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If you’ve ever been told you’re “double-jointed,” or you find your joints bending in ways other people’s don’t, you might be hypermobile. For a lot of people, flexible joints are no big deal. But for others, myself included, hypermobility symptoms go far beyond being bendy, and they can affect nearly every part of your body.
I was formally diagnosed with hypermobility by a physical therapist during my recovery from my double mastectomy and reconstruction surgeries. But the truth is, I’d been living with hypermobility symptoms for most of my life without realizing they were all connected. The easy bruising, the joints that seemed to roll and pop constantly, the injuries that came out of nowhere. I just thought that was how my body worked. Getting a diagnosis finally gave me a framework to understand why my body does what it does.
Since my diagnosis, hypermobility has caused my feet to go up two full shoe sizes in just two years, made my skin heal poorly and bruise at the slightest bump, and turned exercises like bench press into injury minefields because of hyperextending elbows. Add in chronic joint pain, swelling in my feet and ankles, and poor skin elasticity, and you start to understand why this is about so much more than flexibility.
Whether you’re newly diagnosed or just starting to connect the dots on your own symptoms, here are the top 10 questions people search for about hypermobility, answered by someone who lives with it every day.
What Is Hypermobility?
Hypermobility means your joints can move beyond what’s considered a typical range of motion. You may have heard the term “double-jointed.” It’s the same concept, though you don’t actually have extra joints. The most commonly affected joints are the elbows, wrists, fingers, and knees.
For many people, being flexible is harmless or even an advantage (think dancers or gymnasts). About 10 to 25% of the general population is hypermobile to some degree. But when that flexibility comes with pain, instability, fatigue, and other systemic issues, it crosses into what’s known as a hypermobility spectrum disorder (HSD) or, in more specific cases, hypermobile Ehlers-Danlos syndrome (hEDS).
The underlying issue is in the connective tissue. Specifically, how your body produces collagen. Collagen is the protein that gives structure and strength to your skin, ligaments, tendons, and more. When collagen is more lax or stretchy than it should be, joints lose stability and become prone to injury, and hypermobility symptoms can show up in ways you might never expect.
Collagen
I’ve been taking Do Not Age Hydrolysed Collagen Peptides for years. I started taking it primarily for my skin. It’s supposed to support connective tissue structure, skin elasticity and joint integrity.
What Are the Most Common Hypermobility Symptoms?
Hypermobility symptoms go well beyond flexible joints. People with symptomatic hypermobility commonly experience joint and muscle pain (often chronic), frequent dislocations, subluxations, and sprains, easy bruising and poor wound healing, and skin that feels soft and velvety but is fragile. There’s also chronic fatigue, digestive issues including IBS-like symptoms, dizziness and fainting (linked to autonomic dysfunction), flat feet and ankle instability, stretch marks appearing at a young age or in unusual places like the elbows or chest, anxiety, and brain fog.
Looking back, I’ve experienced most of these hypermobility symptoms for as long as I can remember. The bruising and poor skin elasticity were some of the earliest signs, but I didn’t have a name for it until my physical therapist connected the dots during my post-surgery recovery. I bruise from things that wouldn’t leave a mark on most people. Once I had the diagnosis, suddenly a lifetime of “random” issues made sense.
Is Hypermobility Genetic?
Yes, hypermobility tends to run in families. It follows an autosomal dominant inheritance pattern, which means that if one parent is affected, each child has roughly a 50% chance of inheriting the condition. However, the severity can vary widely even within the same family. One person might just be “bendy” while another has debilitating pain and frequent injuries. As far as I’m aware, no one else in my family has hypermobility.
The specific genes responsible for hEDS have not yet been identified, which is one reason there’s no genetic test for it (unlike some rarer forms of Ehlers-Danlos syndrome). Researchers believe it involves changes in how collagen and other structural proteins are produced, but the exact genetic mechanism remains a major area of ongoing study. Spontaneous mutations (called de novo mutations) can also occur, meaning someone could be the first in their family to have it.
How Is Hypermobility Diagnosed?
Diagnosis for hypermobility typically starts with a clinical assessment. The most widely used tool is the Beighton score, a nine-point scale that tests the flexibility of specific joints: bending your little fingers back past 90 degrees, touching your thumbs to your forearms, hyperextending your elbows, hyperextending your knees, and bending forward to place your palms flat on the floor. A score of 4 or more, combined with joint pain lasting at least three months, may indicate hypermobility syndrome.
