Joint hypermobility affects millions of people worldwide, yet it remains one of the most misunderstood conditions in healthcare. While many view it as simply being “double-jointed” or unusually flexible, the reality is far more complex. Hypermobility creates a cascade of effects throughout the body, particularly impacting the nervous system in ways that can profoundly affect daily life and overall health.
What Is Hypermobility?
Hypermobility occurs when joints move beyond their normal range of motion due to increased flexibility in connective tissues, including ligaments, tendons, and joint capsules. This increased flexibility stems from variations in collagen structure—the protein that provides strength and stability to our connective tissues. While some degree of flexibility is beneficial for movement and athletic performance, excessive hypermobility can lead to joint instability and a host of secondary complications.
The condition exists on a spectrum, from mild hypermobility that causes occasional discomfort to hypermobility spectrum disorders (HSD) and Ehlers-Danlos syndromes (EDS), which can significantly impact quality of life. What many people don’t realize is that this connective tissue variation doesn’t just affect joints—it influences the entire nervous system.
The Nervous System Connection
The relationship between hypermobility and the nervous system is intricate and multifaceted. Connective tissue doesn’t just hold our joints together; it also provides structural support for our nervous system. When this tissue is more elastic than typical, it can affect both the neuromotor system (which controls movement) and the autonomic nervous system (which regulates automatic bodily functions).
Neuromotor System Effects
The neuromotor system relies on precise feedback from joints, muscles, and tendons to coordinate movement effectively. This feedback system, called proprioception, tells our brain where our body is in space and how our joints are positioned. In hypermobile individuals, this system becomes compromised in several ways:
Proprioceptive Deficits: Overstretched ligaments and joint capsules provide less accurate information about joint position. This creates a constant state of uncertainty for the nervous system, which must work harder to maintain stability and coordinate movement. The brain receives mixed signals about where limbs are positioned, leading to compensatory muscle tension and fatigue.
Altered Motor Control Patterns: To compensate for joint instability, the nervous system develops altered movement patterns. Muscles that should work in coordination may fire at inappropriate times or with excessive force. This leads to inefficient movement patterns that can cause pain, fatigue, and increased injury risk.
Muscle Guarding and Compensation: The nervous system responds to joint instability by increasing muscle tension around hypermobile joints. While this provides some stability, it also creates chronic muscle tension, trigger points, and eventually leads to muscle fatigue and pain. Some muscles become overactive while others become inhibited, creating imbalances throughout the body.
Autonomic Nervous System Dysfunction
Perhaps even more significantly, hypermobility frequently affects the autonomic nervous system, leading to a condition called dysautonomia. The autonomic nervous system controls heart rate, blood pressure, digestion, temperature regulation, and many other vital functions. In hypermobile individuals, this system often becomes dysregulated, leading to a wide range of symptoms that may seem unrelated to joint flexibility.
The connection likely stems from several factors: connective tissue abnormalities affecting blood vessel elasticity, altered baroreceptor function (sensors that help regulate blood pressure), and the chronic stress placed on the nervous system by dealing with unstable joints. This creates a perfect storm for autonomic dysfunction.
Common Symptoms: Beyond Joint Pain
The symptoms of hypermobility extend far beyond the joints themselves, often creating a complex picture that can be challenging to diagnose and treat:
Physical Symptoms:
- Joint pain and stiffness, often worse in the morning or after periods of inactivity
- Frequent subluxations (partial dislocations) or complete dislocations
- Chronic fatigue that seems disproportionate to activity level
- Muscle pain and cramping
- Headaches and migraines
- Easy bruising and slow wound healing
- Digestive issues including gastroparesis, constipation, or irritable bowel syndrome
Autonomic Symptoms:
- Postural orthostatic tachycardia syndrome (POTS) – rapid heart rate increase when standing
- Blood pressure fluctuations
- Temperature regulation problems
- Dizziness and lightheadedness
- Sleep disturbances
- Anxiety and panic attacks (often with a clear physiological component)
- Brain fog and concentration difficulties
Neuromotor Symptoms:
- Poor balance and coordination
- Increased clumsiness or tendency to drop things
- Difficulty with fine motor tasks
- Feeling of weakness despite normal strength testing
- Delayed reaction times
Why Traditional Chiropractic Approaches May Not Be Ideal
Traditional chiropractic care focuses heavily on joint manipulation and high-velocity, low-amplitude adjustments. While these techniques can be beneficial for many people, they may not be the best approach for hypermobile individuals, and in some cases, they can even be counterproductive.
