Hypermobility, hypermobility spectrum disorders (HSD), and Ehlers-Danlos syndrome (EDS), all refer to connective tissue disorders, a condition that occurs later on in life but something you are born with. This blog is about the symptoms of hypermobility. From a musculoskeletal perspective, it is your joint’s excess movement and soft tissue laxity that impact how stable your posture and movement are. It means your pelvis, for example, connected to your lower extremities and spine, becomes easily unstable, leading to pelvic floor dysfunction. While there is a gene associated with EDS, the treatment and presentations of EDS and other forms of hypermobility are the same.

The Pelvic floor is the ‘floor’ of the house, with the pelvis being the ‘house’ so how can the floor be stable when the house is unstable? While every person with hypermobility and its versions has pelvic floor dysfunction, every person with pelvic floor dysfunction does not have joint hypermobility. In this blog, we are going to explore what the common signs and symptoms of hypermobility are so if you happen to be reading our website blogs because you have pelvic floor dysfunction, you get to see if the many other issues you may be experiencing that you are considering as separate problems are different faces of the same problem called hypermobility.

Who Gets Hypermobility Or EDS?

While more common in females than males, it is not gender or age-specific. As children or teenagers, we tend to ‘shine’ in activities such as ballet, gymnastics, cheer, acrobatics, and dance because of our abilities to go to the extreme range of motion but that comes with a price which is injuries and aches and pains in as early as teenage and early 20s to much later stages of life.

I look at hypermobility and movement like driving. Instead of driving at the crosswalk, bendy bodies go into the crosswalk, or past the crosswalk and into the intersection when stopping. That is where the spectrum of hypermobility changes.

What Are The Signs And Symptoms Of Joint Hypermobility?

The following list can be discouraging and that is not the purpose of this blog. It is so you see that so many of your symptoms that you might have considered as separate problems are different chapters of the same problem. While the condition does not go away, managing your health is the focus of this blog and all blogs that I write. What matters is to make sure you seek care from those clinicians who treat the hypermobile population or at least show interest in wanting to learn more to help the bendy friends.

While there are so many people with hypermobility who don’t know they are hypermobile, the ‘generic’ treatments do not apply to you as a bendy person. What works for the other population may be damaging to you. Please make sure to contact my office for a provider near you and also consult the EDS Society for the list of providers.

  • Joint Hypermobility

Joints are generally lax and easy to hyperextend. This is from the laxity in the connective tissues such as ligaments.

  • Pelvic Floor Dysfunction

This is because the pelvis, just like all the other parts, is not stable because the connective tissue is loose, and the support structures and proprioception are not as strong. Also because the soft tissue, including the internal organs, is too ‘loose’, it is easier to have prolapse or excess movement of the internal organs. This means it is easier for the bendy person to have prolapse and incontinence though they are not the only presentations of pelvic floor dysfunction. Please make sure to read my blog on this subject.

  • Joint Pain

There does not need to be an incident related to the pain and it can be something as simple as getting out of pain. This can happen in the ankles and hips, shoulders and wrists, back and knees. Joint pain is the most common complaint of the bendy population,

  • Dislocations And Subluxations

Subluxations are excess movement just before dislocation. It is common to see rib and jaw subluxations, and shoulder and hip subluxations without any apparent reason.

  • Jaw Pain And Tooth Grinding

I see so many cases of jaw pain and this happens because of the excess movement at the jaw joint. The pain happens because the ‘disc’ that has blood vessels and nerve ending between the ‘ball’ and socket’ of the TMJ gets pushed on and does not glide with the bones. It is also common to see the jaw locking in the open position which is then an emergency room visit to numb the area to put the joint back in place.

  • Rib Cage Pain

Oftentimes, because of the excess movement on the joints, the connection between the ribs and the spine in the back or the sternum in the front is easily subluxated causing pain on both or one side with movement, when sleeping or at rest. That is why breathing biologically is so important for the bendy population.

  • Headaches

The connection between the skull and the neck is commonly weak and unstable in the hypermobile population. This is referred to as CSI or CranioSacral Instability. This can cause headaches in the form of tension and when coupled with blood vessel complications, can also show up as migraine headaches.

  • Foot And Ankle Pain

Once again, all joints in hypermobility and EDS are involved and when it involves the foot and ankle, given that they have to balance the structure above (the body), it is so common to have sprained foot and ankle or pains in those areas. At my clinic, we focus heavily on the feet and ankle stability and the device I like almost all of my patients have is ToePro.

