Treating hypermobility centers on building muscle strength around loose joints, managing pain, and learning to move in ways that protect your body from injury. There’s no cure for joint hypermobility or hypermobility spectrum disorder, but the right combination of exercise, support tools, and lifestyle adjustments can significantly reduce pain, prevent dislocations, and improve daily function. Most treatment plans are non-surgical and built around physical therapy as the foundation.
How Hypermobility Is Identified
Hypermobility is typically assessed using the Beighton Score, a nine-point system that checks flexibility in five areas: whether your thumbs can touch your forearms, whether your little fingers bend back past 90 degrees, whether your elbows and knees hyperextend, and whether you can place your palms flat on the floor with straight legs. Each side of the body is scored separately for the first four tests, plus one point for the forward bend. A score of 4 or higher out of 9 generally indicates generalized joint hypermobility in adults, while children typically need a score of 5 or higher because they’re naturally more flexible.
A high Beighton Score alone doesn’t mean you need treatment. Hypermobility becomes a clinical concern when it causes chronic pain, frequent subluxations (partial dislocations), fatigue, or difficulty with daily activities. If that’s your situation, building a care team and starting a structured treatment plan makes a real difference.
Exercise: The Core of Treatment
Strengthening the muscles around your joints is the single most effective thing you can do for hypermobility. When your connective tissue is too stretchy to hold joints in place on its own, stronger muscles act as a backup stabilization system. The goal isn’t to become less flexible but to give your body more control over the range of motion it already has.
Isometric exercises, where you contract a muscle without moving the joint, are particularly well suited for hypermobile bodies. They engage the slow-twitch muscle fibers responsible for postural stability and joint support. Because there’s no repetitive joint movement involved, isometric work carries a lower risk of triggering tendon inflammation, bursitis, or the kind of microtrauma that hypermobile joints are prone to. Think wall sits, planks, or pressing your palms together in front of your chest. These exercises build strength at specific joint angles without the cyclic loading that can lead to overuse injuries.
That doesn’t mean all other exercise is off limits. Isotonic exercises (ones involving movement, like squats or bicep curls) are also beneficial and can be introduced gradually. An eight-week program of three sessions per week, with each session lasting 40 to 60 minutes including warmup and cooldown, is a common starting framework. The key is progressing slowly and paying attention to how your joints respond rather than pushing through instability for the sake of a harder workout.
Proprioception and Balance Training
People with hypermobility often have reduced proprioception, meaning their brain gets weaker signals about where their joints are positioned in space. This is one reason hypermobile people are more prone to stumbles, rolled ankles, and accidental hyperextension. Balance training directly addresses this. Standing on one leg, using wobble boards, practicing tai chi or qi gong, and even playing balance-focused video games all help retrain the nervous system to better sense joint position. Taping or lightly wrapping a joint during exercise can also improve proprioceptive feedback by adding sensory input through the skin.
Activity Pacing to Prevent Flare-Ups
One of the most common patterns in hypermobility is the boom-and-bust cycle: you feel good on a particular day, overdo it, then spend the next several days in pain and unable to function. Activity pacing breaks that cycle, but it’s more nuanced than simply “rest more.”
Effective pacing involves planning your activities in advance, prioritizing what matters most, alternating between demanding and lighter tasks, and maintaining consistent activity levels day to day rather than swinging between extremes. The goal isn’t to permanently slow down. It’s to build a sustainable baseline of activity and then gradually increase it over time. This is sometimes called quota-contingent pacing, where you set a target amount of activity and stick to it regardless of how you feel that day, rather than letting symptoms dictate everything. On good days you stop at your quota instead of overdoing it. On harder days you still aim for your baseline rather than doing nothing. Over weeks and months, this approach steadily expands what your body can handle.
Joint Supports and Bracing
External supports serve different purposes depending on the severity of your joint instability, and choosing the right type matters.
- Compression garments provide light pressure on the skin to improve body awareness and reduce pain. They don’t restrict movement but give your nervous system extra proprioceptive input, helping you sense where your joints are. These work well for daily wear during activities like walking or working.
