If you’ve ever been told you’re “double-jointed,” you may have taken it as a compliment. But for many people, that extra flexibility comes with a hidden cost — chronic pain that can interfere with daily life and is often frustratingly difficult to explain.
At Bethesda Physiocare, we work with many patients who are hypermobile and struggling with persistent pain. In this blog, we’ll explore what hypermobility really means, why it leads to chronic pain, and — most importantly — how physical therapy can help. To learn more about how we can help you, contact us online or call (301) 656-5613 today.
What Is Hypermobility?
Hypermobility simply means your joints move beyond the range of motion that’s typical. This happens when connective tissue — particularly the collagen in your ligaments, tendons, and joint capsules — is more lax or elastic than usual.[1]
For some people, hypermobility causes no symptoms at all. For others, it develops into a condition known as Hypermobility Spectrum Disorder (HSD) or, in more complex cases, hypermobile Ehlers-Danlos Syndrome (hEDS). Both conditions share similar features: chronic pain, fatigue, joint instability, and frequent injuries.[2]
You might be surprised to learn just how common this is. Research suggests hypermobility affects a significant portion of the general population — yet it remains one of the most commonly overlooked causes of chronic pain.[1]
Why Does Hypermobility Cause Chronic Pain?
This is one of the most important — and most misunderstood — aspects of hypermobility. The pain isn’t imagined, and it isn’t simply about “being too flexible.” Here’s what’s actually happening in the body:
Joints That Work Overtime
When your joints are unstable, the surrounding muscles have to compensate constantly just to hold things in place. This relentless muscular effort leads to fatigue, tension, and pain — not because something is structurally broken, but because the system is under continuous strain.[2]
Partial dislocations (subluxations) are also common, even from everyday movements like reaching for something on a shelf or sleeping in the wrong position. Over time, this adds up.
Disrupted Proprioception
Proprioception is your body’s ability to sense where your joints are in space. In people with hypermobility, this system is frequently impaired, meaning the brain receives unreliable signals about joint position and movement.[3] This increases the risk of injury and contributes to a frustrating cycle of instability, compensation, and pain.
A Sensitized Nervous System
Over time, chronic pain from hypermobility can take on a neurological dimension. The nervous system becomes sensitized — essentially turning up the volume on pain signals — which is why hypermobility-related pain often feels widespread and disproportionate to what shows up on imaging.[1] It’s a very real process, and understanding it is key to treating it effectively.
Fascial Changes
Emerging research has also highlighted the role of the fascia — the connective tissue web that surrounds muscles, joints, and organs throughout the body. In HSD and hEDS, abnormal fascial mechanics can irritate nerve fibers and disrupt normal movement, adding another layer to the chronic pain experience.[3]
It’s Not Just About Joints
One thing we hear from patients regularly is that their hypermobility affects far more than just their joints — and they’re right. Hypermobility-related chronic pain often comes alongside:
- Persistent fatigue and poor sleep
- Headaches and jaw tension
- Dizziness and heart rate irregularities when standing (sometimes called POTS)
- Gastrointestinal issues and pelvic floor dysfunction
- Anxiety and mood changes, which are both a symptom of and a contributor to chronic pain
Treating hypermobility effectively means looking at the full picture — not just the painful joint.
How Physical Therapy Helps
Here’s the encouraging news: physical therapy is one of the most effective treatments available for hypermobility-related chronic pain. And it’s exactly the kind of care we specialize in at Bethesda Physiocare.
It’s worth clarifying one common misconception right away: the goal is not to stretch hypermobile joints further. In fact, aggressive stretching can make things worse by increasing instability. Instead, our approach focuses on:
Targeted Strengthening
Building strength in the muscles surrounding unstable joints gives your body the support that lax connective tissue cannot provide on its own. This reduces pain, lowers injury risk, and helps patients regain confidence in their movement.[2] Research supports that individualized exercise programs significantly improve pain outcomes in hypermobility patients.[4]
Proprioceptive and Balance Training
We use specialized balance and coordination exercises to retrain your body’s position-sensing system — helping you move more safely and with greater control.[2] At Bethesda Physiocare, we incorporate advanced technology like the Trazer motion capture system and VALD ForceFrame to make this training precise and measurable.[4]
Manual Therapy, Dry Needling, and Pain Relief
Soft tissue release, joint mobilization, dry needling, and other hands-on techniques can provide meaningful relief from acute and chronic pain flares. Our clinic is led by Dr. Jan Dommerholt, a world-renowned expert in dry needling with over 30 years of experience — making Bethesda Physiocare uniquely equipped to treat complex, pain-sensitive conditions like hypermobility.[5]
Pain Science Education
Understanding what is happening in your body — why you hurt, what’s safe to do, and how to pace your activity — is a powerful part of recovery. We believe patient education is at the forefront of any good treatment plan.[6]
A Personalized Plan
No two hypermobility patients are the same. At Bethesda Physiocare, every treatment plan begins with a comprehensive evaluation to understand how hypermobility is uniquely affecting your movement, strength, and pain. We don’t believe in cookie-cutter care — your plan is built around you.[7]
You’re Not “Just Flexible” — And You Don’t Have to Just Manage
If you’ve spent years being told your pain is unexplained, or that being hypermobile isn’t a “real” condition, we want you to know: your pain has a cause, and it is treatable.
At Bethesda Physiocare, we’ve helped many patients with hypermobility — from mild generalized laxity to full hEDS — build strength, reduce pain, and get back to living their lives. Most of our patients tell us that physical therapy here is quite different from what they’ve experienced elsewhere.[8]
Get Started at Bethesda Physiocare
If you or someone you know is living with hypermobility and chronic pain, we’re here to help. Our team will take the time to truly understand your condition and create a treatment plan that gives you real, lasting results.
Call us at (301) 656-5613 or contact us online to schedule your evaluation today.
References
[1] Revolutionizing Treatment of Rare Diseases: Integrating Technology in Physical Therapy for Ehlers-Danlos Syndrome and Dysautonomia – Bethesda Physiocare https://bethesdaphysiocare.com/revolutionizing-treatment-of-rare-diseases-integrating-technology-in-physical-therapy-for-ehlers-danlos-syndrome-and-dysautonomia
[2] Uncategorized – Bethesda Physiocare https://bethesdaphysiocare.com/category/uncategorized/page/2
[3] Understanding CRPS – Bethesda Physiocare https://bethesdaphysiocare.com/understanding-crps
[4] Our Physical Therapy Blog Page | Bethesda Physiocare® https://bethesdaphysiocare.com/blog
[5] Physical Therapy in Bethesda | Schedule an Appointment https://bethesdaphysiocare.com/treatments/physical-therapy
[6] Complex Regional Pain Syndrome in Bethesda | CRPS Treatment & Pain Management https://bethesdaphysiocare.com/conditions/crps
[7] Customized Care: The Importance of Individualized Physical Therapy Plans – Bethesda Physiocare https://bethesdaphysiocare.com/customized-care-the-importance-of-individualized-physical-therapy-plans
[8] Frequently Asked Questions | Physical Therapy in Bethesda https://bethesdaphysiocare.com/faq