Beyond Flexible Joints: 5 Surprising Symptoms of Hypermobility You Might Not Realize Are Connected
Hypermobility is often described simply as having joints that move through a greater-than-usual range of motion. But for people with symptomatic hypermobility, the experience can extend far beyond being unusually flexible or experiencing muscle and joint pain.
Some people with generalized joint hypermobility (GJH) have no symptoms at all and can move through a larger range of motion without any problems. For others, hypermobility can be associated with a variety of symptoms affecting different systems of the body, including the musculoskeletal, neurological, gastrointestinal, autonomic, skin, pelvic, respiratory, and energy systems.
Symptoms can vary significantly from person to person and may change over time.
5 Lesser-Known Symptoms of Hypermobility
You may already associate hypermobility with flexible joints, joint instability, or chronic pain. But there are other symptoms you might not realize can sometimes occur alongside hypermobility.
1. Digestive Issues, Bloating & Constipation
Digestive symptoms such as bloating and constipation are reported by some people with hypermobility.
Pelvic floor dysfunction can also contribute to difficulty with bowel movements. If the pelvic floor muscles do not relax or coordinate effectively during a bowel movement, you may feel the urge to go but have difficulty passing stool.
This can sometimes lead to chronic straining or a feeling of incomplete evacuation, which may contribute to bloating and discomfort.
A pelvic floor physical therapist can assess how the muscles of the pelvic floor are functioning and help address problems with coordination, relaxation, strength, and pressure management when appropriate.
2. Lightheadedness When Standing or in Hot Weather
Do you ever feel lightheaded when you first stand up, stand for a long period of time, or spend time in hot weather?
Some people with hypermobility experience symptoms of orthostatic intolerance, which refers to symptoms that occur when upright, such as lightheadedness, dizziness, fatigue, or a rapid heartbeat.
One proposed contributor is increased pooling of blood in the lower extremities when standing. When appropriate, physical therapy can be part of a broader management plan and may include strategies such as compression garments, hydration and electrolyte strategies as recommended by your medical team, movement strategies, and a gradual cardiovascular conditioning program.
If you experience frequent or significant dizziness, fainting, or other concerning symptoms, it's important to discuss them with your physician or medical team.
3. Exercise Intolerance or Feeling Worse the Next Day
Exercise can be especially challenging when you have hypermobility.
You may feel completely fine while exercising but notice increased pain, fatigue, or other symptoms later that day or the following day. This can make it difficult to build the strength and endurance needed to improve joint stability and participate in the activities you enjoy.
A physical therapist familiar with hypermobility can help create a gradually progressive strengthening and conditioning program based on your current abilities and symptoms.
Rather than simply pushing through pain or repeatedly triggering symptom flares, the goal is to find the right starting point and gradually increase your body's capacity over time.
4. Clumsiness & Poor Body Awareness
Do you feel like you're constantly bumping into things, tripping, losing your footing, or having trouble knowing where your body is in space?
Some people with hypermobility experience differences in proprioception, which is your body's ability to sense the position and movement of your joints and limbs.
When joint position is harder to sense, your body may have to rely more heavily on your muscles and vision to control movement.
Physical therapy can incorporate balance, coordination, strengthening, and proprioceptive exercises to help improve body awareness and movement control.
5. Fidgeting or Sitting in "Weird" Positions
If you're hypermobile, you may find yourself sitting in positions that other people would consider unusual—or constantly shifting positions throughout the day.
There may be a reason for this.
When joints are naturally more mobile, resting at the end of your available range of motion may sometimes feel more stable or comfortable than actively using your muscles to maintain a position.
Fidgeting can also be a way of making small movements when your muscles become fatigued from holding a position.
While there's nothing inherently wrong with sitting in a position that feels comfortable, developing muscular endurance, strength, and movement awareness can give you more options for supporting your body comfortably.
Your physical therapist may also recommend tools such as pillows, bolsters, or other positioning strategies to help you find comfortable and sustainable positions.
Can Physical Therapy Help With Hypermobility Symptoms?
Yes!
Physical therapy can play an important role in managing hypermobility-related pain, joint instability, movement difficulties, and exercise intolerance. Depending on your symptoms and individual needs, treatment may also address areas such as pelvic floor dysfunction, balance and coordination, strength, endurance, posture, and movement strategies.
At Dynamic Flow Physical Therapy, we take a whole-body approach to hypermobility rather than simply focusing on the joint that hurts.
Our goal is to understand why your symptoms are happening and how your entire body is contributing to the way you move and feel.
For someone with hypermobility, treatment may include:
Individualized strengthening to improve joint stability
Progressive exercise and cardiovascular conditioning
Balance and coordination training
Proprioceptive and body-awareness exercises
Movement and posture education
Pelvic floor physical therapy when appropriate
Strategies for managing symptom flares
Education about pacing and gradually increasing activity
Personalized modifications to help you return to the activities you enjoy
The goal isn't to make you less flexible.
If you're naturally hypermobile, you don't necessarily need to "stretch more" or try to eliminate your flexibility.
Instead, the goal is often to help your body better control the range of motion you already have by improving strength, coordination, endurance, and confidence in movement.
Could Your Symptoms Be Related to Hypermobility?
If you've been dealing with a combination of seemingly unrelated symptoms—such as joint pain, pelvic floor problems, digestive issues, dizziness, fatigue, exercise intolerance, or feeling unstable—it may be worth discussing your symptoms with a qualified healthcare professional.
Having one or more of these symptoms does not mean that you are hypermobile. Many of these symptoms have numerous possible causes, and they can occur independently of hypermobility.
A proper evaluation and diagnosis are important so that you can receive the right care.
At Dynamic Flow Physical Therapy, we specialize in helping people with hypermobility and complex, interconnected movement and pelvic health concerns understand their bodies, build strength and stability, and get back to the activities they love.
Your symptoms may be connected—and understanding the bigger picture can be the first step toward feeling better.
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Written by: Mary Panushka