Can you exercise with joint hypermobility? Yes — here’s how
Overview of hypermobility
Hypermobility means that some or all of a person’s joints can move beyond the normal range expected for that joint. This can be due to differences in connective tissue that provide support and stability.
Hypermobility exists on a spectrum. For some people, it’s just a natural variation that doesn’t cause problems. For others, it can lead to pain, joint instability, frequent injuries, fatigue, and other symptoms, especially when part of a condition like:
Generalised Hypermobility Spectrum Disorder (G-HSD)
Hypermobility-Type Ehlers-Danlos Syndrome (hEDS)
Other forms of Hypermobility Spectrum Disorders (HSD)
In these cases, hypermobility isn’t just about doing party tricks. It’s a systemic condition that can affect muscles, joints, digestion, circulation, and energy levels.
When someone is hypermobile and also experiences widespread symptoms throughout their body, it’s worth considering whether they might have hypermobile Ehlers-Danlos syndrome (hEDS). Ehlers-Danlos syndrome (EDS) is a group of heritable connective tissue disorders that affect the structure and function of collagen, a protein that’s abundant in the human body and found in the skin, joints, blood vessels, and other tissues.
There are 13 subtypes of EDS, each with different genetic causes and symptoms. Some are rare and life-threatening, while others—like hEDS—are more common but can still significantly impact quality of life. hEDS is the most common subtype of EDS, but it is also the only one, to date, with no identifiable genetic marker.
Because connective tissue is found throughout the body, individuals with hEDS can experience a wide range of multi-systemic symptoms. However, they typically have:
Joint hypermobility
Chronic pain (which may be widespread or localised)
Joint subluxations and/or dislocations (note: not everyone with hEDS experiences this)
Mild skin hyperextensibility
Injuries that occur easily and in unexpected situations
Skin and tissue fragility
The EDS "trifecta" — EDS, postural orthostatic tachycardia syndrome (POTS), and mast cell activation syndrome (MCAS)
Some believe that HSD and hEDS are the same condition. Both can cause generalised joint hypermobility, pain, fatigue, joint instability, dislocations and/or subluxations, impaired proprioception, digestive issues, and dysautonomia. However, if someone doesn’t meet the full criteria for hEDS, they are diagnosed with HSD.
Functionally, hEDS and HSD are similar. There is a misconception that hEDS is more severe than HSD, but someone with HSD can be just as affected as someone with hEDS. Therefore, both conditions deserve proper recognition, support, and care.
Why movement is still important
For some people with symptomatic hypermobility, the thought of exercise is overwhelming. You might think “why would I exercise when I have hypermobile joints and I’m in constant pain and fatigue?” — and this is completely valid.
Although the prevalence of hEDS is thought to be 1 in 500 (1), it is undeniably under recognised, underdiagnosed, and misunderstood. There are health professionals like myself that specialise in this area, but there still aren’t enough of us to meet the demand of clients with hEDS/HSD seeking treatment. That’s why many of us have gotten ourselves wrapped up with health professionals that don’t understand our bodies and treatment often worsens symptoms or isn’t effective whatsoever.
With the right health professional that specialises in hypermobility and its co-occurring conditions, it’s possible to engage in movement without worsening your symptoms. It’s going to look a little different to how the general population does it, but the beauty of exercise is that there are so many ways to do it.
Movement plays a vital role in managing symptoms for people with hEDS and HSD. Because the joints are hypermobile, muscles have to work harder to provide the stability that lax ligaments can’t. This extra workload can lead to muscle spasms, pain, and fatigue that can be debilitating. On top of that, the unique makeup of connective tissue in people with hEDS and HSD means that structures like tendons and muscles fatigue more quickly and are more prone to damage.
Increased ligament laxity affects proprioception, which is our body’s ability to sense joint position and movement. When this internal “GPS” is off, it becomes harder to move safely and efficiently, increasing the risk of injuries. These factors can make everyday movement more exhausting and painful, and over time, they can have a real impact on function, confidence, and quality of life.
Benefits of movement for hypermobility
1. Improves joint stability
Strengthening the muscles around the joints helps provide stability and support where connective tissue can’t, which makes everyday movements feel more secure.
2. Reduces pain and muscle tension
Pain in hypermobility often comes from a combination of joint instability, poor muscle endurance, and overcompensation. Exercise helps by:
Improving postural control
Building muscle balance
Relieving tightness and spasm
Movement has an analgesic effect, including for people with symptomatic hypermobility. This is done by stimulating the release of endorphins (natural pain-relieving chemicals) and desensitising the nervous system.
3. Builds muscle endurance and strength
People with hypermobility tend to fatigue more quickly due to differences in their connective tissue. Tailored strength and endurance training helps build capacity gradually, reducing the strain on joints and improving resilience during daily activities.
4. Supports proprioception and body awareness
Many hypermobile people experience poor proprioception, meaning the brain has trouble sensing joint position. This can increase the risk of injury and reduce falls risk. Proprioceptive exercises help improve body awareness, balance, and coordination.
