What Is the Best Treatment for Hypermobility?
- Dr. Stephanie House
- 4 days ago
- 5 min read
According to a Neuro-Focused, Integrative Physical Therapist
When someone asks me, “What’s the best treatment for hypermobility?” I often feel a little apologetic in my response. While I know some fun, effective neuro tricks that can help people feel more stable quickly (tongue exercises, anyone?), the real solution for managing hypermobility takes work, and unfortunately is not a quick fix.
What Is Hypermobility?
Hypermobility is a spectrum that describes joints that move beyond the normal range of motion. Ehlers-Danlos Syndrome (hEDS) is a diagnosis on the far end of the mobility spectrum while Hypermobility Spectrum Disorder (HSD) is more generalized.
When someone presents with localized joint hypermobility - one or two hypermobile joints - treatment may be successful with a strengthening program alone. When multiple joints are affected - in cases of generalized joint hypermobility - multi-layered healing beyond strengthening exercises is usually required for success.
While there are common themes among individuals with hypermobility, each person brings their own unique challenges and needs. This means assessment must be comprehensive. Treatment approach must be multi-faceted and dynamic to decrease risk of injuries and pain and to optimize success.
The Connection Beyond "Loose Joints"
People with generalized joint hypermobility have altered collagen and elastin components in their connective tissue. Connective Tissue is found in many structures in the body including skin, tendons, muscles, fascia, and ligaments. Although the connection is not entirely clear, people with symptomatic hypermobility often report dealing with multiple or all categories of Dr. Andrew J. Maxwell's theory of the “Super Pentad Syndrome.”
Hypermobility
Increased joint mobility beyond the normal range of motion.
Gastrointestinal dysfunction
Including Irritable Bowel Syndrome (IBS), gastroparesis (the slowing down or even stopping of portions of the digestive tract), colitis, etc.
Mast Cell Activation Syndrome (MCAS) / histamine intolerance
An overactive immune system that can present as skin issues, allergies, and food sensitivities.
Autoimmunity
Conditions where the body begins attacking itself and can lead to many symptoms including fatigue, brain fog, joint pain, rashes, and more.
Dysautonomia
Dysfunction in the autonomic nervous system which can include Postural Orthostatic Tachycardia Syndrome (POTS), dizziness, blood pressure issues, and light-headedness/fainting.
How is Hypermobility Treated?
Despite individual differences, I generally approach treatment in the following ways:
Step One: Understand That We Can’t Treat Hypermobility Like a Joint Problem Alone
Yes, this population needs to create more joint stability and improve motor coordination. But people with symptomatic hypermobility often also experience:
Chronic pain
Fatigue
Dizziness, positional intolerance, or dysautonomia
Gut issues
Anxiety, overwhelm, and sensory sensitivity
These symptoms can greatly hinder progress. Clients often tell me "I want to get stronger, but I feel like I'm in a cycle of taking two steps forward, one step back."
Step Two: Build Safety in the Nervous System
The nervous system has a key role in the presence and intensity of the symptoms stated above. That’s why hypermobile people find they start reaching their strength, mobility, and symptom goals when treatment includes both movement and nervous system regulation.
If the brain doesn’t feel safe, the body will guard, compensate, and overprotect. In hypermobility, this often shows up as:
Muscle tension that’s always “on”
Difficulty relaxing or sleeping
Pain that doesn’t follow a clear mechanical pattern
Fluctuating symptoms that seem unrelated but are part of a bigger puzzle
Before we ask the body to perform high-level movement tasks, we need the nervous system to be in more of a parasympathetic state - optimal for healing and learning. Techniques to do this might involve:
Breathwork with co-regulation (not just belly breathing)
Slow, grounded sensory work
Eye, inner ear, and cranial nerve integration
Step Three: Train the Deep Stabilizers
Hypermobility is sometimes stated as being “strong but unstable.” In reality, many hypermobile people are strong in compensatory ways. They often brace with large, global muscles, but lack stability in the deep core muscles and joint stabilizers.
Examples of places we retrain:
The diaphragm to coordinate with the pelvic floor
The intrinsic foot muscles and deep hip rotators
The scapular stabilizers and deep cervical flexors
Controlled co-contraction strategies that build joint integrity without locking out
Step Four: Pacing and Patience Instead of Pushing Progress
In traditional rehab, we often talk about progressive overload and pushing through. But with hypermobility, too much too soon may lead to flare-ups, shutdowns, or injury.
That’s why treatment must involve nervous system-informed pacing:
Gentle, graded exposure to activity
Consistent, low-threat movement
Additional external tactile, visual, and verbal support while learning new motor patterns. (Think taping, hands-on support, mirrors, cupping)
Learning to recognize early signs of fatigue, instability, or dysregulation
Being willing to deviate or change the plan as the body needs
It’s not about getting to the finish line the fastest. It's also not about doing less forever. It's about training smarter, so the body can learn to trust itself again.
Step Five: Treat the Whole Person
The best treatment for hypermobility is collaborative and holistic - a clinical environment that honors complexity, rather than simplifying or dismissing symptoms:
Manual therapy that supports, rather than overstretches
Nervous system regulation tools that can be used between sessions and beyond physical therapy
Education to reduce fear and rebuild body trust
Strategies to improve movement quality and reduce pain - sending signals of safety to the brain while building new movement patterns
Education on inflammation and lifestyle medicine
Sleep hygiene optimization
Final Words of Advice for Treating Hypermobility:
People with hypermobility often feel like their myriad of symptoms have been written off or downplayed by medical professionals. Because so many body systems are involved, it is difficult to find a provider that can put all of the pieces together. In my opinion, a physical therapist is set up to be an excellent point person for this population as we can spend more time with our patients than physicians and have training across several body systems. We are also compassionate, problem-solvers to a fault, and great advocates.
Maybe most importantly we need a shift in the conversation. Because hypermobility isn’t just about joints that move too much. It’s about bodies that feel too much in some ways and not enough in others. It’s about systems working overtime to stay upright. And it’s about people who have been told they’re too complicated - or that “it’s all in your head.”
You are not too complicated to help. Things really are connected. It’s not all in your head. You just need a treatment approach that’s as integrative and adaptive as you are.
*Disclaimer: The information provided is for educational purposes only. Always consult with a healthcare professional for personalized advice. If you are interested in working with House of Balance, please book a free consultation.
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
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