Joint Hypermobility

Joint Hypermobility Syndrome

Hypermobility means that your joints are more flexible than other people’s (you may think of yourself as being double jointed). When this causes pain, it might be joint hypermobility syndrome.

People with high levels of flexibility often gravitate towards activities where flexibility is a goal or even rewarded.  Think of activities such as dance, yoga, performance art, and the circus arts.  This increased level of flexibility, however, comes at a price.  If you are one of those amazingly flexible few, you need to consider how to age well and protect yourself from injury.

Intrigued?  Read on!

The Nuts and Bolts of Hypermobility

Joint Hypermobility

Hypermobility usually comes up when I’m initially working on a patient.  It may be really hard to get their joints to tension, or when I do an ankle adjustment their knee and hip come along for the ride.  They may not have that classic “double jointed” presentation, but it is distinctly noticeable.  Your connective tissues don’t lie.


Bare with me for a minute while we go down a scientific rabbit hole.  It’s worth the trip.

Your ligaments are comprised primarily of two types of protein, the aforementioned collagen and elastin.  Collagen provides structural integrity while the Elastin is responsible for a ligament’s ability to stretch and deform.  Without Collagen you would be a rubbery mess, and without Elastin you would be as stiff and the tin man.  

Your specific mix of Collagen and Elastin is dictated by a dozen or so genes.  Thanks mom!  

Collagen and Elastin make up most of what we think of as being our soft and connective tissues: skin, fascia, ligaments, tendons, etc.  Muscles are different because they also contain contractile elements.

Ligaments, specifically, provide a supportive role.  They hold your joints together, your organs in place, your teeth in their sockets…you get the idea.  You can think of the texture of a ligament as being somewhat akin to that of saltwater taffy?  It’s pretty darn tough, but if you keep at it you can get it to stretch.  This quality is known as a ligament’s “creep.”  The fibers are slow to lengthen, but under sustained stress they do.  They don’t really snap back…a good analogy is when you overstretch the elastic in your sock.  It does the job, but that sucker is going to sag.


From the direction of the conversation, you may have already guessed what is coming next.  If you are already more flexible than the average bear, and you continue to stretch your ligaments…at some point you may find yourself with an unstable joint.  This means that your ligaments are not able to hold their respective bones in a proper alignment.

Now, you may be looking down at yourself and noticing that your joints are not flopping around like raggedy ann or andy despite the fact that you are very flexible.  Well, our bodies are good at their jobs.  We have redundant systems in place.

If you are overly flexible, you make up for that lack of ligamentous stability with muscular strength.  Your muscles also attach to the bones, kind of necessary for movement to occur.  Since muscles have contractile fibers, they are able to shorten and don’t stay stretched out.  “So what’s the problem?” you may ask.

In a nutshell, your muscles are doing two jobs instead of one.  They aren’t just moving you through space, they are also holding you together.  This makes repetitive activities especially trying on the muscles around the joints.  You may have noticed that you are more likely to get tendinitis, plantar fasciitis, shin splints…any one of those pesky inflammatory connective tissue injuries.  This common inflammatory theme also means that you are more likely to build up scar tissue in your fascia (ouch!).

On a more serious note, when you are in an accident your joints usually have two lines of defense: muscles and ligaments.  You are pretty much flying with one engine.  You may be more likely to dislocate a joint when a stiffer soul would only sprain a ligament.  Also, you are more prone to recurring injuries such as ankle sprains and shoulder dislocations.

The makeup of your connective tissue also affects the valves in your veins and heart.  Those with excessive flexibility may be more prone to varicose veins and swelling of the legs.  In more extreme inherited genetic connective tissue syndromes, such as Ehler Danlos, the heart may be more profoundly affected.



Play to your strengths, literally!

If you happen to be in San Francisco,  I’d love to help!  You can see my schedule and make an appointment online.

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