- Functional splints allow movement through a controlled range. Silver ring splints, for example, prevent finger joints from hyperextending while still letting you write, type, and grip. Ankle braces like the Richie brace serve a similar purpose for walking. These are useful when a joint is unstable enough to cause problems during normal activity but doesn’t need to be immobilized.
- Rigid braces are reserved for situations involving significant instability and pain, such as after a dislocation or when nerve damage affects muscle function. They fully restrict movement to protect the joint while it recovers.
The general principle is to use the least restrictive support that keeps you functional. Over-bracing can lead to muscle weakness over time, which makes instability worse in the long run.
Managing Pain
Pain in hypermobility comes from multiple sources: joint instability, muscle fatigue from compensating for loose joints, nerve irritation, and secondary inflammation from repeated injuries like subluxations or tendinitis. Because the causes overlap, pain management often requires layering several approaches.
Over-the-counter pain relievers like acetaminophen are a reasonable starting point for everyday joint aches. Anti-inflammatory medications work well when there’s a specific inflammatory trigger like bursitis, tendinitis, or post-dislocation swelling. For people who get stomach problems from standard anti-inflammatories, COX-2 inhibitors offer similar relief with fewer gastrointestinal side effects.
When pain has a nerve component, which is common in hypermobility as unstable joints can compress or irritate nerves, different medications come into play. Certain anti-seizure medications originally developed for epilepsy are effective for this type of burning, shooting, or tingling pain. Low-dose tricyclic antidepressants are another option that can address nerve pain while also helping with the sleep disruption that many hypermobile people experience. These medications are typically tried in combination rather than alone, and finding the right mix takes time and adjustment.
What’s notably absent from best-practice guidelines is any rush toward stronger pain medications. The treatment ladder moves through several levels of non-opioid options first, because hypermobility is a lifelong condition and pain management needs to be sustainable over decades.
Building a Care Team
Hypermobility affects multiple body systems, so treatment works best when it involves more than one type of specialist. A well-rounded care team typically includes a rheumatologist to manage joint symptoms, a physical therapist with experience in hypermobility to guide your exercise program, a psychologist to address the mental health impact of chronic pain and fatigue, and in some cases a geneticist to clarify whether your hypermobility is part of a connective tissue disorder like Ehlers-Danlos syndrome. Cardiology may also be involved, since some hypermobility syndromes affect the cardiovascular system.
The challenge is that many of these specialists aren’t used to working together. Multidisciplinary clinics specifically for hypermobility and Ehlers-Danlos syndrome are still relatively uncommon, though they’re growing. If one isn’t available near you, having a primary care provider who’s willing to coordinate between specialists fills much of the same role. The important thing is that your providers communicate with each other, because treatments in one area (like a new exercise program) directly affect others (like pain levels and medication needs).
When Surgery Is Considered
Surgery is generally a last resort for hypermobility, and for good reason. A systematic review of outcomes after joint stabilization surgery in hypermobile patients found that results were similar to or slightly worse than outcomes in people without hypermobility. The connective tissue fragility that causes the problem in the first place also complicates healing: wound recovery is slower, and the risk of the same joint becoming unstable again after surgery is higher. That said, surgery isn’t ruled out entirely. For joints that dislocate repeatedly despite months or years of physical therapy and bracing, a stabilization procedure may still offer meaningful improvement. The decision depends on which joint is involved, how severely it affects your life, and whether all conservative options have been genuinely exhausted.
Nutritional Considerations
Vitamin C plays a direct role in collagen production, and since hypermobility involves deficient or faulty connective tissue, ensuring adequate vitamin C intake supports whatever collagen synthesis your body can manage. Magnesium is relevant for a different reason: it helps regulate muscle contraction and relaxation, and deficiency can worsen the muscle cramps and spasms that many hypermobile people experience. Researchers have noted that several symptoms associated with Ehlers-Danlos syndrome overlap with symptoms of specific nutritional deficiencies, suggesting that targeted supplementation may help alleviate some complaints. This isn’t a substitute for physical therapy or medical treatment, but it’s a low-risk addition that addresses real physiological needs.