The Connection Between Hypermobility, Nervous System Dysregulation, and Trauma

If you’re hypermobile or have been told you might have EDS or a hypermobility spectrum disorder, you may have noticed a pattern:

• Pain that doesn’t fully make sense based on imaging

• Dizziness, fatigue, or “weird body symptoms”

• Feeling stuck in fight-or-flight

• Symptoms that flare with stress, illness, or lack of sleep

• A history of injuries that seem to linger longer than expected

  
  

You might also have heard that the nervous system or trauma plays a role, which can feel confusing or, for some, invalidating.

We are hitting a surge of research in these fields, but there is much still to discover about root cause. Here is what the current research tells us:

No hard proof that hypermobility itself is caused by trauma or anxiety

We currently do not have strong evidence for causation of hypermobility being expressed because someone went through trauma. However, many practitioners in this field do notice a clinical link between the two (meaning many people with hypermobility also happen to have a history of trauma and/or anxiety).

Generalized joint hypermobility (including hypermobile EDS and hypermobility spectrum disorders) is considered a connective tissue–based condition. In other words, the joints truly do move more than average. We do know that the effects of hypermobility can show up in daily life as more than "flexible bodies." Many struggle daily with pain, instability, fatigue, dizziness, and symptom flares, and this is strongly influenced by the nervous system.

Why the nervous system matters in hypermobility

Your nervous system is constantly deciding:

• How much muscle tone to apply

• How safe movement feels

• How much pain to amplify or dampen

• How your heart rate, blood pressure, and digestion respond

In hypermobile bodies, several things can stress this system over time.

1. Increased injury and micro-trauma

   Hypermobile joints often move further before muscles can stabilize them. Even without major injuries, this can lead to:

   
   

   • Repeated minor strains

   • Joint irritation

   • Ongoing “background” pain signals

     
     

   Over time, the nervous system may stay on higher alert.

   
   

2. Proprioception challenges

   Many hypermobile people have reduced joint position sense — meaning the brain gets fuzzier information about where joints are in space.

   
   

   When the brain doesn’t trust the body’s position, it often responds with:

   
   

   • Guarding

   • Muscle tension

   • Avoidance or over-control

   • Pain as a protective signal

     
     

3. Autonomic nervous system differences (dysautonomia)

   Research shows high overlap between hypermobility and autonomic symptoms such as:

   
   

   • Dizziness or lightheadedness

   • Heart rate spikes with standing

   • Fatigue

   • Temperature sensitivity

   • Exercise intolerance

     
     

   This doesn’t mean everyone with hypermobility has dysautonomia, but it does mean the systems that regulate internal balance are often more sensitive.

   
   

 Where does trauma fit into this?

Trauma doesn’t necessarily mean a single (or several) catastrophic event(s).

Many people also experience trauma as:

• Repeated injuries

• Years of unexplained symptoms

• Being told “everything looks normal”

• Feeling dismissed or not believed

• Pushing through pain because rest wasn’t an option

  
  

(If you want to know your "trauma score" you can test it here: Acesaware.org)

Research shows higher rates of PTSD symptoms and nervous system hyper-reactivity in people with joint hypermobility. This doesn’t mean trauma causes hypermobility, but it can shape how symptoms are processed and maintained. I find it helpful to think of trauma as something that can turn the volume up for a preexisting condition or sensitivity.

The “chicken or the egg” question

So which comes first?

The current most accurate answer is: it’s usually a feedback loop meaning the nervous system and connective tissue are constantly interacting.

• A hypermobile body is more vulnerable to injury and instability

• Injuries and unpredictability increase nervous system threat

• Ongoing threat increases pain sensitivity, muscle guarding, and fatigue

• Those changes make joints feel even less stable

Does nervous system dysregulation cause hypermobility?

Short answer: No, not in the structural sense.

There is currently no strong evidence that nervous system dysregulation or trauma causes the connective tissue changes that lead to generalized joint hypermobility.

However, there is growing evidence that nervous system dysregulation:

• Influences pain severity

• Affects muscle coordination and joint control

• Impacts recovery timelines

• Contributes to chronic symptoms even after injuries heal

  
  

So while dysregulation doesn’t create hypermobility, it can absolutely shape how limiting or disabling it feels.

Why this matters for treatment and feeling better

If treatment only focuses on strengthening or “fixing” joints, many people plateau.

If treatment only focuses on calming the nervous system, joints may still feel unstable.

The most effective approach usually includes:

• Improving joint control and strength

• Restoring proprioception

• Supporting autonomic regulation

• Reducing pain sensitivity

• Building confidence in movement again

  
  

It's common for those who have experienced stress or trauma to get caught in old cycles of movement and tension holding, but feeling better begins when you can understand triggers and relationships and start learning the tools your mind and body need to find safety and build resilience.

A reframe that many people find helpful

Hypermobility doesn’t mean your body is broken. Trauma and nervous system dysregulation may contribute to severity of symptoms but there are ways to rewire your system to feel and move better.

• Your system is highly adaptable

• Your nervous system is very responsive

• You may need more precision, pacing, and support than the average rehab model provides

Please keep in mind that the information presented are for education only. If you are interested in working with House of Balance, please book a free consultation.

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Sources:

Mathias CJ, Low DA, Iodice V, Owens AP, Kirbis M, Grahame R. Postural tachycardia syndrome—current experience and concepts. Nature Reviews Neurology. 2021.

Wu W, et al. Autonomic dysfunction in Ehlers–Danlos syndrome and hypermobility spectrum disorders. Frontiers in Neurology. 2024.

Hertel J, et al. Cardiovascular autonomic symptoms in hypermobile Ehlers–Danlos syndrome. Journal of Clinical Medicine. 2024.

Malfait F, et al. Pain mechanisms in the Ehlers–Danlos syndromes. American Journal of Medical Genetics. 2021.

Celletti C, et al. Central sensitization and pain processing in joint hypermobility. Pain Research & Management. 2024.

Halverson C, et al. Clinician-associated traumatization in patients with hypermobile Ehlers–Danlos syndrome. Disability and Rehabilitation. 2023.

Llach CD, et al. Association between joint hypermobility and PTSD symptoms. Journal of Psychiatric Research. 2025.

Autonomic Neuroscience Editorial Board. Sensory and autonomic nervous system involvement in hEDS. Autonomic Neuroscience. 2025.

Dr. Stephanie House has over 15 years of experience in the health and wellness field and currently owns her own practice as a mind-body physical therapist in Charlottesville, VA.

She holds post doctoral certifications in vestibular therapy, dry needling, yoga therapy, and pregnancy and postpartum. With extensive continued study on topics such as mind-body medicine, integrative health, breathwork, and somatic therapy, Dr. House's extensive knowledge and comprehensive approach gets to the root of movement dysfunction and pain.

If you are ready to change the way you move and feel, work directly with Dr. House or join the House of Balance Newsletter.

"I don't heal or fix people. What I do is get your body and mind to an optimal place so you can start to heal yourself. We all have a greater capacity to heal than we are led to believe. With the appropriate input and support, our bodies can do amazing things." Stephanie House, PT, Founder

For specific questions or inquiries, reach out to Dr. House directly: info@houseofbalancept.com or visit her website: www.houseofbalancept.com