Hyper-mobility Syndrome is a genetic disorder which is caused by a decrease in the amount of collagen fibers within the connective tissue especially ligaments and joint capsules.

This means that joints, muscles, tendons and ligaments are more fragile, allowing excessive movement which can then predispose you to overstretching and sustain injuries.

Many people with hyper-mobile joints do not have any problems and do not need treatment. However, there are symptoms associated with joint hyper-mobility such as joint pain, dislocated joints, tenosynovitis and systemic hyper-sensitivity.


What causes hyper-mobility?

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

One of the main causes of joint hyper-mobility is thought to be the lack of amount of collagen fibers within the connective tissues. This makes the connective tissue more flexible.


Signs and Symptoms

Hyper-mobility is generally divided into 2 groups – the hyperactive people and the lethargic people.

It goes without saying that main problems are joint ache 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 also often have an increased sense of hearing, smell and taste.

They also suffer from tiredness and fatigue

Suffer from delayed soreness syndrome meaning that they are fine on day of activity, but a day or two after they are in agony, stiff and tired.

Hyper-mobile people also have an increased prevalence of Irritable Bowel Syndrome.

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

Things which will indicate if you are hyper-mobile 

hypermobility test


  • Bending forward placing your palms on the floor with their knees fully extended.
  • Hyper-extending the knee and elbow beyond degrees.
  • Able to touch the thumb to the forearm.
  • Old and present dislocations without significant trauma.
  • Repeated sprains.
  • Scoliosis (curvature of the spine) occurs more frequently in people with hyper-mobile joints.
  • Hyper-mobile women has a higher prevalence of migraine.

Symptoms tend to subside with time because joint hyper-mobility tends to decrease with aging as the body becomes naturally less flexible.

Physiotherapy treatment

Treatment is specific to the individual and based on the presentation and history.

can include any of the below….

  • Patient education
  • Joint protection
  • Movement control, balance work & strengthening
  • Brushing Therapy (link to brushing therapy)
  • Posture re-education & core strengthening
  • Compression therapy (specific manual therapy)
  • Manual therapy (NO MANIPULATIONS)
  • Electrotherapy
  •  Pain management
  • Relaxation techniques / mindfulness
  • Providing advice on types of exercise and sports & injury prevention
  • Advice and problem solving

You may not know that you are hyper-mobile but it could be adversely affecting your ability to enjoy and advance in sport. Training and receiving treatment needs to be tailored specifically to your physical state and needs to be holistic (whole body) to create the optimal effect.


Beighton Score


The Beighton modification of the Carter & Wilkinson scoring system has been used for many years as an indicator of widespread hyper-mobility. However, it is more of a research tool and an indicator of generalized hyper-mobility. As a clinical tool it can be a quick and straightforward thing to do BUT there are two important things to realize:

  1. A high Beighton score by itself does not mean that an individual has a hyper-mobility syndrome. The full history needs to indicate this as well as a further physical examination.
  2. A low score should be considered with caution when assessing someone for widespread pain as hyper-mobility can be present at a number of sites that are not counted in the Beighton score. For example, this can be at the jaw joint (the ‘TMJ’), neck (cervical spine), shoulders, mid (thoracic) spine, hips, ankles and feet.

The Beighton score is calculated as follows:


  • One point if while standing forward bending you can place palms on the ground with legs straight
  • One point for each elbow that bends backwards
  • One point for each knee that bends backwards
  • One point for each thumb that touches the forearm when bent backwards
  • One point for each little finger that bends backwards beyond 90 degrees.


Another quick tool to use is the hyper-mobility questionnaire. An answer of ‘Yes’ to 2 or more of the questions gives a very high prediction of the presence of hyper-mobility. Again, like the Beighton score, this does not mean that the person has a Hyper-mobility Syndrome.


  • Can you now (or could you ever) place your hands flat on the floor without bending your knees?
  • Can you now (or could you ever) bend your thumb to touch your forearm?
  • As a child did you amuse your friends by contorting your body into strange shapes OR could you do the splits?
  • As a child or teenager did your shoulder or kneecap dislocate on more than one occasion?
  • Do you consider yourself double-jointed?


Concerned about yourself or your children as to whether you are hyper-mobile and would like a consultation about how to best manage having hyper-mobility, then book an appointment.

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