Hypermobility and Ehlers-Danlos Syndromes

Hypermobile joints often come with dysautonomia, mast cell patterns, gut issues, and pain. We address stability, the autonomic system, and the whole connective tissue picture.

What you may be noticing

Joints that bend further than they should, and sometimes slip partly out of place. Frequent sprains, chronic pain, and fatigue. Many people with hypermobility also notice dizziness on standing, racing heart, digestive problems, easy bruising, jaw clicking, skin that is soft or stretchy, and reactions to foods or environments.

Hypermobile Ehlers-Danlos syndrome is a clinical diagnosis made by a qualified physician using established criteria. Other forms of Ehlers-Danlos have genetic tests and some carry vascular risks that need specialist care.

Why it is rarely one thing

Hypermobility reflects differences in connective tissue, the collagen-based scaffolding of joints, skin, blood vessels, and the gut. When that scaffolding is more elastic, joints rely more on muscle and nervous system control for stability.

That is why I see hypermobility as a brain and nervous system story as much as a joint story. Proprioception is often reduced, so the brain receives a blurrier picture of where each joint sits, and the cerebellum, which refines that picture on the same side of the body, has less to work with. Stretchier vessels can pool blood, contributing to POTS and dysautonomia. Mast cell activation is frequently reported alongside it, and a full toxic burden bucket can keep that reactivity high. The gut may move too slowly or too quickly. Not only loose joints, but a connective tissue, autonomic, and nervous system picture.

Patterns we look for

• Joint stability, proprioception, and muscle recruitment.
• Beighton score, subluxation history, and cervical instability symptoms.
• Autonomic balance: heart rate and blood pressure response to standing.
• Jaw opening range and deviation.
• Eye movements: pursuits, saccades, convergence, and focusing.
• Cerebellar and vestibular function.
• Mast cell, histamine, and toxic burden patterns.
• Gut motility and digestive function.
• Iron, vitamin D, and nutrient status.

How I evaluate it

The comprehensive functional neurological exam includes a hypermobility assessment, joint position sense, deep neck flexor coordination, cranial nerves, eye movements, balance, coordination, and autonomic testing from lying to standing.

Functional labs may include ferritin, vitamin D, B12, a thyroid panel, inflammatory markers, and, when indicated, mast cell mediators and comprehensive stool analysis. I coordinate with your physician for diagnosis and for genetic testing when another Ehlers-Danlos type is suspected.

How we address it

1. Coordinate with your physicians for diagnosis and any vascular screening.
2. Regulate before exertion: calm the autonomic system with breath and vagal practice, hydration, electrolytes, and compression.
3. Build stability through slow, controlled strength training with graded muscle recruitment, avoiding end-range stretching and high-impact drills.
4. Retrain proprioception and cerebellar control with brain-based rehabilitation, training each side deliberately.
5. Calm mast cell reactivity, lower toxic burden, and open drainage gently.
6. Support gut motility and nutrient status.
7. Reduce pain sensitization with sleep, pacing, and nervous system regulation.

Pacing is essential. Many hypermobile people push hard on good days and crash for several days afterward. Steady, moderate activity builds capacity far more reliably than cycles of boom and bust.

Children with loose ankles, frequent falls, or one-sided weakness benefit from early neuro-motor work alongside physical and occupational therapy, so stability is built while the brain is wiring movement patterns.

Stability can be built. Muscles and the nervous system can provide what the connective tissue does not.

Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.