Understanding and Managing Hypermobility

What is Hypermobility?

Hypermobility refers to joints that move beyond their normal range of motion. While some people may have a few hypermobile joints without any issues, Hypermobility Spectrum Disorder (HSD) and hypermobile Ehlers-Danlos Syndrome (hEDS) are conditions where widespread joint hypermobility occurs alongside other symptoms that can significantly impact daily life.

Understanding the Genetics and Collagen Connection

Both HSD and hEDS are genetic conditions that affect collagen - the protein that provides structure and strength to our connective tissues. Collagen is found throughout the body in skin, joints, blood vessels, organs, and more. When collagen is altered or defective, it can affect multiple body systems, not just the joints.

Beyond Joint Flexibility: The Whole-Body Impact

What many people don't realise is that hypermobility conditions can affect far more than just joint stability:

Organ and System Effects:

  • Digestive issues (gastroparesis, IBS, food intolerances)

  • Cardiovascular problems (POTS, blood pressure irregularities)

  • Respiratory challenges

  • Bladder and pelvic floor dysfunction

Neurological Concerns:

  • Chronic fatigue syndrome

  • Brain fog and concentration difficulties

  • Sleep disturbances

  • Headaches and migraines

Mast Cell Activation Syndrome (MCAS): Many people with hEDS also experience MCAS, which can cause allergic-type reactions, skin issues, and digestive problems.

Dysautonomia: This affects the autonomic nervous system, leading to issues with heart rate, blood pressure, temperature regulation, and digestion.

Psychological Health: Living with chronic pain and unpredictable symptoms can impact mental health. Additionally, there may be direct neurological connections between hypermobility and anxiety or depression.

Neurodivergence: Research suggests higher rates of ADHD, autism, and other neurodivergent conditions in people with hypermobility.

Chronic Pain: Pain in hypermobile conditions is often complex, involving not just joint pain but also muscle tension, nerve sensitivity, and central pain processing changes.

The Role of Manual Therapy in Hypermobility Management

At Skye Osteopathy, my focus is on hands-on musculoskeletal treatment to address the imbalances that commonly develop in hypermobile bodies. Through manual therapy techniques, I work to:

  • Restore proper joint alignment

  • Release tension in overworked compensatory muscles

  • Improve tissue quality and circulation

  • Reduce pain and discomfort

  • Create a foundation for better movement patterns

When your body is properly aligned and muscular imbalances are addressed, exercises become more effective and can be performed with greater ease and less pain.

Getting Started: Basic Postural Awareness and Gentle Exercises

While comprehensive exercise programs are best developed with a physiotherapist, here are some foundational concepts and gentle exercises to get you started:

Postural Awareness: Your Foundation

What is postural awareness? Simply put, postural awareness is a form of proprioception - your body's ability to understand where it is in space. For hypermobile individuals, this awareness is often compromised due to reduced joint stability and altered sensory feedback.

Starting Small: Begin with just 2 minutes of conscious standing each day, plus brief check-ins throughout the day whenever you think of it.

Steps to Proper Standing Alignment:

  1. Feet: Place feet hip-width apart, weight evenly distributed

  2. Knees: Keep slightly bent (never locked back into hyperextension)

  3. Pelvis: Find neutral position - not tilted forward or tucked under

  4. Core: Gently engage your deep abdominal muscles

  5. Shoulders: Draw shoulder blades down and back, away from ears

  6. Head: Lengthen through the crown of your head, chin parallel to floor

  7. Breathing: Maintain steady, relaxed breathing throughout

Gentle Stabilising Exercises

These exercises focus on "waking up" your stabilising muscles - the smaller, deeper muscles that help support your joints.

Core Stabilisers

Dead Bug (Modified for Hypermobility)

  • Lie on back, knees bent at 90°, arms reaching toward ceiling

  • Keep lower back gently pressed to floor (avoid forcing it flat)

  • Slowly extend opposite arm and leg, maintaining core connection

  • Return to start position with control

  • Key: Move only as far as you can maintain stability

Modified Plank Progression

  • Start on knees and forearms

  • Focus on maintaining neutral spine (avoid sagging or hiking hips)

  • Hold for 10-15 seconds initially, building gradually

Shoulder Stabilisers

Wall Slides

  • Stand with back against wall, arms in "goal post" position

  • Slide arms up and down wall while maintaining contact

  • Focus on shoulder blade control

Hip Stabilisers

Double-Leg Glute Bridge

  • Lie on back, both feet flat on floor, knees bent

  • Lift hips using glute muscles (not back muscles)

  • Keep pelvis level and avoid arching lower back

  • Hold for 2-3 seconds at the top

Deep Neck Stabilisers

Chin Tucks (Cervical Retraction)

  • Sitting or standing, create a "double chin"

  • Hold 5 seconds, focusing on deep neck flexors

  • Avoid tilting head up or down

Important Guidelines:

  • Start with 5-8 repetitions and build gradually

  • Quality over quantity - perfect form is essential

  • Stop before fatigue - hypermobile joints are vulnerable when muscles tire

  • Listen to your body - some days you'll need to modify or skip exercises

Red Flags to Watch For:

  • Joint pain during or after exercise

  • Increased fatigue lasting more than 24 hours

  • Dizziness or light-headedness

  • Feeling "loose" or unstable after exercise

A Collaborative Approach to Your Care

Managing hypermobility effectively often requires a team approach. At Skye Osteopathy, we focus on the manual therapy component - addressing musculoskeletal imbalances and getting your body properly aligned. For comprehensive exercise programs, we refer to physiotherapists who specialise in exercise prescription for hypermobile individuals.

Ready to address your musculoskeletal imbalances? Contact Skye Osteopathy at info@skyeosteopathy.com.au or call 0421 467 389 to book your consultation and start your journey toward better alignment and reduced pain.

Remember

  • Only GPs or specialists can provide a formal diagnosis of hEDS or HSD

  • There is currently no genetic testing available for these conditions

  • Diagnosis is based on meeting specific clinical criteria


About the Author: Dr. Kamisha Cleaver (BaClinSci MOstMed) is a registered osteopath and owner of Skye Osteopathy in Bunbury, WA. She specialises in gentle, patient-centred care with additional training in Osteopathy in the Cranial Field (OCF), Biodynamic Osteopathy, and paediatrics.

References and Sources: This article is based on current clinical understanding, professional education including the 'Hypermobility for Healthcare and Fitness Professionals' course by Dr Ashton Wilson (Osteopath), established clinical guidelines, and resources from The Ehlers-Danlos Society.

This information is for educational purposes only and doesn't replace professional medical advice. If you're experiencing symptoms that concern you, please consult with your healthcare provider for proper assessment and diagnosis.

 

Kamisha Cleaver