There’s also a five-question screening questionnaire that asks about your history of flexibility, contorting your body as a child, and any history of dislocations. Answering yes to two or more suggests generalized joint hypermobility.
My own diagnosis came somewhat unexpectedly. I was working with a physical therapist on recovery from my double mastectomy and reconstruction surgeries when she noticed my joints were consistently moving well beyond normal range during our exercises. She formally assessed me and confirmed hypermobility. It was validating but also eye-opening. I’d spent decades experiencing these symptoms without anyone putting the pieces together.
One important note: hypermobility often goes underdiagnosed. The symptoms are variable, no single blood test confirms it, and many clinicians lack familiarity with the condition. If you suspect you’re hypermobile, seeking out a rheumatologist or a provider who specializes in connective tissue disorders can make a big difference.
Hypermobility vs EDS: What’s the Difference?
Understanding hypermobility vs EDS is one of the most commonly asked questions, and the line between them can be genuinely confusing. Hypermobility on its own, without pain or other issues, is called asymptomatic joint hypermobility and doesn’t require treatment. When symptoms like pain, instability, and other systemic issues are present, it falls under the umbrella of hypermobility spectrum disorders (HSD).
Hypermobile Ehlers-Danlos syndrome (hEDS) is a specific diagnosis within the broader category of the Ehlers-Danlos syndromes, a group of 13 heritable connective tissue disorders. hEDS is the most common type, accounting for about 90% of EDS cases. It has more specific and restrictive diagnostic criteria that were updated in 2017, requiring generalized joint hypermobility along with additional systemic features like skin involvement, musculoskeletal complications, or a family history.
Your diagnosis may evolve over time. For example, someone initially diagnosed with HSD might later meet the criteria for hEDS as additional symptoms develop. Both conditions are taken seriously and managed similarly. The distinction between hypermobility vs EDS matters more for research classification than for your day-to-day treatment plan.
Hypermobility and Bruising: Why Do I Bruise So Easily?
The connection between hypermobility and bruising is one that really hits home for me. The easy bruising and slow healing aren’t just coincidences. They’re directly linked to the connective tissue differences that define hypermobility conditions.
The structural proteins in your skin (collagen, fibrillin, fibronectin) aren’t knit together as tightly as in someone without the condition. This makes your small capillary blood vessels more fragile, so they break more easily under pressure, leading to bruises from what seems like nothing. It’s not a clotting problem; blood tests for coagulation usually come back normal. The bruising is caused by the fragility of the skin and blood vessel walls themselves.
Poor wound healing is a feature seen from an early age in hypermobility syndromes. The same collagen differences that make joints loose also slow down the skin’s ability to repair itself. Scars may be wider, thinner, or more prominent than expected, sometimes described as “papyraceous” or “cigarette paper” scars. Stretch marks can also appear early in life and in atypical locations like the inner arms, chest, or elbows.
Nails are another thing most people don’t associate with hypermobility. Mine are extra bendy, extra flexible, and want to break constantly, so I’m always using CND Rescue RXX on them. The same connective tissue differences that affect your skin and blood vessels also affect the nail bed, leaving nails softer and more prone to peeling, splitting, and bending.
I’ve dealt with hypermobility and bruising my entire life. I used to think I was just clumsy or had thin skin, but it turns out the constant mystery bruises are a hallmark of this condition. There’s no way to “fix” the underlying collagen difference, but general skin care (avoiding unnecessary trauma, allowing wounds extra time to heal, and protecting skin from sun damage) can help manage things. Some research also suggests vitamin C supplementation may support collagen synthesis and reduce bruising, though more evidence is needed.
Hypermobility Flat Feet: Can Hypermobility Change Your Feet?
Absolutely, and hypermobility flat feet are one of the most underrecognized ways this condition affects daily life. Your feet contain 26 bones and 33 joints each. That’s a lot of opportunity for lax connective tissue to cause problems.
Many people with hypermobility develop flat feet (pes planus) because the ligaments supporting the arch become too lax to hold their shape under the force of gravity and body weight. This collapse of the arch can, over time, make your feet wider and longer, which is exactly what happened to me. My feet have gone up two full shoe sizes in two years because the connective tissue simply isn’t holding things together the way it should. It’s one of the most frustrating hypermobility symptoms I deal with, because it means constantly replacing shoes and dealing with foot pain that radiates upward.
Hypermobility flat feet are more than a shoe shopping inconvenience. When foot mechanics are altered, it creates a domino effect up the entire kinetic chain: your knees, hips, pelvis, and lower back all compensate. You’re also more susceptible to ankle instability, chronic sprains, plantar fasciitis, bunions, and swelling in the feet and ankles.