  • “Clumsiness” And Poor Proprioception

Most bendy persons call themselves clumsy while as children or teenagers, they have a history of performing tasks that others simply could not do. The clumsiness happens because the joints are not stable and the poor proprioception, while still being studied, in my opinion, comes from not being stable enough in any given position, long and often enough to establish what it takes to end with a stronger proprioception.

  • Soft Or Stretchy Skin

Because hypermobility is a connective tissue condition, it is easy to have more elastic skin.

  • Muscle Weakness

Weakness in the muscles happens because all soft tissue is more lax and joints don’t have the full collection of nature’s best tools needed for stability. This means that muscles are pulled into the picture out of sync. sometimes much longer than they are designed to be and for tasks that are not the specific muscles’ tasks. Weak muscles happen as a result of being overworked and tired or not being used enough so they are not conditioned. In the world of pelvic floor dysfunction, this can mean too tight or too ‘weak’ of the pelvic floor.

  • Fatigue

The level of ‘chaotic’ order of use of the body only means tiredness and fatigue. Lack of sleep does not help the matter either. Also, there seem to be low levels of testosterone in women that should be measured since the low levels cause a lack of energy, fatigue and not building muscles.

  • Allergies

Mast Cell Activation is a common finding among the hypermobile and as a part of its activation, histamine is released. Histamine leads to allergies so a ‘bug’ bite can easily turn into a blister that lasts a long time before it heals.

  • Increased Healing Time

This again happens as a result of mast cell activation and soft tissue involvement.

  • Bruising

Blood vessels are soft tissue and with the involvement of the blood vessels and their rupture, it is easy to get a bruise.

  • Digestive Issues

Gastrointestinal problems are common as a result of dysautonomia which is a common finding of the bendy population. Dysautonomia is when the sympathetic and parasympathetic nervous systems do not control each other so if for instance, the stomach acid is produced for digestion, it is not downregulated by the parasympathetic nervous system when enough of it is produced to digest the food. Dysautonomia impacts all functions of the body and requires the autonomic nervous system to control the functions.

  • Constipation

A great example of dysautonomia is constipation which is a multidimensional issue. So while movement of the food along the intestine is an autonomic nervous system function, it is also controlled by the function of a muscle called puborectalis. When that muscle is tight, it does not relax enough for the fecal material to go down the colon to exit. The tightness can easily happen as a result of pelvis instability. Most often people think of constipation as a nutrition-related issue and while nutrition plays a role, it is not the only factor to consider.

  • Orthostatic Intolerance Or POTS

Postural orthostatic tachycardia syndrome, or POTS, is an increase in heart rate when standing up from a lying position which can cause dizziness and nausea. This is a result of dysautonomia discussed before. POTS is another common presentation among the hypermobile population.

  • Flat Feet Or Pronated Arch

The arches of the feet may be flattened or collapsed because of joint instability.

  • Anxiety

Another presentation of dysautonomia is anxiety which unfortunately gets treated with psychiatric medications while it is the lack of control of the parasympathetic vs sympathetic nervous system.

  • Heat And Cold Intolerance

Here comes another way dysautonomia can show up: controlling the constriction vs dilation of the blood vessels is the function of the autonomic nervous system which is impacted by hypermobility.

  • Swelling In Hands And / Or Feet

When blood vessels dilate but don’t constrict accordingly, the hands and feet can get swollen.

  • Daily Aches And Pains

With all that I listed, you can see how so many functions of the body are compromised and how the unstable joints can be taxing to the supportive structures causing aches and pain. The question to the bendy population is not if they have no pain but how intense their pain is each day.

There seems to be a high incidence of scoliosis and neurodivergence such as ADHD, and autism but I don’t necessarily see that across the board.

What To Do Next If You Are Hypermobile?

If you are hypermobile regardless of if you have pelvic floor dysfunction or not, please make sure you seek care from clinicians who have experience working with the hypermobile population. We are connected to other providers and chances are we may know someone in your area that treats hypermobility. Once again, you can use the directory on the EDS Society for a provider near you. Look on social media and ask around; whatever you do, make sure you educate yourself about your condition and be an advocate for yourself.

Please contact me regardless as I may be able to point you in the right direction; of course, for those close to me, do not hesitate to contact my office for an appointment and those from other states or far away, contact me for a coaching session. 

Dr. Shakib