I’m hyper-mobile…is that why I hurt?

I would say that about 70% of clients coming to me for physiotherapy are hyper-mobile. It is a hugely under diagnosed syndrome and is very often the precipitate behind that repeated sprained ankle, the recurrent headache and why for no reason what so ever the back went this morning.

Hyper-mobility syndrome is a genetic disorder that is characterized by the fact that you have fewer fibres within the connective tissue especially ligaments and joint capsules.

“This means that joints, muscles, tendons and ligaments are more fragile and allow excessive movement, which can then predispose you to overstretching and thus injury.”

It is fair to say that there are a vast number of people with hyper-mobile joints, who do not have any problems and therefore do not need treatment. However they should count themselves lucky as it can be and often is an on going struggle with symptoms such as multiple joint pains, dislocated joints, tenosynovitis and systemic hypersensitivity.


What causes hyper-mobility?

Benign hyper-mobility is hereditary hence if your parents are hyper-mobile, there is a chance you may be too.

Occasionally joint hyper-mobility is part of a more serious condition such as Marfan syndrome, which is a condition that also affects the blood vessels and eyes. Ehlers-Danlos syndrome is a condition that causes stretchy skin and the skin to bruise easily.

Signs and Symptoms

Hyper-mobility is generally divided into 2 kinds of people – the hyperactive and the lethargic. The hyperactive hyper-mobile person fidgets and is generally a high achiever bordering on being a perfectionist. The lethargic hyper-mobile is the opposite.

It goes without saying that main problems are joint ache, higher chance of scoliosis and dislocated joints, but there are other signs and symptoms, which people do not generally attribute to hyper-mobility.

Often hyper-mobile people have very poor balance and proprioception. This is because the laxity adversely affects their sensory input often making them clumsy and walking into table edges and doors.

They can also often have an increased sense of hearing, smell and taste. They will be the ones who will walk into a room and say, “Can you smell that?” and no one else can.

“They also suffer from tiredness and fatigue. There just doesn’t seem to be that much petrol in their tank. Where their friends will be able to party all night, they are shattered by 10 pm and if they over-exert themselves they’ll feel it for days (feeling achy all over).”

Hyper-mobile people also have an increased prevalence of Irritable Bowel Syndrome (IBS). Suffering from IBS has an adverse effect on your ability to activate your core stability muscles around your abdomen, making you more at risk of scoliosis and back pain.

They are also often emotionally more sensitive, friends describing them as taking things to heart and easily hurt.

It has furthermore been clinically proven that hyper-mobile women have a higher prevalence of migraine and sadly there is also a higher chance of depression of people who are hyper-mobile.

“Hyper-mobility has a diverse spectrum of symptoms which can severely affect your life if you do not know how to help yourself. If you think you may be hyper-mobile and would like advice and/or treatment; I would be happy to see you.”

Look out for upcoming post: “Hyper-mobile…Is there help for me?”

Patient Case Study: Iliotibial band pain – but not an iliotibial band injury

Iliotibial band

A lovely 40 something gentleman came to see me last year as he had been struggling with right sided knee pain which had been ongoing for two years. He was not aware of any injury, which had brought this on and had been diagnosed with Iliotibial band pain. He had had treatment for this for nearly two years. However he found he was still not able to do his road-biking without pain. He was looking for another opinion, and somehow ended up on my door.

As physiotherapists we take a subjective examination (where we ask tons of medical questions) and he told me that his pain was aggravated by road biking; where he would be okay at the time, but then the following day he would get stabbing pains on the side of the knee over the Iliotibial band and it would take about 2 days to go.

His past medical history included two MRI scans which showed nothing abnormal. He had furthermore had 2 cortisone injections, which made little progress.

Asking further back into older injuries he mentioned that he fell off his bike 8 years ago and had hurt his left hip. There was noticeable scar tissue, numbness and a haematoma over the hip at the time. He never received physiotherapy for this, but felt that it was fine.

Research has been done into the effect injuries have on the rest of our body and it has been proven that if you hurt any part of your leg, your core stability in your hip will “stop” activating and become weak.

This will then create a weakness in your mechanical chain and other structures will have to work harder to compensate.

After an integrative/holistic physical examination, I found that the reason he was suffering from right knee pain was because the scar tissue on the left hip was adversely affecting the core stability muscles ability to activate. This in turn was affecting his spiral line fascial tension making the Iliotibial band on the right side overwork during biking. There were global as well as intrinsic biomechanical imbalances.

Spiral-line1  Spiral Line

I saw my client 4 times focusing on softening the left hip scar tissue, core stability training exercises related to biking; incorporating release of the spiral fascial line as well as rebalancing the Quad/Hamstring strength ratio and after one month, he was pain-free and back to his road biking.

It was not necessary to treat his Iliotibial band because as soon as the muscle and fascial imbalances were addressed and sorted, the iliotibial band relaxed and stopped irritating the knee.


Sometimes the pain we are experiencing can be due to other factors, so if you have an injury that does not seem to improve or settle – and want a second opinion – feel free to contact me for an assessment – I’d be happy to help.


 Tina Nielsen- Talbot BSc MCSP HCPC

Integrative and Holistic Physiotherapist

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