Hypermobility describes joints that move beyond their typical range of motion. While common, its classification as a disability is nuanced. The impact of hypermobility varies significantly, ranging from asymptomatic flexibility to conditions that profoundly affect daily functioning. Understanding these distinctions and disability criteria helps clarify this complex topic.
Understanding Hypermobility
Hypermobility refers to the ability of one or more joints to extend beyond the normal range of movement. While many children exhibit natural flexibility, hypermobility can persist into adulthood for some, affecting approximately 20% of people. For a significant portion, hypermobility does not cause pain or other issues and is considered asymptomatic.
The presence of hypermobility exists on a spectrum. It can affect a single joint, a group of joints, or multiple joints throughout the body, known as generalized joint hypermobility. When hypermobility leads to symptoms like pain or injury, it may be classified as a hypermobility syndrome or a hypermobility spectrum disorder (HSD). These conditions arise when connective tissues, particularly ligaments that stabilize joints, are looser or weaker than typical.
Impact on Daily Life
When hypermobility becomes symptomatic, its effects can significantly influence daily life. Chronic pain is a common symptom, which can be musculoskeletal or neuropathic, often worsening towards the end of the day or after physical activity. Joint instability is another issue, leading to recurrent partial or full dislocations, particularly in joints like the shoulders, knees, or fingers. This instability can result in sprains, strains, and other soft tissue injuries.
Beyond joint issues, individuals with symptomatic hypermobility often experience fatigue that does not resolve with rest. This exhaustion can stem from muscles working harder to stabilize loose joints, issues with blood flow regulation (dysautonomia), or disturbed sleep patterns due to pain. Systemic symptoms, such as digestive issues, bladder problems, and dizziness, can also occur, further limiting daily activities. These symptoms can collectively impair mobility, work participation, social engagement, and self-care tasks.
Official Disability Recognition
Whether hypermobility constitutes a disability depends on its impact on major life activities, not merely the presence of flexible joints. Asymptomatic benign joint hypermobility is not considered a disability. However, specific connective tissue disorders where hypermobility is a key feature, such as Hypermobility Spectrum Disorder (HSD) and hypermobile Ehlers-Danlos Syndrome (hEDS), can be recognized as disabilities. These conditions involve symptomatic joint hypermobility that disrupts normal function or causes pain.
Disability status is determined by the severity of functional impairment and its influence on a person’s ability to perform major life activities. In the United States, the Americans with Disabilities Act (ADA) defines a disability as a physical or mental impairment that substantially limits one or more major life activities, such as walking, seeing, hearing, or working. In the United Kingdom, the Disability Discrimination Act (DDA) uses comparable criteria focusing on long-term and substantial adverse effects on daily activities. A diagnosis of HSD or hEDS does not automatically confer disability status; rather, it is the degree to which the condition impairs daily functioning that is assessed.
Managing Hypermobility for Improved Function
Managing symptomatic hypermobility requires an individualized approach to reduce symptoms and improve functional capacity. Physical therapy plays a central role, focusing on strengthening muscles around hypermobile joints to enhance stability and improve proprioception. Exercises build strength without overextending joints, often starting with low-impact activities. Occupational therapy assists by providing strategies and adaptive equipment to make daily tasks easier and reduce joint strain.
Pain management techniques include medication, heat/cold therapy, mindfulness, and cognitive behavioral therapy (CBT). Lifestyle adjustments, such as pacing activities and conserving energy, prevent symptom flare-ups and manage fatigue. This involves breaking down tasks, scheduling rest periods, and listening to the body’s signals to avoid overexertion. Assistive devices, like braces or supportive footwear, provide external support and stability for vulnerable joints. Psychological support can also address the emotional impact of living with a chronic condition.