What is hypermobility?

Ligaments are structures which act like rubber bands and support the joints. They tend to be longer and stretch more in people with hypermobility. This causes a person to have more movement at their joints, which is also known as being double jointed. Their muscles have to work hard to control this bigger range of movement and a lot of strength is needed to keep the joint safe and in place.

Is it normal?

In most cases people with hypermobility are only mildly affected. They are the same as everyone else, but just have slightly more movement at their joints. In rare cases, hypermobility can be a part of a more severe disorder which affects the other systems of the body, but the treatment is always the same.

How will it affect me?

You may have to come to a therapy assessment or to see a healthcare professional because you have had an injury, some pain or a problem with completing daily tasks or activities. This leaflet should answer your questions about these problems and give you advice on how to deal with them.

Whenever I do lots of exercise I get pain – what should I do?

Pain and injury can be a warning you are asking some muscles to work too hard and perhaps not using other muscles which could do the job better.

There are two types of muscles, those which work to help us move and those which work to support the body, like a corset. By strengthening the corset muscles, you provide your body with extra support so you can enjoy activity without pain or injury.

You may find you have less pain once the muscles in your abdomen, back and legs are stronger. Your physiotherapist will be able to advise you about exercises which will help you in this way.

Does it matter which shoes I wear?

Footwear can be a big help when combined with strengthening exercises. When you are buying shoes, look for ones with:

• stiffness around the heel
• a sturdy sole to act as a shock absorber
• soft uppers, preferably with lace-ups.

Trainers are often very comfortable.

When buying shoes, avoid:

• shallow uppers
• thin soles
• slip-on shoes
• shoes with no support around the ankle.

This does not mean you can’t wear slip-on or heeled shoes for short lengths of time, for example to a party or for special occasions, but be careful if you want to spend a lot of time doing strenuous activities like dancing and long distance walking, especially on uneven ground.

Sometimes it may be sensible to be assessed by a podiatrist for insoles which can be slipped inside your shoes. These can provide extra support to your foot and ankle.

Are there things I should or should not do?

Everyone should avoid stressing their joints too much and if your joints move into extreme positions, it is important your muscles are strong enough to cope with this. Some sports are better for people with hypermobility than others, but any activity is possible as long as you are strong. You may also need specialist advice before getting involved in heavy impact sports, such as football, rugby, basketball and most other contact sports.

Some things I do with my hands are especially difficult – do I need special tools or equipment?

Occupational therapists are trained to help solve problems you may have with daily tasks such as dressing, handwriting, using cutlery and turning handles. They will be able to look at the activities you find difficult and advise on different ways these can be done. In rare cases, special equipment is recommended but usually it is enough to change the way you carry out the task, especially when this is combined with exercises to strengthen your back, shoulder and arm muscles.