Shoes with a strong heel counter, a robust upper, solid fastening, and a cushioned midsole are recommended. Custom orthotics from a podiatrist can also help control excessive joint motion. Importantly, strengthening exercises for the intrinsic foot muscles, like short foot exercises using resistance bands as tactile cues, can actually help rebuild arch support over time, rather than just relying on passive support from insoles alone.
Exercise with Hypermobility: Is It Safe to Work Out?
Yes, and in fact, exercise with hypermobility is one of the most important tools you have. Strengthening the muscles around your joints gives them the stability that your looser ligaments can’t provide on their own. Research has shown that people with hypermobility can build strength at a similar rate to non-hypermobile people, though they may be starting from a weaker baseline.
That said, how you approach exercise with hypermobility matters enormously. Here’s what I’ve learned the hard way:
Never lock out your joints.
This is critical. When I was doing bench press, I was hyperextending my elbows at lockout without even realizing it. That puts enormous stress on ligaments and joint capsules rather than muscles. Stop just short of full extension on presses, squats, and any movement where you’d normally “lock out.”
Prioritize stability before strength.
Start with isometric exercises like wall sits, planks, and glute bridges. Build a solid foundation of neuromuscular control before chasing heavier weights. I also love to do tree pose in yoga; balancing on one foot at a time helps.
Use lighter loads with strict form.
The goal isn’t to lift the heaviest weight possible, though this was definitely my goal initially. It’s to build joint stability and muscle control. Resistance bands and fixed machines can be great starting points because they control the movement path for you. Resistance bands are especially great because they minimize the risk of injury.
Avoid overstretching.
This one surprises people, but if your joints already have excessive range of motion, stretching deeper just makes things worse. Focus on active flexibility within your mid-range rather than passive stretching into extreme positions. Yoga is actually how I first injured my Achilles tendon. When I went to get it looked at, the response was, “Oh yeah, it’s because you’re hypermobile. I figured you already knew that.” No, that was news to me at 46. That experience taught me that even “gentle” exercises require modifications when you’re hypermobile.
Consider working with a professional.
A physical therapist or trainer who understands hypermobility can help you develop a safe progression. Low-impact activities like yoga, swimming, cycling, Pilates, and walking are also excellent options for exercise with hypermobility.
Yoga, walking, the rowing machine, resistance brands and strength training are all in my current exercise routine.
Is There a Cure for Hypermobility?
There is currently no cure for hypermobility or the connective tissue disorders associated with it. The underlying genetic differences in how your body produces collagen and other structural proteins can’t be reversed with medication or procedures.
However, that doesn’t mean you’re without options. Treatment focuses on managing symptoms, protecting your joints, and improving your quality of life. A multidisciplinary approach tends to work best: physical therapy to build strength and improve proprioception, occupational therapy for daily joint protection strategies, pain management (including both medication and approaches like cognitive behavioral therapy), podiatry for foot and ankle support, and regular monitoring from specialists as needed.
For many people, good posture habits, supportive footwear, consistent strengthening exercise, and learning to move within a safe range of motion can dramatically reduce flare-ups and improve function. It’s a condition you manage, not one that’s fixed. But effective management can make a tremendous difference in how you experience your hypermobility symptoms day to day.
Can Hypermobility Get Worse with Age?
This one is nuanced. For some people, especially those with milder, asymptomatic hypermobility, flexibility actually decreases naturally with age, and the condition becomes less noticeable. Children and young people tend to be the most hypermobile.
But for those with symptomatic hypermobility, the secondary effects can worsen over time. Years of joint instability can lead to degenerative joint disease, chronic soft tissue injuries, and cumulative damage. Muscles that have been compensating for loose ligaments may fatigue, leading to deconditioning. Changes in activity level, stress, injury, pregnancy, or hormonal shifts can tip a hypermobile body from “managing” to “crisis.”
The connective tissue laxity itself doesn’t necessarily get worse, but the downstream consequences of living in a hypermobile body can accumulate. I can say from my own experience that while I’ve had hypermobility symptoms most of my life, it wasn’t until more recently that things like my feet changing size and the chronic swelling really escalated. This is exactly why proactive management (strengthening exercises, joint protection, and regular check-ins with healthcare providers) is so important at every stage.
