Physiotherapy For Hypermobility
Are you unusually flexible but also experience joint pain, instability, frequent injuries, or muscle fatigue? You may have joint hypermobility.
Hypermobility means that one or more joints can move through a greater range of motion than is typical. While being flexible does not necessarily cause problems, some people with hypermobility experience ongoing symptoms that can interfere with exercise, work, sports, and everyday activities.
Physiotherapy for hypermobility can help you understand your body's movement patterns and develop the strength and control needed to better support your joints.
At Integrative Physiotherapy & Wellness, our physiotherapists take an individualized approach to hypermobility treatment. Rather than simply trying to reduce flexibility, treatment focuses on improving strength, stability, proprioception, movement control, and physical capacity.
What Is Joint Hypermobility?
Joint hypermobility occurs when a joint moves beyond the range generally expected for that joint.
Hypermobility can affect one particular joint or multiple areas of the body. Common areas include:
Shoulders
Elbows
Wrists and hands
Spine
Hips
Knees
Ankles and feet
Some people are naturally flexible and have no symptoms. Others may experience pain, instability, recurrent injuries, or difficulty controlling their joints during movement.
Hypermobility is not automatically a medical condition. However, when increased joint mobility is accompanied by significant symptoms, it may be associated with conditions such as hypermobility spectrum disorder (HSD) or, in some individuals, hypermobile Ehlers-Danlos syndrome (hEDS).
A physiotherapist can help assess how your mobility is affecting your movement and function and determine whether further medical assessment may be appropriate.
What Are the Symptoms of Hypermobility?
Joint hypermobility can look different from person to person. Some people have significant flexibility with no problems, while others experience recurring symptoms.
Common symptoms may include:
Joint pain or aching
Feeling that a joint is loose or unstable
Frequent sprains and strains
Recurrent joint injuries
Joint clicking or popping accompanied by discomfort
Repeated subluxations or dislocations
Muscle fatigue
Difficulty maintaining certain positions
Poor balance or body awareness
Difficulty controlling joints during exercise
Pain after physical activity
Reduced confidence with movement
If these symptoms are affecting your ability to work, exercise, play sports, or participate in everyday activities, physiotherapy may help.
Why Can Hypermobility Cause Joint Pain?
Having a greater range of motion does not necessarily mean that a joint is damaged.
However, when joints move into positions that are difficult for the surrounding muscles to control, the muscles may need to work harder to provide stability.
For example, someone with hypermobile knees may regularly stand with their knees pushed backward into their end range. Someone with shoulder hypermobility may rely heavily on the muscles around the shoulder to maintain stability during reaching or lifting.
Over time, this increased demand can contribute to muscle fatigue, discomfort, and difficulty controlling movement.
This is why physiotherapy treatment for hypermobility often focuses less on increasing flexibility and more on building strength and improving control.
How Can Physiotherapy Help Hypermobility?
There is no single treatment program for everyone with hypermobility. Your physiotherapist will consider your symptoms, strength, joint mobility, movement patterns, activity level, previous injuries, and goals.
Strengthening the Muscles Around Your Joints
Strength training is an important part of managing symptomatic hypermobility.
Your physiotherapist may prescribe exercises targeting areas such as:
Core and trunk muscles
Hip and pelvic stabilizers
Gluteal muscles
Shoulder and scapular muscles
Quadriceps and hamstrings
Calves and foot muscles
The goal is to gradually improve your muscles' ability to support and control your joints.
Improving Joint Stability
Physiotherapy can help you develop better active control of your joints.
Exercises may focus on maintaining appropriate joint alignment during:
Squatting
Lunging
Reaching
Lifting
Walking
Running
Stair climbing
Sports and recreational activities
Better control can help you feel more stable and confident during movement.
Improving Proprioception
Proprioception is your body's ability to sense where your joints are positioned.
Because joint hypermobility can sometimes be associated with reduced awareness of joint position, your physiotherapist may incorporate balance and coordination exercises into your rehabilitation program.
These exercises can help your nervous system better coordinate your muscles and joints.
Managing Hypermobility-Related Pain
Physiotherapy can help you understand factors that may contribute to your pain and develop strategies to manage symptoms.
Depending on your individual needs, treatment may include:
Therapeutic exercise
Strength training
Movement retraining
Manual therapy
Activity modification
Pacing strategies
Education about pain
Gradual return to activity
Treatment is designed around your symptoms and goals rather than using a one-size-fits-all approach.
Returning to Exercise and Sports
Having hypermobility does not mean you have to stop exercising.
In fact, appropriately prescribed exercise can be an important part of improving physical capacity and joint stability.
A physiotherapist can help you gradually return to activities such as:
Walking
Running
Strength training
Pilates
Golf
Yoga
Cycling
Dancing
Recreational sports
Fitness classes
The focus is on finding the appropriate level of challenge and gradually progressing your program.
Should You Stretch If You Have Hypermobility?
If your joints are already very mobile, more stretching may not always be beneficial.
Some people with hypermobility are accustomed to stretching because they feel tight or uncomfortable. However, the sensation of tightness does not necessarily mean that a muscle needs more flexibility.
In some situations, what feels like "tightness" may actually be your muscles working to provide stability around a mobile joint.
