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. Children with Down syndrome are often hypermobile. Girls tend to be more hypermobile than boys. Hypermobility seems to run in families and can be present in any child. Rarely, children with hypermobility have a connective tissue disorder, such as Marfan or Ehlers-Danlos syndrome.
What Are the Signs/Symptoms?
Hypermobility may cause chronic joint or muscle pain. Some children may develop chronic pain syndromes such as pain amplification or fibromyalgia. Joints may swell after activity, in the late afternoon, or at night. Hypermobile children are more likely to have sprains or soft tissue injuries of the affected joints. They may have poor joint position sense, back pain or flat feet. Others have loose skin, easy bruising, thin scars, and conditions where nerves get pressed or pinched. Growing pains, or deep aches in limbs and muscles, may also be seen more often in hypermobile children. The diagnosis is based on a physical exam showing an excess range of motion in certain joints. Some children need lab tests to rule out genetic or diseases.
What Are Common Treatments?
Muscle aches and pains occurring after activity, and growing pains may improve with rest and massage. Exercising, building muscle strength, using joint protection steps, and practice ways to improve your balance, like standing on one foot or walking in a straight line may ease symptoms. Physical therapy is helpful for guiding and teaching these techniques. Children with flat feet may need shoe inserts. Medications like ibuprofen (Advil, Motrin), naproxen sodium (Aleve) or acetaminophen (Tylenol) may ease occasional pain.
Living with Hypermobility Syndrome
Physical therapy and daily exercise 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 a healthy weight. Parents can change the child’s activity according to pain levels. Over-the-counter NSAIDs (such as Motrin or Aleve) or pain medicines should only be used for occasional pain relief before or after activity or exercise.
Updated March 2025 by Miriah Gillispie-Taylor, MD, 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.