Understanding Hypermobility Disorders and Effective Management Strategies

Hypermobility disorders, including hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD), affect thousands of people worldwide. These conditions cause joints to move beyond the normal range, often leading to pain, fatigue, and instability. Despite their prevalence, many cases remain undiagnosed, especially among women. Understanding these disorders and how to manage them effectively can improve quality of life for those affected.

Physiotherapist applying kinesiology tape to a hypermobile knee

What Are Hypermobility Disorders?

Hypermobility disorders are inherited connective tissue conditions characterized by joints that extend beyond typical limits. This increased flexibility can cause joint instability, chronic pain, and other symptoms such as fatigue and autonomic dysfunction.

• Hypermobile Ehlers-Danlos syndrome (hEDS) is a specific diagnosis with strict criteria, including generalized joint hypermobility and systemic symptoms.

• Hypermobility spectrum disorder (HSD) covers a range of hypermobility-related symptoms that do not meet the full criteria for hEDS but still cause significant issues.

  
  

Both conditions share many symptoms but differ in diagnostic requirements. Estimates suggest that between 1 in 500 and 1 in 5,000 people have hEDS or HSD, with many cases going unrecognized.

Recognizing the Symptoms

People with hypermobility disorders often experience:

• Joint pain and frequent dislocations or subluxations (partial dislocations)

• Muscle fatigue and weakness

• Chronic widespread pain

• Autonomic symptoms like dizziness or rapid heartbeat

• Difficulty with daily activities due to joint instability

  
  

These symptoms can vary widely in severity and may worsen with activity or over time.

Why Physiotherapy Is Key

There is no cure for hEDS or HSD, and medications alone rarely provide sufficient relief. Physiotherapy remains the cornerstone of treatment, focusing on improving joint stability and reducing pain.

Effective physiotherapy includes:

• Proprioceptive retraining: Teaching the body to sense joint position better, which helps prevent injuries.

• Muscle strengthening: Building muscle support around joints to improve stability.

• Pain neuroscience education: Helping patients understand pain mechanisms to reduce fear and improve coping.

• Pacing and energy management: Managing activity levels to avoid fatigue and post-exertional malaise.

  
  

A 2014 systematic review found that physiotherapy significantly improved pain, function, and quality of life in people with hypermobility spectrum disorders.

What to Avoid in Treatment

Contrary to what some might expect, passive stretching is not recommended for hypermobility disorders. Stretching loose joints can increase instability and risk of injury. Instead, therapy focuses on active stability through muscle co-contraction, where muscles work together to support the joint.

Additional Therapies That Help

Several adjunct treatments can support physiotherapy:

• Taping techniques: Kinesiology taping and rigid strapping can improve joint proprioception and reduce the frequency of joint subluxations.

• Acupuncture: May provide pain relief for chronic widespread pain associated with hEDS.

• Multidisciplinary care: Combining physiotherapy with psychological support and pain medicine often yields the best outcomes.

  
  

Managing Fatigue and Activity Levels

Fatigue is a common and challenging symptom in hypermobility disorders. Patients often experience post-exertional malaise, where symptoms worsen after physical or mental activity.

Strategies to manage fatigue include:

• Pacing: Balancing activity and rest to avoid overexertion.

• Graded activity programs: Gradually increasing activity levels to build endurance safely.

• Energy conservation techniques: Prioritizing tasks and using assistive devices when needed.

  
  

These approaches help maintain function without triggering symptom flare-ups.

Seeking Help Locally

If you live in South Kensington and need support with hypermobility and joint instability, physiotherapy services are available. Ali Momeni Pour at Physiome offers specialized care tailored to these conditions, focusing on evidence-based treatments to improve joint stability and reduce pain.