Joint hypermobility factsheet
Introduction
Joint hypermobility is when some of a child’s joints move further or more than normal. It is called generalised joint hypermobility when multiple joints are affected.
Joint hypermobility is a congenital condition, meaning your child is born with it. It often affects the:
- wrists
- ankles
- elbows
- fingers
- knees.
Children are at a higher risk if they:
- have a genetic condition like Down syndrome or Marfan syndrome
- are female
- have family members with joint hypermobility.
Joint hypermobility is common and can be helpful with activities flexibility, including:
- gymnastics
- swimming
- ballet.
Some children may also have problems with joint weakness and instability.
Signs and symptoms
Children with joint hypermobility may:
- bend their thumbs and elbows backwards, further than normal
- extend their knees and elbows further than normal
- reach movement milestones, like sitting or crawling, slightly later than other children the same age.
Older children with joint hypermobility may find they have weakness or instability in their joints if they:
- are more active
- play sports
- do activities where they don’t have full control of their bodies, like bouncing on a trampoline.
This can cause repeated:
- muscle tears, strains, and sprains
- subluxations - when joints slip out of their sockets slightly
- dislocations – when joints slip out of their sockets completely.
They may also have pain during or after an activity. This often improves, but can last longer for some.
Other symptoms can include:
- ongoing muscle pain and weakness
- fatigue – ongoing tiredness
- poor sleep
- dizziness
- low fitness levels
- ongoing constipation - hard poos that are difficult to pass
- gastro-oesophageal reflux
- ongoing stomach aches
- irritable bowel syndrome (IBS) – a condition that causes cramping, pain, bloating, gas, diarrhoea and constipation
- ongoing urinary tract infections or problems
- weak pelvic floor muscles.
Diagnosis
A doctor will ask about your child’s health and family history and do a physical check.
If more than four joints are affected, talk to your doctor about related health issues. This helps manage symptoms and prevent injury.
Your child may also be checked for other conditions like Joint Hypermobility Syndrome or Ehlers-Danlos Syndrome if they have:
- ongoing joint or muscle pain
- fatigue
- pain that stops them from going to school or doing activities.
Treatment
Treatment helps to manage symptoms and may include:
- building strength
- regular exercise
- pain management
- managing stress and anxiety
- treating other related issues like digestive problems.
Children can protect their joints with safe movement and good nutrition. Their treatment team may include:
- physiotherapists – to support exercise
- dieticians – to help with nutrition
- occupational therapists – to help with daily tasks that are affected, like handwriting
- psychologists – to support mental health
- gastroenterologists – to manage digestive issues
If your child gets injured, it may take longer to recover. Recovery treatments may include:
- rest
- using a brace or splint
- gentle exercise in water
- pain management.
Management
Physical Activity
Exercise is important, especially for children with joint hypermobility. Not moving enough can lead to weak muscles and more injuries.
Talk to the doctor or physiotherapist about the best types of sport or activity for your child. Some children may need to:
- avoid certain sports or activities
- spread activity across the day to prevent fatigue or pain.
Good activities for strength and joint mobility include:
- swimming
- pilates
- bike riding
- walking
- water aerobics.
Children with hypermobility will need to:
- avoid contact sports
- avoid activities where they can’t control their body, like trampolining
- pace themselves with sport and activity
- avoid “boom and bust” activity cycles, where they do too much activity one day and none the next.
Pain management
Your child’s treatment team can help with managing ongoing pain. This might include:
- physiotherapy for strength
- psychology for pain-related support
- medicine
- other strategies based on specific needs.
Digestive issues
Too much flexibility in the muscles and connective tissue can affect how the digestive and urinary systems work.
Digestive problems may improve with:
- plenty of water
- regular, safe movement
- a high-fibre, whole food diet.
These help make poo softer and easier to pass.
Talk to the doctor before using products like laxatives. Probiotic-rich foods like yoghurt or kefir may help with cramping and gas.
Functional difficulties
Some children may struggle with tasks that involve fine motor skills. These can include:
- hand-writing
- hygiene tasks
- doing up buttons and zips.
An occupational therapist can help with strategies and tools to support your child and improve their confidence.
Mental health and well-being
Children with joint hypermobility may experience:
- anxiety
- panic attacks
- depression
- chronic pain
- fatigue.
A psychologist can help with coping strategies, therapy and building resilience.
At home, support your child to learn about their condition and focus on what their body can do. Highlight the benefits of flexibility, such as skills in sports like gymnastics.