The Problem with High-Force Adjustments: Hypermobile joints already move beyond their normal range. High-force manipulations can potentially increase joint laxity further, leading to greater instability rather than improved function. The temporary relief that may follow an adjustment often gives way to increased symptoms as the overstretched tissues struggle to provide adequate support.
Lack of Stability Focus: Traditional chiropractic often emphasizes restoring mobility to restricted joints. However, hypermobile individuals typically don’t lack mobility—they lack stability. Treatments that focus solely on increasing range of motion may exacerbate the underlying problem.
Missing the Bigger Picture: Hypermobility is a systemic condition affecting multiple body systems. Approaches that focus only on individual joint restrictions may miss the broader neurological and systemic implications of the condition.
Better Approaches for Hypermobile Patients: Hypermobile individuals often benefit more from gentle, low-force techniques that focus on improving proprioception and muscle activation patterns. Approaches such as muscle energy techniques, soft tissue work, and exercises that improve joint stability and motor control tend to be more effective. The goal shifts from increasing mobility to optimizing stability and nervous system function.
Theories Behind the Increasing Prevalence
Healthcare providers and researchers have noted what appears to be an increasing prevalence of hypermobility and related conditions. While some of this increase may be due to better recognition and diagnosis, several theories attempt to explain why these conditions might genuinely be becoming more common:
Environmental Factors: Modern lifestyle changes may contribute to the development or expression of hypermobility traits. Reduced physical activity levels, particularly during childhood development, may affect collagen formation and joint stability. Additionally, exposure to environmental toxins and chemicals may influence collagen synthesis and structure.
Evolutionary Advantage Theory: Some researchers propose that hypermobility traits may have provided evolutionary advantages in certain environments or activities. As survival pressures have changed, these traits may be more prevalent in the population than they were historically. The “triple helix” nature of human evolution suggests that traits that were once advantageous may now create challenges in our modern environment.
Improved Survival Rates: Advances in medical care mean that individuals with connective tissue disorders who might not have survived to reproductive age in previous generations now live full lives and pass on their genetic traits. This could contribute to an apparent increase in prevalence over time.
Hormonal and Nutritional Factors: Changes in diet, exposure to hormonal disruptors, and nutritional deficiencies may affect collagen formation and connective tissue health. The modern Western diet, often lacking in nutrients essential for collagen synthesis like vitamin C, zinc, and certain amino acids, may contribute to connective tissue abnormalities.
Diagnostic Awareness: Much of the apparent increase may simply reflect better awareness and diagnostic criteria. Conditions that were previously dismissed as “growing pains,” “chronic fatigue,” or “anxiety” are now being recognized as manifestations of hypermobility spectrum disorders.
The Path Forward: Comprehensive Care
Understanding hypermobility as a complex, multi-system condition is crucial for effective treatment. Rather than focusing solely on joint manipulation, successful management typically requires a comprehensive approach that addresses:
- Stability training: Exercises that improve proprioception and teach the nervous system to provide better joint support. The brain learns. Often patients with this issue are engaging in over-stretching and encouraging too much movement!
- Autonomic nervous system support: Lifestyle modifications, stress management, and chiropractic care to address dysautonomia
- Pain management: Addressing chronic pain through multiple modalities while avoiding approaches that might increase joint laxity (various exercises and stretches)
- Nutritional support: Ensuring adequate nutrients for collagen synthesis and overall nervous system health
- Education and self-management: Helping patients understand their condition and develop strategies for long-term management
Conclusion
Hypermobility is far more than just being “flexible.” It represents a complex interaction between connective tissue structure and nervous system function that can affect virtually every aspect of health and daily life. As our understanding of these connections continues to evolve, it becomes increasingly clear that effective treatment must address the condition holistically, focusing not just on individual joints but on the broader neurological and systemic implications.
For healthcare providers, recognizing the signs of hypermobility and understanding its far-reaching effects is crucial for providing appropriate care. For individuals with hypermobility, understanding these connections can be empowering, providing a framework for making sense of seemingly disparate symptoms and pursuing more effective treatment approaches.
The key lies in shifting our perspective from seeing hypermobility as simply a musculoskeletal issue to understanding it as a complex neurological and systemic condition that requires thoughtful, comprehensive care.