Bonus: Perimenopause, Estrogen, and Hypermobility
Something that doesn’t get talked about nearly enough is how hormones interact with hypermobility. Estrogen, progesterone, and other reproductive hormones have a direct effect on connective tissue, and when those hormones fluctuate or are out of balance, hypermobility symptoms can flare in a big way.
Estrogen helps preserve muscle mass and supports collagen creation. It plays a crucial role in maintaining connective tissue health by enhancing collagen production, which is essential for joint stability. So when estrogen levels swing wildly during perimenopause, or drop off during menopause, many people with hypermobility notice their symptoms getting significantly worse. Research shows that around 61% of people with hEDS report increased joint pain, instability, and fatigue during this transition.
But here’s the thing that caught me off guard: too much estrogen can also be a problem. I was recently on too much estrogen for several months, and it triggered intense joint pain flares. The relationship between estrogen and connective tissue isn’t as simple as “more is better” or “less is worse.” Higher estrogen levels have been associated with increased knee laxity in women. Finding the right hormone levels is individual, and it can take time and trial and error. For someone with hypermobility, where connective tissue is already more lax than it should be, that balance is even more delicate.
Perimenopause, the phase with variable hormone fluctuations, tends to be more challenging than menopause itself, when estrogen stabilizes at low levels. Those rapid hormonal swings are what make perimenopause so destabilizing for hypermobile bodies. More than one-third of participants in one study experienced a worsening of symptoms before their periods while in perimenopause, and some researchers note that perimenopause can even be when hEDS is first diagnosed because symptoms escalate so noticeably.
Progesterone tends to increase joint laxity, so it should be used with caution in hypermobile people. This means that if you’re on HRT or hormonal contraceptives, the specific formulation matters. HRT can impact collagen production in the skin, potentially improving skin elasticity and hydration, but the balance between estrogen and progesterone needs to be carefully managed with your provider.
If you’re hypermobile and entering perimenopause, or if you’re on any form of hormonal therapy, it’s worth having a conversation with your doctor about how your hormones might be amplifying your hypermobility symptoms. This is still a vastly under-researched area, but awareness is growing, and getting your hormone levels checked could be an important piece of the puzzle. I’m currently waiting to see an HRT specialist here in the Netherlands who can help me better manage my perimenopause and estrogen, as I take a progesterone only pill, as well as two different estrogen medications.
Shoes
Shoes are integral to fashion, and I definitely feel like my shoe game is the weakest it’s ever been right now. I’ve had to say goodbye to almost all of my Strangecvlt. I got rid of a lot of shoes that I’ve purchased as well, because they no longer fit me or hurt to wear. But I’m the most heartbroken over a lot of the cool shoes that I found thrifting that no longer fit. I’m down to wearing one pair of shoes for everything right now.
The first pair of shoes that I’ve found that are comfortable for me are the Brooks Adrenaline GTS 24 GTX shoes size 40,5. Waterproof shoes are a must in the Netherlands and the Brooks Running Shoes fit that because they have a waterproof GORE-TEX(R) layer. They’re cushioned and do a good job supporting my feet. And this is the pair of shoes that I wear everywhere, with everything, right now.
Dave has helped me research for boots and it looks like the RM Williams Lady Yearling Boot might be a good replacement for the Taos Crave Boot that I loved. I now know my feet are too wide for my old pair.
The RM Williams Lady Yearling Boots are designed for all day wear and comfort, walking long distances, with a tiny 4.5cm block heel and rubber sole. While I prefer pointed toed shoes, almond toe is more forgiving for hypermobility. The 3/4 Goodyear welt means that it is fully repairable. As I wore my Taos Crave boots for 8 years, I prefer to shop for items that are buy it for life quality and can be repaired when needed.
Final Thoughts
Living with hypermobility is an ongoing learning process. I’m still figuring out which shoes work now that my feet are a completely different size, how to modify my workouts to avoid injury, and how to explain to people that “yes, being flexible can actually hurt.” Having lived with these symptoms most of my life and only getting diagnosed during physical therapy for an unrelated surgery, I know firsthand how easy it is for hypermobility to fly under the radar.
If any of this resonates with you, I’d encourage you to talk to your doctor or physical therapist about an assessment. Hypermobility symptoms are extremely common, but the condition is also extremely underdiagnosed. Getting a proper evaluation can be the first step toward understanding your body better and getting the support you need.
Have you been diagnosed with hypermobility or hEDS? I’d love to hear about your experience in the comments.
Disclaimer: I am not a medical professional. This article is based on my personal experience with hypermobility and publicly available medical resources. Please consult your healthcare provider for personalized medical advice.
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