Hypermobility Syndrome (Juvenile)

In hypermobility syndrome, a child’s joints move past the normal range of motion. Children with hypermobile joints are often called “double" or "loose" jointed. Hypermobile children may have joint or muscle pain that worsens at night or with activity. Their joints are not inflamed. Rarely, children with hypermobility have a connective tissue disorder, such as Marfan or Ehlers-Danlos syndrome. Children with Down syndrome are often hypermobile. Girls tend to be more hypermobile than boys. Hypermobility seems to run in families and is present in children of many ethnic groups and nationalities. A gene involved in the production of collagen, a protein important for joint, ligament, and tendon function, may play a role in hypermobility.

What Are the Signs/Symptoms?

In hypermobility syndrome, a child’s joints move past the normal range of motion. Children with hypermobile joints are often called “double" or "loose" jointed. Hypermobile children may have joint or muscle pain that worsens at night or with activity. Their joints are not inflamed. Rarely, children with hypermobility have a connective tissue disorder, such as Marfan or Ehlers-Danlos syndrome. Children with Down syndrome are often hypermobile. Girls tend to be more hypermobile than boys. Hypermobility seems to run in families and is present in children of many ethnic groups and nationalities. A gene involved in the production of collagen, a protein important for joint, ligament, and tendon function, may play a role in hypermobility.

What Are Common Treatments?

Muscle aches and pains occurring after activity, especially from growing pains, may improve with rest and massage. Exercising, building muscle strength, using joint protection techniques to prevent injury, and practicing balance improvement techniques may ease symptoms. Physical therapy is helpful for guiding and teaching these techniques. Children with flat feet may need orthotics. Medications like ibuprofen (Advil, Motrin), naproxen sodium (Aleve) or acetaminophen (Tylenol) may ease occasional pain.

Living with Hypermobility Syndrome

Physical therapy and a daily exercise regimen can strengthen a child’s muscles and stabilize joints. Good posture while standing and sitting, standing with knees slightly bent, avoiding extreme ranges of motion, and wearing good shoes with arch supports may help manage symptoms or prevent joint injuries. This may also prevent joint overuse. Children should stay physically active, eat a balanced diet, and maintain optimal weight. Parents can adjust the child’s activity according to pain levels. Over the counter NSAIDs or analgesics should only be used for occasional pain relief before or after activity or exercise.

Updated February 2023 by Nina T. Washington, MD, MPH, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.