Hypermobility is a term often used and not completely understood. When referring to anatomy, the identification of hypermobility is given to someone who has excessive joint laxity, meaning their normal anatomical joint movement can move past a usual anatomical barrier. This also means that ligaments, the structures that stabilise joints throughout the body, are looser and stretchier. Roughly 10-20 % of the population are considered hypermobile.
So how is hypermobility screened? The standard test used is known as the Beighton Score, which is a 9 point physical scoring system used to measure range of motion and flexibility in joints. Essentially, each point is given individually for each specific movement below, with one point for left side and one point for right:
Little finger can be passively extended beyond 90° — right
Little finger can be passively extended beyond 90° — left
Thumb can be passively opposed to the flexor aspect of the forearm — right
Thumb can be passively opposed to the flexor aspect of the forearm — left
Elbow hyperextends beyond 10° — right
Elbow hyperextends beyond 10° — left
Knee hyperextends beyond 10° — right
Knee hyperextends beyond 10° — left
Forward flexion with knees straight, allowing palms to rest flat on the floor
Maximum score 9 is achieved if all tests are positive.
When interpreting the scores, a higher score indicates greater joint laxity. A commonly used threshold for generalised joint hypermobility in adults is 5/9 or higher, although the appropriate threshold can vary with age and population. In children and adolescents, higher thresholds may be used. It is however important to note that the Beighton score is a screening measure rather than a specific diagnosis. A high score does not by itself establish a diagnosis such as hypermobile Ehlers-Danlos syndrome (hEDS), and a lower score does not necessarily exclude clinically significant hypermobility. Assessment should also consider the person's symptoms, history, other joints not captured by the score, and relevant diagnostic criteria.
So how can hypermobility impact someone’s physical wellbeing?
A primary factor is the impact on muscles. Your muscles essentially create movement, but additionally they also help keep your joints controlled and stable. When a joint is particularly mobile, the surrounding muscles may need to stay active for longer to maintain control. This can contribute to muscle fatigue and soreness, particularly after prolonged activity. For example, someone with hypermobile hips may find that their hip and surrounding muscles become tired or sore after standing or walking for extended periods. If a joint feels unstable, the body may naturally recruit nearby muscles to provide additional support. Over time, this increased muscular workload can contribute to feelings of tightness, aching, or fatigue. Someone with hypermobility might notice that certain areas such as the neck, shoulders, lower back, hips, or calves can all become particularly prone to soreness.
Hypermobility isn't necessarily just about being "too flexible." For some people, the bigger issue is controlling movement within that range. If a joint regularly moves toward the end of its available range, muscles may need to work harder to slow, control, or redirect the movement. This can become especially noticeable during exercise when muscles are repeatedly contracting to stabilise a joint. For someone with symptomatic hypermobility, the additional demand placed on stabilising muscles may make certain exercises feel disproportionately tiring. This doesn't mean exercise should be avoided. In many cases, appropriately prescribed strengthening and conditioning can help improve muscular control and joint stability.
Osteopathy can help to address hypermobility and its impacts through a few different approaches:
1. Managing muscle tension and soreness
People with hypermobility may use surrounding muscles more heavily to help stabilise joints. This can contribute to muscular fatigue, tightness, and soreness. Osteopathic treatment may use hands-on techniques to help reduce discomfort and improve movement.
2. Improving movement and coordination
Treatment may focus on how different areas of the body move together rather than simply trying to increase flexibility. This can be particularly useful when someone has difficulty controlling certain movements.
3. Supporting joint stability
Rather than repeatedly stretching already-mobile joints, an osteopath may incorporate exercises designed to improve strength, control, and stability around symptomatic joints.
4. Helping manage activity-related pain
An osteopath can help identify activities, postures, or training patterns that may be aggravating symptoms and develop a gradual approach to returning to or modifying those activities.
5. Working alongside exercise rehabilitation
For long-term management, strengthening and progressive conditioning are generally important components. Hands-on treatment can potentially be used alongside an exercise program rather than as the sole treatment.
In short, Osteopathy can be used as part of a broader, holistic approach to managing symptomatic hypermobility, particularly when muscle tension, pain, movement patterns, or activity-related problems are involved. It’s important to distinguish managing symptoms from “fixing” hypermobility—the underlying joint mobility generally isn’t something manual treatment can permanently change.
If you suspect you may have hypermobility, or wish to investigate muscle soreness and fatigue further, feel free to book your initial consultation at Elevate Osteopathy via our online booking system.
