The only facility of its kind, the forward-thinking multi-disciplinary Hypermobility Unit at the world-renowned Hospital of St John and St Elizabeth caters for all the medical needs of patients with Joint Hypermobility Syndrome (JHS).

Physiotherapy can be used to help those with hypermobile joints to:

  • reduce pain
  • improve muscle strength and fitness
  • improve posture
  • correct the movement of individual joints


Physiotherapists manage the multiple joint and pain problems which hypermobility patients present with. Acute injury is more likely to occur with less trauma and more easily if the person undertakes vigorous exercise of any kind. Shoulder problems are particularly common in hypermobile patients as the shoulder is a naturally mobile and unstable joint in normal situations, so is even more vulnerable when the ligaments are unusually lax. Keeping the large ball of the arm bone centred on the small socket is a challenge to the muscular control and abnormal muscle patterning is common. Patients may often dislocate sockets.

Hypermobility is a lifelong chronic condition so sufferers are faced with managing this daily in all their postures and activities. Dysfunctional muscle patterns are common when the joints are significantly stressed, forcing them into unsuitable positions where they suffer strains. Physiotherapists can help with retraining of muscle patterns and treatment of painful joints. The largest component in this programme is vital self-management and therefore patient education

Initial Consultation

After an initial consultation with a Consultant Rheumatologist, a comprehensive physiotherapy assessment will follow with one of our Specialist Physiotherapists. Depending on appointment availability, the assessment may take place on the same day in the Physiotherapy department situated in the main hospital building.

The (physiotherapy) assessment will be carried out by one of our specialist physiotherapists. Please allow up to an hour and a half for your appointment, although this may include report writing by the physiotherapist. The examination will include gathering information about your symptoms (attained from your specific history), followed by a detailed physical examination to identify how your symptoms are affecting you day to day.

The assessment will conclude with a discussion on the treatment planned and there will be time to answer any questions you may have. You may be asked to undress as part of the assessment so it may be worth bringing shorts/vest top.  A report is written detailing the proposed treatment plan and this is sent to your consultant.


Treatment will be carried out at the hospital by a member of the hypermobility team. As people often come from far away it may be more convenient to have treatment closer to home and in these cases the report detailing the recommended treatment will be sent to you and your GP to be passed to the relevant physiotherapist.

Treatment sessions take between 30 to 60 minutes and will be carried out on a one-to-one basis by one of the specialist hypermobility physiotherapists. If you are covered by insurance you may need to check whether they have limitations on the amount of physiotherapy you are entitled to.

Treatment is specific to the individual and based on the presentation and history. It is frequently multi-faceted and may include some or all of the following:

  • Manual therapy such as massage
  • Joint mobilisation
  • Muscle release/soft tissue mobilization
  • Electrotherapy
  • Posture re-education
  • Specific corrective exercise to improve mobility, muscle performance (strength), balance, proprioception and fitness.
  • Core muscle strengthening

Advice and problem-solving is also included in your treatment programme.

For particular problems, we may recommend seeing our other specialist therapists who are skilled in various areas, including:

Women’s Health Physiotherapist – for any incontinence, pelvic floor or pregnancy related issues with specialist skills in the following:

  • Pelvic floor function
  • Post gynaecological surgery or childbirth
  • Bladder retraining and fluid management

Paediatric Physiotherapist – specialist in treating children.

Our Paediatric physiotherapist treats babies through to adolescents with a variety of conditions including:

  • musculoskeletal outpatients
  • rheumatological conditions (JIA and hypermobility)
  • developmental disorders
  • ankle injury / pain
  • orthopaedics conditions
  • neurological conditions
  • respiratory conditions

Hypermobility syndrome can be worrying for children and parents. However, our specialist paediatric physiotherapist provides reassurance, support and assessment and effective treatment for your child in order to improve their quality of life.

Some children with hypermobility syndrome will grow out of the associated problems as their ligaments get stronger. Others may have persistent problems and our specialist paediatric physiotherapist can help to reduce the effects of hypermobility syndrome by:

  • Providing an exercise programme to strengthen muscles and support the joints
  • Providing advice on types of exercise and sports
  • Providing pain management techniques
  • Reducing risk of injury
  • Providing advice on reducing factors which may worsen symptoms such as carrying excessive weight

Podiatrist –for the assessment and supply of foot orthoses (insoles).This assessment may be carried out somewhere other than the Hospital of St. John and St. Elizabeth.

Flat feet, where the inner part of the feet (the arches) are flattened, are frequently associated with hypermobility. This is due to the foot arches collapsing under the body’s weight due to the ligaments on the bottom of your feet being too loose.

Repositioning your foot arches by wearing insoles, assessed and supplied by our podiatrist, may reduce knee and ankle pain.

Occupational Therapist – to provide advice and equipment to improve function e.g. splints.

Our occupational therapist can help you to adapt your home around your condition.

By using techniques to help improve your ability, or by changing the environment or equipment you are using, an occupational therapist can help you regain or improve your independence. For example:

  • bed rails can be fitted to help you to get in and out of bed
  • toilet seats can be raised
  • equipment can be used to help with dressing

To Make An Appointment