What is it?

A hypermobile joint is defined by Grahame (2012) as “….hypermobile when the range of motion in that joint is deemed to be excessive, taking into account, age, gender and ethnic background”

Joint hypermobility syndrome is defined as “A benign multi-system disorder of connective tissue with overlap features” (Grahame 2013)


Features in Childhood:

  • Late developmental Landmarks
  • Easy bruising
  • Clumsy
  • Fatigue
  • Dislocations and subluxations
  • Family History
  • Poor response to local anaesthetics
  • Gastro intestinal problems
  • Dizzyness and fainting
  • ‘Growing pains’

Ross and Grahame (2011) advocate referral to a Podiatrist when joint hypermobility syndrome is identified for “tailor made orthotics”.

Patients with joint hypermobility syndrome do commonly present with a flat foot type when weightbearing (Hakim and Grahame 2003).

There are two commonly used tests for the condition, the Beighton scale and Brighton Criteria. The Beighton was the original scale used focusing just on joint range of motion however as it was realised that this is a multi system condition the Brighton criteria was developed to give a more holistic assessment.


This must be multi-disciplinary to address the individual’s complaint and presentation. Modalities aimed at stabilising and supporting the hypermobile joints with improving muscular strength are necessary and this can be achieved with appropriate strengthening programmes, activity modification, orthoses, taping and every day advice on sitting and standing postures.

If other complaints are present such as fainting then this must also be addressed appropriately.

Overall aims must be to increase function, decrease disability/pain and prevent future problems such as inherit fear of exercise and weightbearing.  

There are many sports people from multiple disciplines who are hypermobile and at the top of their sport:

Michael Phelps is the greatest Olympian of all time, look at his warm up routine where it is clear to see the hypermobility in his joints as he can slap his own back!


Gymnasts of the various disciplines are at a clear advantage by being hypermobile:


Novak Djokovic is hypermobile (google image ‘Djokovic splits’ and look out at around midway down for his mid air splits as he launches a backhand) and can be seen in this video removing his orthoses before he sends his shoes into the crowd: