Many children present with generalised joint hypermobility, meaning their joints move more than average. Hypermobility is a common assessment finding in childhood and, on its own, does not necessarily indicate a problem. Many hypermobile children have no pain or functional difficulties and do not require intervention. 

However, in some children, hypermobility can be associated with challenges that affect movement, confidence, and participation. Understanding when hypermobility is simply a variation of normal development, and when it may be contributing to difficulties, is an important part of physiotherapy assessment. 

When can hypermobility cause difficulties? 

When joint movement is excessive or not well supported by strength and control, children may experience: 

• Balance difficulties or appearing unsteady 

• Reduced body awareness (proprioception) 

• Frequent falls or clumsiness 

• Fatigue with physical activity 

• Joint pain or discomfort 

• Difficulty keeping up with peers during play or sport 

• Avoidance of movement or reduced confidence 

In these situations, physiotherapy can help support joint stability, movement control, and confidence in a safe and appropriate way. 

Hypermobility syndrome and Ehlers–Danlos syndrome 

In some cases, ongoing symptoms such as pain, repeated injuries, significant fatigue, or functional difficulties may indicate an underlying connective tissue condition. 

• Hypermobility syndrome refers to a pattern where joint hypermobility is associated with symptoms such as pain, fatigue, or functional difficulties. 

• Ehlers–Danlos syndromes (EDS) are a group of inherited connective tissue conditions where the body’s connective tissues are more elastic or fragile than typical. This can affect joints, skin, and other body systems. 

Hypermobility syndrome and EDS are related, with joint hypermobility being a common feature. Not all hypermobile children have a connective tissue condition, and assessment over time is often important in understanding the bigger picture. 

What is connective tissue? 

Connective tissue provides structure, support, and stability throughout the body. It is found in ligaments, tendons, joint capsules, skin, and other tissues. In connective tissue conditions, the building blocks of these tissues are affected, often due to genetic factors, which can lead to increased joint movement and reduced joint stability. 

How physiotherapy can help 

Physiotherapy aims to support children with hypermobility or joint issues by focusing on safe, effective movement development, rather than restricting activity unnecessarily. Support may include: 

• Improving strength and muscle support around joints 

• Supporting balance, coordination, and body awareness 

• Reducing falls and injury risk 

• Supporting endurance and movement confidence 

• Guidance on pacing, rest, and recovery 

• Helping children participate in play, PE, and sport in a way that feels manageable 

Intervention is tailored to the child’s age, development, and individual needs, with a strong emphasis on building confidence and resilience. 

The importance of early support 

Early physiotherapy support can help protect joints, support healthy movement patterns, and reduce the risk of unnecessary pain, injury, or movement avoidance over time. By addressing difficulties early, children are better supported to participate in physical activity and everyday life with confidence. 

If you have concerns about your child’s joint mobility, pain, or movement, physiotherapy assessment can help clarify what support may be helpful and whether further input is needed. 

Additional considerations 

In some children, hypermobility may occur alongside other conditions, such as neurodevelopmental differences (for example, autism), autonomic differences such as POTS, or other orthopaedic and connective tissue-related issues. Physiotherapy remains focused on supporting safe movement, joint stability, confidence, and participation, and can be adapted to meet the child’s broader developmental and physical needs. 

📩 Please get in touch to discuss your concerns or to arrange an appointment.