The quickest way to check for hypermobility is a simple set of five movements you can do right now, no equipment needed. These movements make up the Beighton Score, a nine-point scale used by clinicians worldwide to measure how far your joints bend beyond the typical range. But a high score alone doesn’t tell the whole story. Hypermobility becomes medically significant when it comes with symptoms like chronic joint pain, instability, or fatigue.
The Beighton Score: Five Moves to Try
You earn one point for each of the following you can do:
- Pinky fingers: Bend each pinky backward past 90 degrees (one point per hand)
- Thumbs: Bend each thumb back to touch your forearm (one point per hand)
- Elbows: Straighten each elbow past a neutral, straight position so it curves backward (one point per arm)
- Knees: Straighten each knee past neutral so it bows backward when you stand (one point per leg)
- Palms to floor: Bend forward and place your hands flat on the floor without bending your knees (one point)
That gives a maximum of nine points. Generally, a score of 5 or higher in adults aged 8 to 39 (for women) or 4 or higher (for men) suggests generalized joint hypermobility. These thresholds shift with age because everyone naturally loses flexibility over time. Women over 40 typically meet the threshold at 4 or more, while men over 40 may qualify at just 2. For older adults over 60, even lower scores can be significant.
When Flexible Joints Become a Problem
Plenty of people score high on the Beighton test and never have issues. Dancers, gymnasts, and naturally bendy people can go through life without pain or instability. Hypermobility only becomes a medical concern when your joints don’t just move far, they also cause trouble.
The most telling combination is a Beighton Score of 4 or higher plus pain in four or more joints lasting at least three months. The joints most commonly affected are elbows, wrists, fingers, and knees. For some people the pain is mild and occasional. For others it’s severe enough to interfere with daily tasks. The pain often worsens after physical activity or long periods of standing.
Beyond joint pain, there are subtler signs that point to hypermobility affecting your connective tissue more broadly. Your joints may feel unstable or like they “give way.” You might be unusually clumsy, bump into things, or struggle with balance. This happens because the loose ligaments around hypermobile joints send less reliable signals to your brain about where your body is in space, a sense called proprioception. If you’ve always been the person who trips on flat ground or can never quite tell how hard you’re gripping something, lax connective tissue could be part of the reason.
Signs Beyond Your Joints
Connective tissue isn’t just in your joints. It’s in your skin, your gut lining, your blood vessels, and virtually everywhere else. So hypermobility can show up in places you wouldn’t expect.
Skin that stretches unusually far is one classic sign. A rough guideline: if the skin on your forearm or the back of your hand stretches more than 1.5 cm when you pull it, or the skin on your neck or knees stretches past 3 cm, that’s considered hyperextensible. You might also notice your skin is unusually soft or velvety, bruises easily, or heals slowly with thin, papery scars.
Digestive symptoms are common too. Many hypermobile people deal with bloating, reflux, nausea, or irregular bowel habits that overlap with what’s often diagnosed as irritable bowel syndrome. Gastroenterologists are increasingly recognizing the link between gut symptoms and joint hypermobility, and some now use the Beighton Score as a screening tool when patients come in with chronic digestive complaints.
Some people with significant hypermobility also notice their heart races when they stand up, they feel lightheaded in the shower, or they can’t tolerate heat well. These can be signs of autonomic nervous system involvement, where the body struggles to regulate heart rate and blood pressure with position changes. This isn’t something to test for on your own, but it’s worth mentioning to a doctor if you recognize the pattern.
Hypermobility Spectrum Disorder vs. Ehlers-Danlos Syndrome
If your self-assessment suggests hypermobility with symptoms, two diagnoses sit on the same spectrum. Hypermobility Spectrum Disorder (HSD) is the broader category. Hypermobile Ehlers-Danlos Syndrome (hEDS) is a more specific diagnosis with stricter criteria established in 2017. The distinction matters less than you might think, because both can significantly affect quality of life.
Research comparing the two groups has found some interesting patterns. People with hEDS tend to report more joint dislocations, hernias, and structural features like a high, narrow palate and dental crowding. People with HSD, on the other hand, report more joint pain, muscle weakness, easy bruising, jaw problems, sleep difficulties, and gastrointestinal symptoms. HSD patients also report higher rates of anxiety and depression. In other words, HSD is not a “milder” version of hEDS. The symptom burden can be just as heavy or heavier, it’s just distributed differently.
It’s also worth knowing that updated global diagnostic criteria are expected in late 2026, which may reshape how these conditions are classified. The current framework has been criticized for being too rigid in some areas, and the revision aims to better reflect the full range of how hypermobility affects people.
What to Do With Your Results
If you scored high on the Beighton test but feel fine, you likely have benign joint hypermobility. It’s a trait, not a disorder. Being aware of it can help you protect your joints during exercise by focusing on strength and stability rather than pushing your flexibility further.
If you scored high and recognized yourself in the symptom descriptions, bringing your Beighton Score to a doctor gives you a concrete starting point for conversation. Many people with hypermobility spend years bouncing between specialists for pain, fatigue, and gut issues before anyone connects the dots. Having the language to describe what you’re experiencing, along with a self-assessed score, can speed that process up considerably.
Regardless of whether you pursue a formal diagnosis, the most effective thing you can do for symptomatic hypermobility is targeted exercise. Strengthening the muscles around your loosest joints compensates for what your ligaments can’t do on their own. Balance training improves proprioception, reducing clumsiness and the risk of sprains or subluxations. A physiotherapist familiar with hypermobility can design a program that builds stability without aggravating pain, which is the tricky balance most hypermobile people need help finding.