hypermobility

Hypermobility describes joints that move beyond the normal range expected for a person’s age, sex, and body build. It can involve a single joint or many joints and results from a combination of ligamentous laxity, variation in collagen structure, and neuromuscular control. In many people, hypermobility is harmless and part of normal variation. In others, it is associated with pain, fatigue, frequent injuries, or a spectrum of connective tissue disorders.

Assessment commonly uses the Beighton score, a 9-point scale that tests five movements: little finger extension, thumb-to-forearm opposition, elbow extension, knee extension, and ability to place the palms on the floor with straight legs. Each positive result scores points for both sides, except the floor test which is a single point. Scores range 0–9; higher scores indicate greater laxity. Thresholds vary by age and population, but a score of 4/9 or higher is frequently used to indicate generalized hypermobility in adults.

Hypermobility can be benign, but when accompanied by symptoms it may be categorized as hypermobility spectrum disorders or Ehlers-Danlos syndrome, hypermobility type. These conditions are inherited and may involve multiple systems. The term “joint hypermobility syndrome” has been used in the past; contemporary classifications emphasize functional symptoms and associated systemic features.

Common symptoms include joint pain, instability, sprains, dislocations, soft-tissue injuries, and sometimes autonomic symptoms such as tachycardia. Not all individuals with hypermobility develop symptoms.

Management focuses on education, activity modification, and non-pharmacologic therapy. Physical therapy aims to strengthen stabilizing muscles, improve proprioception, and teach safe movement patterns. Regular, low-impact exercise is encouraged; coordination and balance work is emphasized. Pain relief may involve analgesics as needed. In some cases, bracing or taping, occupational therapy, or management of associated conditions is indicated.