Hypermobility Spectrum Disorder

I’m refering to hypermobility spectrum disorder (HSD), formerly known as hypermobility type three, or hypermobility EDS. It’s also commonly described as simply as being double-jointed.

For years, I’ve walked alongside patients with a litany of chronic issues like the list above. Eventually, I began to notice many of these patients shared something suprising: hypermobility.

In this article, I’ll introduce you to hypermobility, explore why it is so common, some of its benefits (there are several), and how it morphs from a superpower to a supersyndrome — the root cause of countless chronic health issues.

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What is Hypermobility Spectrum Disorder?

Simply put, hypermobility is a condition where a person’s connective tissues, joints, ligaments, and sinew that connect their muscles are stretchy or very flexible. We all know people (or are people) who are “double-jointed” and can bend fingers, arms or legs in ways that make others squirm. That’s one of the outward manifestions of hypermobility, but being hypermobile affects the connective tissue throughout our body—all the stuff that holds our bodies together.

As the word spectrum implies, the hypermobility spectrum should not be viewed as binary (on/off). Hypermobility is not something you do or do not have. Rather, many of us are hypermobile to varying degrees.

The word disorder, of course, implies that something is wrong. As we will discover, however, being on the hypermobility spectrum is not necessarily bad. In fact, it can be an advantage. If you have an extreme case, or if hypermobility leads to further health issues, it then becomes a disorder.

Hypermobility is Not the Same as Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome (EDS) and Marfan Syndrome are the severe extremes of the spectrum. People with Ehlers-Danlos can experience dislocated limbs or lenses in their eyes, and severe cases can result in strokes, aneurysms, or premature death. Marfan syndrome is another genetic variant, which typically affects males and can be associated with aortic aneurysms.

If you start searching these syndromes online, you’ll be lead along a rabbit trail of rare and extreme cases. My advice to you is: don’t go down that path! These syndromes are extremely rare. I have practiced medicine in five countries on four continents, and seen over 100,000 patients. Of all of those patients, I’ve encountered maybe three patients with Marfan Syndrome and fewer than 10 with Ehlers-Danlos. On the flip side, I see hypermobility spectrum disorder every single day.

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How Common is Hypermobility?

They say numbers don’t lie. Unfortunately, statistics can easily distort the truth. In trying to uncover just how prevalent hypermobility is, we need to work through some confusing and potentially deceptive statistics.

Edge Case: Ehlers-Danlos

Let’s begin with the extreme end of the hypermobility spectrum: Ehlers-Danlos Syndrome (EDS). According to the current medical literature, only 1 in 5,000 people have Ehlers-Danlos Syndrome. ^[1]

1 in 5,000 is quite rare. But if EDS is so rare, why are so many people searching for it online? Google Keyword Planner estimates 100k – 1 million searches related to EDS on average per month. That’s a lot of people looking for answers to something that hardly anyone has. What’s going on?

The Literature Lag

Medical literature takes 20–30 years to catch up with medicine. Thankfully, that time is getting shorter, but it takes years — sometimes decades — for the official statistics to catch up with what doctors see. EDS is largely overlooked in the traditional medical system (ERs, hospitals, medical universities) because only 1 in 5,000 have it … at least according to the official statistics. And while EDS truly is rare, many people may be dealing with serious degrees of the hypermobility spectrum (and searching for the rarest edge cases).

Medical literature takes 20–30 years to catch up with medicine. Thankfully, that time is getting shorter, but it takes years — sometimes decades — for the official statistics to catch up with what doctors see.

Assessing Hypermobility

So what about hypermobility more generally? Some current literature suggests 1 in 30 adults has “hypermobile EDS,” a milder variant of EDS.^[2] 1 in 30 is much more common. That means every doctor in the U.S. encounters this at least every other day (and probably overlooks it).

But it’s worse than that.

In pediatric psychiatry, a lot of energy is presently invested in studying neurodivergence. Autism Spectrum, once estimated at 1 in 600, then 1 in 300, is now estimated at 1 in 54. This radical re-estimate has lead many to question, “Is neurodivergence becoming more prevalent? Or are we developing better diagnostic criteria for it?” But as these pediatric psychiatrists research neurodivergence, they’re discovering 20% of kids are hypermobile.^[3] 20% is a lot — that’s 1 in 5 kids.

A Persistent Blind Spot

Hypermobility isn’t always bad. In many cases, it’s a biological superpower (keep reading for more on that). If it’s not an obvious problem, then it’s easily overlooked. Consequently, a lot of people are hypermobile and don’t realize it. And when hypermobility does result in adverse health issues, that also gets overlooked. Therefore, people with fibromyalgia or chronic fatigue don’t realize they’re also hypermobile. People struggling with POTS or dysautonomia don’t know they’re also hypermobile. People with autoimmune, gut, or mold issues don’t know they’re also hypermobile.

And because so few people are connecting the dots between connective tissue and these supposedly unrelated issues, that connection is largely overlooked. Hypermobility is not yet widely researched, and it’s not yet seriously counted.

Which means there is a disparity in our statistics.

Less than 20 years ago, mold-related illness supposedly didn’t exist; chronic Lyme disease wasn’t a known issue. Now we see it everywhere. In my clinical experience, with my eyes open to hypermobility, I can see that it’s ridiculously common. In 10 years, every doctor will discuss hypermobility — not because more people are becoming hypermobile, but because the diagnostic statistics will finally catch up to what is already happening.

So, Just How Common is Hypermobility?