Your physiotherapist can determine whether stretching is appropriate for you and identify when strengthening, active mobility, or movement control may be more useful.
The goal is not to eliminate your flexibility. It is to help you develop the control to use your available range safely.
What Happens During a Physiotherapy Assessment for Hypermobility?
Your physiotherapist will look at more than just how flexible you are.
Your assessment may include:
Joint mobility: Looking at how your joints move and whether certain areas demonstrate excessive mobility.
Strength: Assessing the strength and endurance of muscles that help stabilize your joints.
Movement control: Looking at how you control your joints during functional movements.
Balance and proprioception: Assessing your awareness and control of joint position.
Posture and movement patterns: Identifying habits that may contribute to symptoms.
Functional activities: Considering how your symptoms affect work, exercise, sports, and daily activities.
Your goals: Understanding what you want to be able to do comfortably and confidently.
This information helps your physiotherapist create a personalized hypermobility treatment plan.
Exercises for Hypermobility
There is no universal list of "best exercises" for hypermobility.
Your exercise program should be based on your current strength, symptoms, joint stability, physical activity, and goals.
Depending on your needs, your physiotherapist may use:
Isometric exercises
These involve contracting a muscle while keeping the joint relatively still and can be useful when beginning strengthening.
Controlled resistance exercises
Slow, controlled strengthening can help improve muscle capacity and joint control.
Progressive strength training
Gradually increasing resistance can help your muscles become better equipped to support your joints.
Balance exercises
Single-leg balance and other stability exercises can improve proprioception and lower-limb control.
Functional strengthening
Exercises such as squats, step-ups, lunges, lifting, pushing, and pulling can help translate strength into everyday activities.
The goal is progressive improvement, not pushing your joints to their maximum range.
Tips for Managing Hypermobility at Home
Focus on strength, not just flexibility
If your joints already move easily, your exercise program may benefit more from strengthening and control than additional stretching.
Avoid repeatedly locking your joints
Try to become aware of positions where you consistently push your elbows, knees, or other joints into their end range.
Progress exercise gradually
Doing too much too quickly can contribute to increased symptoms. Gradually increasing activity can help your body adapt.
Build consistency
Regular, manageable exercise is often more sustainable than occasional intense workouts followed by prolonged rest.
Allow adequate recovery
Muscles that are working hard to stabilize joints may fatigue more quickly. Recovery is an important part of rehabilitation.
When Should You See a Physiotherapist for Hypermobility?
Consider booking a physiotherapy assessment if you experience:
Ongoing joint pain
Frequent sprains or strains
Recurrent injuries
Joint instability
Repeated subluxations or dislocations
Muscle fatigue
Difficulty exercising because of pain
Difficulty returning to sports
Pain that persists despite normal imaging
Uncertainty about how to exercise safely with hypermobility
A diagnosis of HSD or hEDS and you would like support with exercise and rehabilitation
Early guidance can help you develop strategies for building strength and managing your symptoms before they significantly interfere with your daily life.
Physiotherapy for Hypermobility in Barrie
If you are looking for physiotherapy for hypermobility in Barrie, the team at Integrative Physiotherapy & Wellness can help you develop an individualized approach to improving strength, stability, movement control, and physical confidence.
Your treatment plan may include therapeutic exercise, progressive strengthening, movement retraining, manual therapy when appropriate, education, and strategies for safely returning to the activities you enjoy.
Our treatment sessions are always personalized to the patient and completed without an assistant, allowing your physiotherapist to focus directly on your individual needs.
Whether hypermobility is affecting your hips, knees, shoulders, spine, ankles, or multiple joints, physiotherapy can help you develop the tools to move with greater control and confidence.
Contact Integrative Physiotherapy & Wellness in Barrie today to book a physiotherapy assessment and learn how a personalized hypermobility rehabilitation program can help you move stronger and feel more confident in your body.
References
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2. Engelbert, R. H. H., Juul-Kristensen, B., Pacey, V., de Vandele, I., Smeenk, S., Woinarosky, N., Sabo, S., Scheper, M. C., Russek, L., & Simmonds, J. V. (2017). The evidence-based rationale for physical therapy treatment of children, adolescents and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers-Danlos syndrome. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 158–167. https://doi.org/10.1002/ajmg.c.31545
3. Malfait, F., Francomano, C., Byers, P., Belmont, J., Berglund, B., Black, J., Bloom, L., Bowen, J. M., Brady, A. F., Burrows, N. P., et al. (2017). The 2017 international classification of the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 8–26. https://doi.org/10.1002/ajmg.c.31552
4. Palmer, S., Bailey, S., Barker, L., Barney, L., & Elliott, A. (2014). The effectiveness of therapeutic exercise for joint hypermobility syndrome: A systematic review. Physiotherapy, 100(3), 220–227. https://doi.org/10.1016/j.physio.2013.09.002
5. Simmonds, J. V., Herbland, A., & Hakim, A. (2019). Physical therapy treatment of hypermobile Ehlers-Danlos syndrome: A systematic review. Journal of Physical Therapy Science, 31(9), 732–741.
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7. Castori, M., Tinkle, B., Levy, H., Grahame, R., Malfait, F., & Hakim, A. (2017). A framework for the classification of joint hypermobility and related conditions. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 148–157.
