Understanding Hypermobility in Children: What it Means and How Physiotherapy Can Help

Hypermobility in children is more common than many parents realise — and while some flexibility is perfectly normal, children whose joints move beyond the typical range may need extra support to build strength, stability, and confidence.

In this post, we explain what hypermobility means, how to recognise the signs, and how paediatric physiotherapy on the Gold Coast can help your child move comfortably and safely.

Early physiotherapy intervention during childhood takes advantage of the brain and nervous system’s heightened adaptability, a concept supported by research into neuroplasticity in paediatric populations.

What is Hypermobility in Children?

Hypermobility occurs when a child’s joints move beyond the normal range expected for their age. Some people call this being “double-jointed”.

For some children, hypermobility is just a normal variation and does not cause any problems. For others, it can lead to discomfort, fatigue, or difficulties with coordination and strength.

Hypermobility is more common in children than in adults because growing joints and soft tissues are naturally more flexible. While many children grow out of it, persistent hypermobility may be linked to underlying conditions such as Ehlers-Danlos Syndrome (EDS), Hypermobility Spectrum Disorder (HSD), or low muscle tone (hypotonia).

The 2017 international classification of Ehlers-Danlos Syndromes identified 13 subtypes, with hypermobile EDS (hEDS) being the most common — though diagnosis requires careful clinical assessment as there is currently no genetic test for hEDS (Malfait et al., 2017).

A paediatric physiotherapy assessment can help determine the most likely cause of your child’s hypermobility and guide the right treatment plan, including referral to other health professionals if needed.

Signs and Symptoms of Hypermobility in Children” which is closer to what parents actually search.

Some common signs of hypermobility in children include:

• Very flexible joints. Elbows or knees may bend backwards beyond the typical range. Stretchy connective tissue allows joints to move more than usual.
• Frequent tripping or poor coordination. Less stable joints make balance and controlled movement harder.
• Fatigue after physical activity. Muscles around hypermobile joints work harder, which can tire children faster than their peers.
• Joint pain, especially after play or sports. Extra joint movement can strain surrounding muscles and soft tissue.
• Flat feet. Lack of arch support can affect overall alignment and put strain on knees, hips, and lower back.
• Poor posture. Muscle fatigue may lead to slumping or sitting in positions that require less effort.
• Difficulty keeping up with peers in gross motor activities. Tasks like hopping, skipping, or team sports may be more challenging, which can affect confidence.

Not every flexible child will experience these issues, but if your child is affected, it is important to seek support.

How Physiotherapy Can Help Children with Hypermobility

Physiotherapy is essential in helping children with hypermobility build strength, stability, and confidence. Treatment is fun, play-based, and tailored to children because kids aren’t just small adults.

Here are some ways physiotherapy can help:

1. Strengthening muscles. Targeted exercises improve joint support, reduce strain, and increase control.
2. Improving balance and coordination. Fun, engaging activities can help reduce clumsiness and improve motor planning.
3. Managing pain and fatigue. Physiotherapists can suggest strategies to prevent overuse injuries and pace activity throughout the day.
4. Building confidence in movement. Achievable goals help children participate in sport, school, and play.
5. Advice on footwear, bracing, and posture. Supportive shoes, orthotics, or posture strategies can reduce stress on joints.

Research supports strengthening and proprioceptive training as the primary physiotherapy approach for children with hypermobility, with studies showing improvements in pain, function, and quality of life (Scheper et al., 2016).

Final Thoughts

Hypermobility can present challenges, but most children with bendy joints grow up to be strong, capable, and confident movers. Early physiotherapy assessment and intervention, especially when hypermobility is linked to low muscle tone, EDS, or hypermobility spectrum disorder, can make a significant difference in comfort, movement, and confidence.

Our team has completed additional training in hypermobility and related conditions, and we offer clinic and mobile physiotherapy appointments across the Gold Coast and Tweed. For families who cannot access face-to-face care, including those in regional or remote areas, we also provide telehealth consultations.

If you have concerns about your child’s flexibility, coordination, or physical development, get in touch with our experienced paediatric physiotherapists.

Further Reading

• Malfait F et al. (2017). The 2017 international classification of Ehlers-Danlos syndromes. American Journal of Medical Genetics.
• Scheper M et al. (2016). The relationship between generalised joint hypermobility and motor development. Clinical Rheumatology.
• Castori M et al. (2017). A framework for the classification of joint hypermobility and related conditions. American Journal of Medical Genetics.