Hypermobility isn’t just about being extra flexible—it can impact everything from your joints to your digestion, bladder, and pelvic floor.
For some, it’s a benign quirk. For others, it’s part of a more complex condition affecting day-to-day function and quality of life. In this blog, we’re introducing what hypermobility is, what connective tissue disorders look like, and why pelvic health physiotherapy can play a key role in helping people feel more supported, stable, and in control of their symptoms.
What is hypermobility?
Hypermobility means your body is more flexible than what is considered normal. This is often due to stretchier than average connective tissue. Hypermobility can be measured by a test called the Beightons score and a series of questions.
What is a hypermobility connective tissue disorder?
Think of connective tissue like the support frame. We have different kinds of connective tissue throughout our body like having multiple different types of support frames. Connective tissue is firm but still somewhat flexible. It’s main role is to hold everything in its designated place (eg. organs, muscles, skin, etc.) while still allowing some movement.
Some people have a “connective tissue disorder” where the hypermobility is causing many problems in their day to day life. This is when the hypermobility in that person is diagnosed as a disorder. It is important to note that the level of hypermobility does not always correlate with the severity of symptoms. And people that do experience severe symptoms, it is less of a spectrum of mild to severe overall symptoms, but rather an individual mixture of symptoms. Everyone presents slightly differently.
Ehler’s Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD) are common conditions that affect the connective tissue. For example, some people present with a mixture of some of these symptoms (Ritelli et al., 2020):
– Acute and chronic pain
– Dislocations, frequent injuries
– Joint instability
– “Clumsiness” (poor proprioception)
– Delayed toilet training as a child
– Fatigue
– Dysautonomia (POTS, dizziness, fainting)
What common hypermobility symptoms are pelvic health physiotherapists involved in treating?
Pelvic Health Physiotherapists often work with people who experience a wide range of symptoms related to hypermobility and connective tissue disorders—many of which involve the bladder, bowel, and pelvic organs. While presentations vary, research and clinical experience suggest that these are some of the most common issues seen:
– 16% experience unexplained abdominal pain
– 26% have delayed gastric, bowel, or colonic transit
– 33% report defecation dysfunction or difficulty fully emptying the bowels
– 40% experience reflux symptoms
– 70–80% report general gastrointestinal issues, including constipation
– 50% experience gynaecological concerns such as pelvic organ prolapse or incontinence
– 45% report bladder-related symptoms
These statistics highlight how interconnected hypermobility can be with pelvic health, and why a targeted physiotherapy approach can be so valuable in supporting this population.
Can pelvic physiotherapy support patients with hypermobility conditions, and related symptoms?
There are a lot of issues that occur around the pelvis for some people with a connective tissue disorder. However, there are many ways to help! Pelvic Health Physiotherapists are highly skilled at using evidence based treatments to help improve these pelvic related concerns that are common among this population (Thia, I., & Jeewa, F. 2024).
References:
Hakim A. Hypermobile Ehlers-Danlos Syndrome. 2004 Oct 22 [Updated 2024 Feb 22]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1279/
Ritelli M, Colombi M. Molecular Genetics and Pathogenesis of Ehlers-Danlos Syndrome and Related Connective Tissue Disorders. Genes (Basel). 2020 May 13;11(5):547. doi: 10.3390/genes11050547. PMID: 32414079; PMCID: PMC7288446.
Thia, I., & Jeewa, F. (2024). Management of Pelvic Floor Dysfunction in Connective Tissue Disorders Including Ehlers-Danlos Syndrome. IntechOpen. doi: 10.5772/intechopen.114013
Other Blogs in the Hypermobility Series
Deep dive into education written by our pelvic physiotherapist, Courtney, all about hypermobility – including symptoms across a range of pelvic health areas, treatment options for hypermobile patients & emerging research in the hypermobility space.
Do you want to learn more about pelvic health, specialised to your symptoms?