One recent study cites 25–50% of young children (under the age of 10) exhibit signs of hypermobility, with prevalence dropping to 7–10% in school age children. Another study found that as many as 26% of college age students exhibit “Generalized Joint Hypermobility (GJH)” and 19.5% exhibit “joint hypermobility syndrome (JHS).”^[4] These statistics are averages, with higher prevalence in women over men. While we wait for the scoring to standardize and the counting to improve, it is reasonable to assume 20% of the general population fall somewhere on the hypermobility spectrum. That’s 1 in 5 people in the U.S. — roughly 67 million — more than the combined population of New York, Los Angeles, Chicago, Houston, Dallas-Fort Worth, Miami, and Atlanta.

In other words, a lot of people are hypermobile. You or someone you love is hypermobile.

A lot of people are hypermobile. You or someone you love is hypermobile.

Why is Hypermobility So Common?

Hypermobility has significant survival benefits. Back in the day, if you were a little “loosey-goosey,” you could run a little faster. You could throw a spear a little farther. These physical skills provide a survival benefit. Think about your tall, lanky person that’s super athletic. Because hypermobility was an asset for survival, people were able to pass on their genes to more and more hypermobile people. We see it run in families who are naturally gifted at certain sports like volleyball, swimming, ballet, etc. Even some baseball pitchers and other elite athletes are hypermobile and it makes them better at their sport.

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What Are the Advantages of Hypermobility?

Several benefits come with the increased flexibility and larger cerebellum connected with hypermobility:

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The Achilles Heel:

What Are the Disadvantages of Hypermobility?

While there are benefits, hypermobility also comes with drawbacks and risk factors:

Nutritional Deficiencies

The flexibility of connective tissue that accompanies hypermobility can increase your risk for certain nutrient deficiencies. Hypermobile tissues require nutrients like vitamin C, trace minerals, protein, and collagen. Unfortunately, in the last 50 years, we’ve removed many of these important components from our diet.

• Callagen: Important sorces of callagen — bone broth, organ meats, and eating meat on the bone — are rare in current diets.
• Trace Minerals: We eat too many processed foods, and we’re not getting the trace minerals we used to get from eating plants.
• Protein: Many of us are also eating insufficient levels of the protein we need.

Inadequate intake of these critical nutrients can affect anyone’s immune system, bone structure, and many other systems in the body. For people with hypermobility, who have an increased need, these deficiencies can be especially problematic.

Quick Tip: We understand … not everyone is ready to start eating liver again, even if it provides significant health benefits for hypermobility. If that’s you, try our recommended partner: Pluck. Pluck is a mixture of spices to put on food, popcorn, or to use in cooking that is based on clean freeze dried organ meat. Learn More (and get a 10% discount).

Digestive Issues

If you’ve been following me online, you probably know that most, if not all, chronic diseases are related to gut health. Many even claim that all chronic diseases begin in the gut. Hypermobility is a big player here.

Hypermobility affects digestion and gut motility — setting you up for issues like gut bacteria imbalances, dysbiosis, SIBO (small intestine bacterial overgrowth), decreased pancreatic function, reduced digestive enzyme secretion, and decreased stomach acid production. Lower stomach acid can also affect your body’s ability to absorb nutrients. I often find that my hypermobile patients are low in B vitamins, magnesium, and other minerals.

Detoxification

Hypermobility can make it more difficult for people to remove toxins from their bodies. Hundreds of years ago, this was not as significant an issue. But in today’s environment, with water-damaged buildings (which includes 50% of the buildings in our country), increased environmental toxins, chemicals, and heavy metals, this can create a heavy toxic burden for everyone and especially those who cannot adequately detoxify.

Consider that the average woman in the U.S. uses 12 products on her body per day, which contain 168 different chemicals. This is a heavy burden for all of us but can become overwhelming for people that are hypermobile and have a harder time detoxifying.

Sleep Apnea

People with hypermobility spectrum disorder tend to have narrow airway passages. These “skinny passages” may not be problematic at 20–30 years of age. Over time, however, things get looser causing upper airway resistance syndrome. This is commonly acknowledged by oral surgeons, dentists, and anesthesiologists, and overlooked by everyone else. If you have
hypermobility, you might experience minimal symptoms like jaw pain, TMJ, cracked teeth, and receding gum lines, without realizing these are symptoms of mild sleep apnea.

Sleep is critical for health; poor sleep can set you up for a long list of chronic diseases.

Trauma

The last health issue I want to mention here is trauma. Because of their underlying physiology, people with hypermobility tend to have a higher cortisol baseline. Elevated cortisol is great if you’re competing or in survival-mode, but chronically elevated cortisol can become very problematic over time.

If you’ve been traumatized as a child, had a traumatic brain injury, been in a dysfunctional home, or were in a relationship with someone who was abusive, these things can set you up for a trauma-like response, which can cause brain inflammation that can last for years.

Once again, trauma is never healthy; but for people withy hypermobility and elevated cortisol, the problem is exacerbated.

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Conclusion

In Greek mythology, the hero Achilles was invulnerable save for the single spot where his mother held him as an infant, dipping him into the river Styx. That one weakness beceame his downfall in the Battle of Troy. Superpowers are like that. Superman has kryptonite. Spiderman runs out of web fluid. Black Panther’s vibranium is susceptible to sound waves. We could learn a thing or two from comic books (or the Iliad). Iron Man keeps improving his suit. Spiderman brings a lot of backup web cartidges. Superman works really hard to stay away from krytonite. And Achilles probably could have protected his heel.

Hypermobility does not have to be your downfall. It can be a superpower.

The first step, of course, is understanding how hypermobility may be affecting you personally. You’re probably wondering whether any of this applies to you personally. If hypermobility is a spectrum, where are you on that spectrum? We’ve designed a simple self-assessment to help you answer that question.

Are You Hypermobile?

Take the ConnectCODE Self Assessment to discover your individual ConnectCODE, and what impact hypermobility may have on your health.

Take the Quiz

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