Introduction
What is hypermobility?
‘Hyper’ means more and ‘mobility’ means movement, so children who are hypermobile have more movement in their joints than their peers. They can put themselves in strange positions and do party tricks with their joints, for example bending their thumb to get it to touch their forearm.
This is mostly due to the child having more elasticity in their connective tissue (the bits that hold the body together). It is not an illness or disease but may cause symptoms which can cause tiredness, discomfort or be inconvenient.
The symptoms are related to weaker muscles and the joints being less strong, and the muscles needing to work harder. The stronger and fitter your child is, the better it is for their hypermobility and general health. Make sure your child does not become overweight as this may put extra strain on their muscles and joints.
By trying the strategies below, any symptoms relating to hypermobile joints should improve and be more manageable.
What you may see
- The child may do the splits easily or contort themselves into odd positions.
- they may have very flat feet or struggle to keep on daps or slip-on shoes if they have flexible feet and ankles.
- When running, they may go over on their ankles and frequently sprain these joints.
- they may struggle to hold a pen correctly or manipulate buttons when dressing.
- They may complain of their hands hurting when they write and be slower than their peers to finish their work
- They may be slower walkers than their peers and tire more quickly,
- They may experience pain due to muscle fatigue as the muscles surrounding the hypermobile joints have to work harder to support the joints.
- They may also have poor proprioception (knowing where your body parts are in a space, with your eyes closed) and therefore can appear less co-ordinated during movement.
- They may also have pain but there may not be any physical signs to see as the joints will not swell or look any different.
Strategies and advice for teachers in the classroom
The following strategies can help if children are having difficulties with hypermobility in their upper limbs.
- Try using thicker pens and pencils which are easier to grip or using pen grips (see resources). You can also attach pipe lagging around pens or cutlery to increase their width.
- When writing, encourage frequent rest breaks to allow stretching of the hands and fingers to prevent muscle cramp. A good stretch is to place the palm flat on the seat of the chair with the elbow straight and the fingers facing forwards and put weight through the hand.
- If struggling to fasten buttons, then Velcro, zips or larger buttons can be used instead.
- If struggling to do laces, Velcro can be used on shoes or gripper laces
- Encourage the child not to W sit (kneeling with bottom between knees) as this can cause leg alignment problems as the joints don’t like bending this way.
- Encourage cross legged sitting or sitting with legs straight out in front. If they struggle with either of these, offer a chair to sit on instead.
- Encourage a good posture in sitting with bottom well back in the chair and the chair pulled right up to the table. A writing slope on the table may encourage a better sitting position.
- Pacing activities that cause discomfort is very important to prevent pain
If children are having difficulties with hypermobility in their lower limbs try these tips.
- They need to wear trainers rather than daps/plimsoles to give support to their feet and ankles.
Avoid jumping from heights onto hard surfaces. This is because it is hard to control hypermobile joints on landing and they may be damaged by being overstretched. - They will tire more quickly on repetitive movements so be prepared to offer rest breaks. Long distance running will be difficult, especially over uneven surfaces, and this activity may need to be adapted.
- If any activity causes pain, allow them to rest and return to the activity if the pain stops.
Around the school site
Encourage school bags to be carried over both shoulders and to use lockers and only carry books which are completely necessary to make sure their school bag is as light as possible.
Encourage well fitting shoes avoiding high heels and slip-on shoes. Ideally, shoes should be securely fastened with laces or Velcro. If children go over on their ankles frequently, boots are recommended to give the ankles more support.
Children may be tired by the end of the day if the school site is large and they may need to make use of lifts, if available, if their legs become sore.
Pace high impact activities.
Suggested resources
Hypermobility Syndromes Association
Last reviewed September 2025