Why Hypermobility Makes it so Difficult to Build Strength

It is not impossible to build strength in hypermobile kids and adults.  But it is far more difficult than any hypermobile client or an inexperienced therapist really expects.

If you took high school physics, you should be able to figure out TWO of the most important reasons why building strength is so tough for hypermobile children and adults.

No ideas?

That’s OK.  This post is here to help you out!

  1. Instability reduces the force generated and/or painfree sustained action when muscles contract.  Because muscles originate on a bone,  cross over a joint, and then attach onto another bone, the origin bone must remain stabile during contraction.  If that joint isn’t stable enough, insufficient force will be generated or pain in ligaments or tendons will occur.  So hypermobile people often find that they tire out, develop pain or overuse syndromes, or simply do not gain strength unless the have external stabilization from splints, braces, or positioning.
  2. The effort required to achieve stabilization is either fatiguing or creates trigger points or “knots”, in muscles.  When muscles must sustain constant contraction to replace the stability that should be provided by ligaments and tendons, they give out, sometimes rapidly or suddenly.  Trigger points develop in muscle tissue as chronic muscle tension deprives tissue of blood flow and the removal of the products of contraction.  Hypermobile individuals may substitute another muscle group or movement to keep going, but this produces incorrect movement patterns and encourages habitual patterns less efficient than when using the correct muscle groups.

What can be done in these situations?

Have a skilled licensed therapist rather than a “coach”.  Understanding the whole-body effects of conditions like low muscle tone and connective tissue disorders separates the healthcare providers from the exercise gurus:


  • External stabilization can be chosen for each movement or muscle group.  This can be the best strategy of all.
  • Carefully selecting and alternating exercises to minimize fatigue and optimize strengthening.
  • Using the best positioning to allow for less compensation and more repetitions.
  • Responding to muscle fatigue promptly and correctly.
  • Using hydration, diet, and room temperature to maximize endurance.
  • Using ergonomic tools to prevent injury and support good positioning.

Looking for more information?

You can contact me for a consultation, or you can take a look at my two books on how to help kids living with hypermobility:

The JointSmart Child series is practical, just like the rest of my books.  Nobody needs theories.  They need answers and ideas.  I provide them!

  1. Learn why hypermobility is also a sensory processing problem to address.
  2. Understand how being “bendy” creates social and emotional issues in many kids (and can continue into adulthood!)
  3. Start thinking like a rehab therapist when you ask a hypermobile child to be more independent and not take so long to do anything.
  4. Learn how to buy chairs, toys, even bikes that make life easier, not harder.

Where can you get a copy?  Where else?  on Amazon !!

By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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