5. Helps manage fatigue
Fatigue in hEDS and HSD isn’t just about feeling tired. It’s deep, full-body exhaustion that often has multiple causes. Gentle, well-paced movement can actually help by improving circulation, preventing deconditioning, and supporting steadier energy throughout the day.
6. Can help manage POTS symptoms
Up to 80 per cent of people hypermobility also experience POTS (2), a form of dysautonomia that affects heart rate and blood flow when changing positions. Given that the autonomic nervous system controls involuntary body functions, there is a wide range of POTS symptoms. A well-designed exercise program can:
Improve blood vessel tone
Support cardiovascular fitness
Help the body adapt to upright positions
Recumbent or reclined exercises (like seated cycling or lying leg exercises) are often helpful early on, before progressing to upright movement as tolerated.
7. Supports mental health
Living with chronic symptoms can be emotionally and mentally draining. Movement can boost mood, reduce anxiety, and build a greater sense of trust and confidence in your body.
8. Improves function in daily life
Whether it’s standing longer, walking without pain, or managing stairs, targeted exercise can make daily life more manageable. By improving muscle control, endurance, and joint support, you can reduce injury risk and increase independence.
Key movement principles for hypermobility
Stability first: Focus on building control and joint stability before adding load or complexity.
Start low, go slow: Gentle progressions reduce the risk of flares and setbacks. Start with low reps and lower load before building.
Form matters more than reps: Prioritise alignment and muscle engagement over quantity or intensity.
Start with a smaller range of motion (ROM): Starting with a smaller, more controlled ROM allows the body to build strength and stability within a safe, supported range. You can gradually increase your ROM over time as control improves.
Use mobility aids, braces, or tape if you need to: These tools can be incredibly useful in alleviating symptoms and assisting you in exercising safely. You’re not “cheating” if you do use them. As hypermobile humans, we need a “second skeleton” to help us because our connective tissue is different — so go ahead!
Build in rest and recovery: Because fatigue and flares are common, pacing and recovery are essential. Start small and sustainable, and adjust based on energy, symptoms, and how your body responds.
What types of movement are usually helpful?
I have two answers. In general, there are types of exercise that work well for people with symptomatic hypermobility, such as:
Strength training
Proprioceptive training (e.g. balance work, closed-chain movements).
Isometrics to build strength without joint movement.
Pilates, yoga (modified), and resistance band work with proper support and guidance.
Aerobic training for those with POTS
My other answer is that it depends. Every person with HSD/hEDS is different and are on different health journeys. What works for you may not work for another person. For example, my body loves strength training, including heavy lifts, but I’ve had to work myself up to doing it over the last five years. Based on my personal lived experience and expertise as an exercise physiologist (EP), I encourage people with HSD/hEDS to get strong and build as much neuromuscular control to improve joint control as possible within their capacity.
What to watch out for
Overstretching: Stretching might feel relieving, but it can make instability worse. Just because you have hEDS/HSD doesn’t mean that you don’t have tight muscles. However, passive stretching can cause rebound spasms as it can take away the tension in your muscles needed to stabilise your joints. Hypermobile bodies usually tolerate active stretching or trigger point release better.
Fatigue or flares: Fatigue isn't always muscular; autonomic and connective tissue issues may play a role.
Hyperextending joints during exercises: Encourage “soft” elbows and knees.
Overtraining or boom-bust cycles: When you feel good, it’s understandable to want to make the most of your increased capacity or catch up on things that you’ve missed. Some people, including myself (in the past), tend to exceed their energy envelope and crash physically and mentally when they get into this boom-bust cycle. That’s why it helps to work with an EP or physiotherapist who understands hypermobility — they can help you break that cycle and move more confidently.
Closing thoughts
Living with symptomatic hypermobility comes with unique challenges, but movement can still be safe, empowering, and even enjoyable when approached with care and understanding. The goal is to build stability, confidence, and connection with your body, one small step at a time.
If you’re just starting out, know that it’s okay to go slow. Start with control, honour your limits, and celebrate every win, no matter how small. There’s no wrong way to participate in movement. What works for you may not work for someone else, and that’s okay. There’s beauty in learning what works for your body.
You’re not alone in this, and you deserve support that works with your body, not against it.
If you’re looking for individualised, tailored support, I’m here to help. I have lived experience of hEDS and offer telehealth EP services for people with invisible conditions, including hEDS and HSD. Reach out if you’d like to learn more about how I can support you.
References:
Demmler JC, Atkinson MD, Reinhold EJ, Choy E, Lyons RA, Brophy ST. Diagnosed prevalence of Ehlers-Danlos syndrome and hypermobility spectrum disorder in Wales, UK: a national electronic cohort study and case–control comparison. BMJ Open. 2019;9(11):e031365. doi:10.1136/bmjopen-2019-031365.
Grigoriou E, Boris JR, Dormans JP. Postural Orthostatic Tachycardia Syndrome (POTS): Association with Ehlers-Danlos Syndrome and Orthopaedic Considerations. Clin Orthop Relat Res. 2015;473(2):722–728. doi:10.1007/s11999-014-3898-x.
