Are you flexible, or do you have hypermobility?

You don't need to take that yoga pose so far

Many Australians are hypermobile, but many don’t realise there’s a problem until they get injured. Here’s how to tell the difference between being flexible, and having hypermobility.

I’ve spent almost every yoga and pilates class feeling great about myself as I extend my leg or bend my back further than the rest of the group. 

I have vivid memories of feeling so proud of myself in dance classes as a kid, seeing people’s faces change when I did an acrobatic trick for the first time with little to no stretching. 

But recently, my pride in being ‘naturally flexible’ has faded, after my physiotherapist told me that the bendiness I’ve been boasting about for years is a result of hypermobility, and that overstretching my joints is doing me more harm than good.

What is hypermobility?

Hypermobility is a condition that causes joints to move further than the normal range of movement. 

The NHS states that around 1 in 30 people are hypermobile, though some people have no symptoms at all.

So what’s the difference between hypermobility and simply being flexible?

Physiotherapist Saila Insua Lopez tells Body+Soul, “flexibility refers to the ability of a muscle or muscle group to stretch. A person can be very flexible without having hypermobility, meaning their joints move within the normal range.” 

“However, a person with hypermobility has a range of motion that exceeds what is considered normal, which can lead to joint instability and, in some cases, pain.”

Symptoms of joint hypermobility include extreme flexibility, pain and stiffness in joints and muscles, clicking and dislocating joints, fatigue, poor balance and dizziness.

While super flexible joints can be great for helping you perform in dance, gymnastics or even swimming, they can cause a fair bit of pain and some long-term problems without proper management.

Speaking to the ABC, physiotherapist and expert in generalised joint hypermobility from Macquarie University and The Children's Hospital at Westmead, Dr Verity Pacey said people with hypermobility are “constantly going further than what's considered the normal end range of a joint”, which can put a lot of strain on tendons attaching muscles to bones, and ligaments connecting bones to each other. Joint dislocation, ligament strains and tears, and tendon inflammation can occur as a result.

“However, a person with hypermobility has a range of motion that exceeds what is considered normal, which can lead to joint instability and, in some cases, pain.”

Conditions linked to hypermobility

According to Body+Soul’s Health of the Nation report, one in 10 Australians identify as neurodivergent, with ‘approximately one in 20 adult Australians experience ADHD, and one in 26 have an autism spectrum disorder’.

Both of these disorders are closely linked to hypermobility, with a study from Brighton and Sussex Medical School finding that ‘neurodivergent people are more than twice as likely as the general population to have hypermobile joints’.

Women are more than three times more likely to be affected by hypermobility than men according to Arthritis Australia, and the condition is also often genetic.

People living with hypermobility spectrum disorder, or Ehler’s-Danlos Syndrome also experience overly bendy joints, but these are more serious conditions that come with an array of additional symptoms.

There are also strong links between hypermobility and autoimmune disorders.

There are also strong links between hypermobility and autoimmune disorders. Image: Pexels

Treating hypermobility

While physios, rheumatologists and strength and conditioning coaches will approach clients’ hypermobility with a personalised approach, there are a few things people with the condition should focus on.

It’s important to pay attention to when you’re overextending your joints. The way you’ve been standing your whole life could actually involve overextended knees, you may be pushing your elbows out whenever you plank, or popping your shoulder into an unideal position when adjusting your posture. 

Insua Lopez says it is also “advisable to avoid sudden movements or activities that put stress on the joints, such as high jumps or high-intensity exercises without supervision.”

Our Health of the Nation report highlighted Aussie’s changing attitudes towards working out – with 25 per cent of respondents saying their main motivation to get fit is to manage or prevent a health condition. Strength training is crucial for people with hypermobility, as strengthening the muscles around the overly bendy joints can help to control movement, reducing pain and limiting the risk of injury. So if you have the condition, it’s time to get into the gym.

Beginning strength training can be frustrating if you’ve overextended your muscles daily for your whole life. For example, standing straight with a normal knee extension can feel like bending your knees if you’ve always overstretched your knee joint. 

It’s important to pay attention to when you’re overextending your joints. Image: iStock

Physiotherapist Nigel Morgan explained, “ligaments, tendons and joint capsules have nerve endings that provide information on where you are in space and how much muscle activation is needed to control your joints”. 

“When they're chronically stretched over time, that feedback system is impaired, so your nervous system gradually receives less information. This makes it harder for you to control your movements.”

Associate Professor Nicholson said this is behind the difficulty you can experience when first trying to keep your extensions within a normal range of motion. “You can't really stop yourself going into that range especially when you are fatigued, so it's far better to learn control and strengthen your muscles in that excess range," he said.

Insua Lopez says on top of muscle strengthening exercises, treatment plans often incorporate “stability training, and proprioception exercises, which are critical to improving body awareness and control over joints.”

She adds, “manual therapy can also be used to relieve pain and improve function,” and physios also “ teach patients about how to manage their daily activities in a way that minimises the risk of injury.”

Originally published as Are you flexible, or do you have hypermobility?