Different Causes of Hypermobility
Understanding Different Causes of Hypermobility
Hypermobility is a clinical sign, not a single diagnosis.
It describes joints that move beyond the range typically expected, but this can occur for different reasons.
For some people, it’s a natural variation in how their body moves.
For others, it reflects differences in connective tissue, development, or how the body functions over time.
You might recognise yourself in more than one of these — or not feel like you fit neatly into any category at all.
These categories are not fixed or separate — many people sit across more than one.
Why This Matters
Understanding why hypermobility is present can help make sense of the bigger picture.
In clinical practice, this is particularly important because different causes of hypermobility can present in similar ways, but require different considerations.
For example, hypermobile Ehlers-Danlos syndrome (hEDS) is diagnosed by excluding other conditions that may present similarly.
For many people, this process takes time — and it’s okay if things don’t feel fully clear yet.
Connective Tissue Conditions
Some forms of hypermobility are linked to differences in the structure of connective tissue, the material that provides support and stability throughout the body.
This includes:
Ehlers-Danlos syndromes (EDS)
More common:
Hypermobile (hEDS) → joint hypermobility, instability, multi-system symptoms, chronic pain
Less common:
Classical (cEDS) → stretchable, fragile skin, atrophic scarring, velvety skin texture
Vascular (vEDS) → blood vessel fragility (including aneurysm or rupture), organ involvement, pneumothorax (often without marked joint hypermobility)
Very rare:
Periodontal (pEDS) → early-onset gum disease, gum recession, and tooth loss
Kyphoscoliotic (kEDS) → early-onset kyphoscoliosis and muscle weakness
Spondylodysplastic (spEDS) → short stature, muscle weakness, limb bowing, and characteristic facial features
Brittle Cornea Syndrome (BCS) → corneal fragility, vision changes, and hearing loss
Arthrochalasia (aEDS) → severe hypermobility with frequent dislocations, especially in the hips and from a young age
Musculocontractural (mcEDS) → congenital contractures and characteristic facial features
Classical-like (clEDS) → stretchy, velvety skin without atrophic scarring, often with foot deformities
Dermatosparaxis (dEDS) → extremely fragile, loose skin with severe bruising and characteristic facial features
Myopathic (mEDS) → muscle weakness and proximal joint contractures
Cardiac-valvular (cvEDS) → significant involvement of the heart valves
Marfan syndrome
Often involves taller stature, long limbs, fingers and toes, chest differences (such as pectus excavatum), and features affecting the heart and eyes
Loeys-Dietz syndrome
May involve wide-set eyes, a cleft palate or bifid uvula, and blood vessel differences
Common patterns may include:
Skin → softness, stretch, fragility
Joints → instability, injuries, delayed recovery
Cardiovascular → heart or blood vessel differences
Other features → eyes, facial structure, body proportions
Genetic/Developmental Conditions
Some forms of hypermobility are associated with genetic or developmental conditions that affect how the body develops, moves, and functions over time.
In these cases, hypermobility is often related to factors such as muscle tone, coordination, or overall development, rather than differences in connective tissue structure.
This includes:
Down Syndrome
Fragile X Syndrome
Williams Syndrome
Common patterns may include:
Muscle tone → lower muscle tone (hypotonia)
Movement → coordination differences or delayed motor development
Joints → increased flexibility or joint instability
Development → differences in learning, behaviour, or sensory processing
These patterns can also overlap with other forms of hypermobility.
Neuromuscular Conditions
Some forms of hypermobility are influenced by how muscles and the nervous system work together to support and control movement.
In these cases, joints may appear hypermobile, even when connective tissue structure is typical, not because of differences in connective tissue structure, but due to reduced muscle support, coordination, or control.
This may include:
Cerebral palsy
Muscular disorders (such as muscular dystrophies)
Nerve-related conditions (such as peripheral neuropathies)
Common patterns may include:
Muscle strength → reduced strength or endurance
Movement control → coordination differences or difficulty stabilising joints
Joints → instability or increased movement due to reduced muscular support
Function → fatigue, difficulty with sustained or controlled movements
These patterns can also overlap with other forms of hypermobility.
Acquired / Secondary Hypermobility
Hypermobility can also develop over time, rather than being present from birth.
In these cases, joint movement may increase due to changes in the body’s structure, stability, or how it is used over time.
In people who are already hypermobile, these factors can further increase joint movement or instability over time.
This may include:
Injury or repeated strain → ligament laxity or joint instability following trauma or overuse
Physical activity or training → increased flexibility in dancers, gymnasts, or other movement-based activities
People with underlying hypermobility are often naturally drawn to these activities due to increased flexibility and movement ability, and participation does not exclude other forms of hypermobility.
Hormonal influences → changes in joint stability (for example during pregnancy)
Deconditioning → reduced strength or stability over time
Inflammatory conditions → changes in joint structure or support (such as rheumatoid arthritis)
Common patterns may include:
Onset → changes noticed over time rather than from early childhood
Joints → instability or increased movement in specific areas
Strength → reduced strength or endurance
Function → pain, fatigue, or difficulty with sustained activity
These patterns can also overlap with other forms of hypermobility.
What this means for you
Hypermobility can exist for different reasons — and you don’t need to fit neatly into one category to begin understanding your body.
Often, the focus is less about finding a single label, and more about recognising patterns in how your body responds and what it needs.
From here, the focus becomes:
• recognising your own patterns
• understanding how your body responds
• finding the right support for you