Hypermobility spectrum disorders are a group of conditions that affect connective tissue, which helps support joints, tendons, ligaments and muscles. When connective tissue is more elastic than expected, joints may move further than average. For some children this is simply a normal variation, but for others it can contribute to symptoms such as pain, repeated sprains, fatigue, or difficulty keeping up with sport and daily activities. In many cases, symptoms can be present for years before a clear explanation is found.
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Extra joint range can be helpful in some activities, but it can also increase the demand on the muscles to provide stability. If strength, control and coordination don’t keep up with that demand, joints can become more vulnerable to irritation or injury over time. Common issues we see include:
recurring “tweaks,” sprains or strains
joint pain that flares with sport, growth spurts or increased training loads
a sense of instability, clicking, or joints that “give way”
poor posture endurance and aching with prolonged sitting or standing
A key part of management is learning how to use available range safely. In general, repeated end-of-range positions, especially in uncontrolled movement, can increase symptoms. Stretching and flexibility work is not always helpful for symptomatic hypermobility unless it is paired with a structured strengthening plan that improves control around the joint.
Some hypermobility conditions have a strong family link and can present with more frequent joint subluxations or dislocations and persistent pain. In some cases, hypermobility can also occur alongside other health concerns, such as gastrointestinal symptoms or cardiovascular features, which is why a coordinated approach with your GP or specialist may be recommended when indicated.
Because more muscular effort is required to stabilise flexible joints, some children and teenagers use extra energy for postural control and movement. This can look like:
getting tired quickly or reduced tolerance to sport and exercise
poor concentration with seated tasks, fidgeting, or difficulty staying in one position
slumped sitting posture or leaning on armrests for support
reduced body awareness (proprioception), balance difficulties, or “clumsiness”
pain after activity rather than during it
Paediatric physiotherapy focuses on improving stability, confidence and participation without overloading sensitive joints. We provide:
education for children and parents, including practical strategies for school and sport
activity guidance and load management to reduce flare-ups
strength and control programs for key joints, including core and hip stability
balance and proprioception training to improve coordination and reduce injury risk
advice on technique and movement habits, including avoiding uncontrolled end-range positions
For older children and teenagers, reformer-based exercise can be a great option because it builds strength and joint awareness with controlled resistance and without high impact. Our Clinical Exercise Rehab sessions can support this approach, particularly when the goal is to improve stability, endurance and confidence for sport and daily life.
If you’re concerned about hypermobility, recurring injuries, joint pain, fatigue or poor posture endurance, a paediatric physiotherapy assessment can help clarify what’s going on and provide a practical plan.
