Bendy Joints and Aches: How Strengthening Helps Joint Hypermobility

Being unusually flexible is common and, on its own, not a problem. But for some people, bendy joints come with a frustrating package of aches, fatigue, frequent sprains, and a feeling that joints might give way. The advice they often get, to stretch more, is usually the opposite of what helps.

What joint hypermobility is

Joint hypermobility simply means that some or many of your joints move beyond the range considered typical. It is common, often runs in families, and for a large number of people it never causes any trouble at all. Many flexible people are perfectly comfortable and may even find the extra range useful in dance, gymnastics, or music.

Hypermobility becomes worth addressing when it comes with symptoms: recurring joint pain, easy fatigue, frequent sprains, or a sense that joints are unstable, once other causes have been ruled out. When flexibility and these symptoms occur together, it may be described as a hypermobility spectrum disorder. The distinction matters because it separates harmless flexibility from a pattern that benefits from a structured plan.

The Beighton score

A common way to screen for generalised hypermobility is the Beighton score, a simple 9-point check that looks at how far certain joints move, such as bending the little finger back, bringing the thumb to the forearm, hyperextending the elbows and knees, and placing the palms flat on the floor with straight knees.

A Beighton score of 5 or more out of 9 suggests generalised joint hypermobility. The score is a screen, not a diagnosis in itself, and it is interpreted alongside your symptoms, history, and a full assessment. Someone with a high score and no symptoms is simply flexible; someone with a high score and recurring pain or instability is the person a management plan is built for.

Why more stretching is usually the wrong instinct

When a joint aches, the common instinct, and common advice, is to stretch it. For hypermobile joints, this often backfires. If a joint already moves well beyond the normal range, pushing it further with aggressive stretching does not address the problem and can worsen the feeling of instability.

The issue with a hypermobile joint is not that it is too tight. It is that it lacks firm passive support, because the ligaments give less of a solid end-stop than they do in a typical joint. Adding range to a joint that already has too much is the opposite of what it needs. Some gentle mobility work can have a place for comfort, but it is not the centre of the plan, and treating it as the fix is why many hypermobile people cycle through stretching routines without lasting relief.

Why strength is the mainstay

If the ligaments give less passive support, the muscles have to give more active support. That is the core idea behind managing hypermobility with strength. Building the muscles around a loose joint provides the stability the ligaments alone do not, so the joint feels steadier and tolerates load better.

Physiotherapy for joint hypermobility is built around strengthening, joint-stabilising, and control exercises, and this is the direction most clinical guidance points. The research is still developing and not always tidy: a randomised trial of resistance training in women with generalised joint hypermobility did not find significant gains in muscle function, though the authors linked that to a light training load and limited supervision rather than to strength being the wrong target. In practice, the strengthening is progressed carefully, kept within a controlled range at first rather than loading joints at their extreme end of motion, and supervised closely, which is where a self-guided program often falls short. It becomes the foundation the rest of the plan is built on. This is the same principle, build capacity to handle load, that drives our approach to osteoporosis-safe strength training and most rehabilitation.

The role of proprioception

There is a second piece that is easy to miss. Proprioception is your body's sense of where your joints are in space without looking at them. People with hypermobility sometimes have a less precise version of this sense, which can make joints feel unstable and lead to loading them awkwardly, feeding the pain and sprain cycle.

Training proprioception, through balance work and controlled movement drills, sharpens that sense of joint position, similar to the balance retraining used after ankle sprains. Combined with strengthening, it helps joints feel more secure and move more confidently. A good hypermobility program usually weaves proprioception through the strengthening work rather than treating it as an afterthought.

Building a plan that holds

Managing symptomatic hypermobility is less about a single exercise and more about a sustained, well-paced program. The pieces fit together: strengthening builds active support, proprioception improves control, and load is progressed gradually so the joints adapt rather than flare.

Pacing matters more than usual here, because people with hypermobility often fatigue and flare if they progress too fast. A plan that starts within comfortable ranges, builds steadily, and includes general fitness tends to hold better than an aggressive one that provokes symptoms. Because hypermobility affects many joints, the program usually addresses the body broadly rather than a single sore spot, and it is adjusted as your capacity grows.

When to get assessed

For most flexible people, hypermobility needs no treatment at all. It is worth an assessment if your flexibility comes with recurring joint pain, frequent sprains or dislocations, or significant fatigue, or if there are other features such as very stretchy skin or a family history of connective tissue conditions, which may warrant a broader medical review. A physiotherapist can help sort out whether your hypermobility is simply flexibility or a pattern that would benefit from a management plan.

Book a 30-minute appointment and we will screen your joints, gauge how your hypermobility is affecting you, and build a strengthening and control program paced to keep symptoms settling rather than flaring.

This article is general information about joint hypermobility. It is not personal medical advice. A regulated practitioner can confirm whether the patterns described apply to you, and some hypermobility conditions need a broader medical assessment.

Sources

• Association of Paediatric Chartered Physiotherapists - What is Hypermobility Spectrum Disorder? (2023)
• Effect of resistance training on muscle properties and function in women with generalized joint hypermobility, single-blind randomized controlled trial (2021) - note: reported no significant training effect, attributed to light load and limited supervision
• Physiotherapy for Joint Hypermobility Disorders - Springer (2023)
• College of Physical Therapists of BC (CPTBC)

This article is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary, and assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Care at Medstar Sport Physio & Health is provided by practitioners registered with their respective British Columbia regulatory colleges.