can vary depending on the individual and whether they have an associated condition. Common symptoms include:

• Greater-than-average flexibility or range of motion in one or several joints. 

• Joint pain, especially after prolonged activity or at the end of the day. This is often due to increased strain on the ligaments and muscles supporting your joints.

• Frequent joint injuries, such as sprains, dislocations, or subluxations (partial dislocations). These are more likely to occur during high-impact or repetitive activities.

• Muscle fatigue or a feeling of weakness.

• Joint instability. Some people feel like their joints are “slipping” or moving too much. 

• Clicking or popping joints (crepitus) during movement. 

• Delayed recovery after exercise.

• Balance issues. Joint hypermobility can make it harder for muscles to provide control, which can lead to clumsiness, coordination issues, or an increased risk of falls.

In cases where hypermobility is linked to conditions like hypermobility spectrum disorder (HSD) or Ehlers-Danlos syndrome (EDS), symptoms may extend beyond the joints and include widespread pain, chronic fatigue, or digestive issues.

Exercises for Joint Hypermobility 

Strengthening exercises are essential for managing joint hypermobility, as they help improve joint stability and control. The key is to focus on strengthening the muscles that support your hypermobile joints. These exercises, recommended by Hinge Health physical therapists, target areas commonly affected by hypermobility. For a more tailored approach, work with a physical therapist who can guide you in building strength safely and adapting exercises to fit your needs and daily activities. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment. 

Treatment Options for Joint Hypermobility

For most people, hypermobility is simply a variation in how their body moves, so it doesn’t always require treatment. But if hypermobility is causing discomfort or frequent joint issues, there are ways you can manage your symptoms, improve joint stability, and help prevent injuries. 

• Do strength and stability exercises. "Strengthening the muscles around your joints helps build stability, making movement feel more controlled and comfortable," says Dr. Govani. Resistance training and isometric exercises can reinforce joint support, so you rely less on your ligaments and more on your muscles.

• Work with a physical therapist. A physical therapist can help you find ways to move that feel good while strengthening the muscles that support your joints. They can guide you through exercises to improve coordination, or suggest other treatments that may help your symptoms. “There’s nothing wrong with being hypermobile, so our goal isn’t to take away the hypermobility," says Dr. Govani. "We just want to strengthen the right muscles to support your movement and help prevent injuries." 

• Choose activities that work for you. You don’t have to avoid movement — just find what works best for you. If high-impact activities like running or jumping feel uncomfortable, lower-impact options like Pilates, swimming, or strength training can help you stay active while keeping your joints supported. 

• Modify movements for more comfort. Paying attention to how your body feels during movement and making little modifications can make daily activities more comfortable. "For instance, keeping a soft bend in your elbows and knees instead of locking them out can help reduce fatigue," Dr. Govani notes.

• Consider braces and supportive devices. Sometimes, a little extra support can go a long way. Braces, compression sleeves, or kinesiology tape can help you feel more stable and aware of your movements, especially during activities that challenge your joints. “These tools can offer temporary support when you need it while you work on increasing strength in the areas around your hypermobile joints,” says Dr. Govani. 

Tips to Manage Joint Hypermobility 

It's common to have concerns about how to move safely with joint hypermobility. Here are some practical tips to help you move with more ease and less worry. 

• Move your body in ways that feel good for you. Finding activities that feel good and support your body’s needs can help you stay active without unnecessary strain. Low-impact exercises like swimming, Pilates, and light strength training can be great options for building stability while being gentle on your joints. “The goal isn’t to avoid movement but to move in a way that feels right for your body,” says Dr. Govani. Pay attention to how different activities affect you, and modify movements as needed to stay comfortable and supported.

• Check in with your body mechanics. The way you move can make a big difference in how your joints feel, which is why it’s important to check in with your body mechanics periodically when doing activities for prolonged periods. "If you’re standing for a long time, check if your knees are locked. Or if you wake up in the middle of the night, check to see if your shoulders are in a comfortable, neutral position,” suggests Dr. Govani. Making small adjustments throughout the day can add up to better overall joint support. 

• Ask for help when needed. If you have concerns about a specific joint or activity — like how to play pickleball with hypermobile knees — a physical therapist can provide tailored movement modifications to support your body and goals. “A PT can help you find ways to move more comfortably while building strength and stability, so you can stay active without unnecessary strain,” says Dr. Govani. 

• Pace yourself. It’s important to stay active, but overdoing it can lead to fatigue and discomfort. If certain activities leave you feeling sore, try breaking them into shorter sessions with rest in between. This applies to both exercise and everyday tasks. Listening to your body and giving yourself breaks can help prevent pain flare-ups.

• Eat and drink well. Hydration plays a role in joint health by keeping tissues lubricated and flexible. Eating a balanced diet that includes plenty of fruits, vegetables, protein, and healthy fats can help support joint comfort. While food and hydration won’t change your hypermobility, they can help keep your body feeling its best.

PT Tip: Don’t Be Afraid of Hypermobility  

“Having some degree of hypermobility in one or multiple joints is completely normal,” says Dr. Govani. “Hypermobility itself isn’t necessarily a problem — it just means your joints have more movement available. Strengthening the muscles around hypermobile joints can help provide support and stability, and movement can be a great way to build confidence in your body.”

How Hinge Health Can Help You 

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

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2. Liron Blajwajs, Williams, J., Timmons, W., & Sproule, J. (2023). Hypermobility prevalence, measurements, and outcomes in childhood, adolescence, and emerging adulthood: a systematic review. Rheumatology International, 43(8), 1423–1444. doi:10.1007/s00296-023-05338-x

3. Bennett, S. E., Walsh, N., Moss, T., & Palmer, S. (2019). Understanding the psychosocial impact of joint hypermobility syndrome and Ehlers–Danlos syndrome hypermobility type: a qualitative interview study. Disability and Rehabilitation, 43(6), 1–10. doi:10.1080/09638288.2019.1641848

4. Nicholson, L. L., Simmonds, J., Pacey, V., De Wandele, I., Rombaut, L., Williams, C. M., & Chan, C. (2022). International Perspectives on Joint Hypermobility: A Synthesis of Current Science to Guide Clinical and Research Directions. JCR: Journal of Clinical Rheumatology, 28(6), 314–320. doi:10.1097/RHU.0000000000001864

5. Ostuni, N. F., Marinello, C. A., Luzhnyy, T., Pawlikowski, A., Vlasaty, C., Thomatos, G., & Douris, P. C. (2024). The Effect of Joint Hypermobility Syndrome on DOMS and Recovery Time. International Journal of Sports Physical Therapy, 19(2), 159–165. doi:10.26603/001c.91644