Hypermobility: a sensing problem more than a strength one

A pragmatic trial published this February quietly closed a loop that researchers had been circling for more than a decade. It tested an at home movement program for people with hypermobile joints, and the thing that moved most was not strength. It was body awareness.

The research reads best in order.

Back in 2013, a systematic review in Rheumatology International pooled five studies and 254 people to ask a plain question: do people with benign joint hypermobility actually have poorer proprioception, the sense of where a joint sits without looking? The answer was yes, at least in the lower limbs, where both joint position sense and the ability to detect the very start of a movement were measurably reduced (Smith et al., 2013).

For years that sat awkwardly next to a common assumption in gyms and clinics: that hypermobile joints are simply weak joints, and the answer is to load them and build strength. Then, in late 2025, a study in Scientific Reports put the two ideas in direct comparison. Researchers assessed 83 adults, hypermobile and not, on grip strength, joint position sense at the elbow and knee, and functional stability. The hypermobile group showed significantly poorer proprioception. Their strength and functional performance were no worse (Akaras et al., 2025). The gap, in other words, was in sensing, not in muscle.

This February, a pragmatic trial in the Journal of Multidisciplinary Healthcare followed 420 people with hypermobility, 200 of whom did an online movement program at home, a few short sessions a week over about two months. Function improved meaningfully and held at the six month mark, and so did a measure of body awareness. Reported fear of movement barely shifted, and overall activity levels did not change, which the authors were refreshingly honest about (online Pilates trial, 2026). The gains were modest. The direction was the same one the research keeps pointing toward.

So here is the arc, laid end to end. Across more than ten years, the picture has shifted from "loose, weak joints to be strengthened" toward "joints whose owner has lost some of the fine signal about where they are in space." That reframing changes what is actually worth practicing.

This is the part I recognize from my own work. When someone with very mobile joints comes to me, the problem is rarely that they cannot produce force. It is that they overshoot. The joint slides past the point a less mobile body would stop at, because the quiet internal signal that says "you have arrived, this is the edge" is faint. You cannot strengthen your way out of a sensing gap. You can, slowly, get better at reading that signal.

That is what the Feldenkrais Method® is built to do. Awareness Through Movement® lessons are not strength drills. They are sensory retraining delivered through attention: small, slow, repeated movements whose whole purpose is to feel the difference between one position and the next. For a hypermobile body, two things matter. First, the work stays inside a comfortable range, where you only go where it feels easy, pleasant, and comfortable, rather than chasing the dramatic end range stretch that already comes far too easily. Second, it trains the exact channel these studies keep implicating. You can read more about why proprioceptive awareness tends to matter more than raw strength in mobile joints in our Feldypedia entry on hypermobility and joint instability, and on how that sense changes over time.

Pilates, the method tested in the newest trial, is a different way of working with the body, and it clearly helped some of those participants. Each gentle movement method has its own strengths. What stayed with me from that study was not the label on the program. It was that the format was online and done at home, at your own pace, and it still moved the body awareness measure. That is genuinely encouraging for anyone who cannot reach a weekly in person class.

If you live with hypermobile joints, the cautious takeaway from this run of research is not "do more reps," and it is not "stretch further." It is that learning to feel your joints, slowly and within a range that stays comfortable, may be at least as valuable as loading them. This sits alongside what a physiotherapist or other clinician has given you rather than replacing it. If you are already working with someone on stability, gentle awareness work is a reasonable companion to raise with them.

None of this is a cure, and the honest read of the newest trial is that its gains were real but modest. Still, the through line is hard to miss. Year after year, the research keeps landing on the same quiet idea: in a hypermobile body, the work worth doing may be less about getting stronger and more about getting better at sensing what is already there. The Feldy online movement program is built around that kind of slow, attentive movement, if it is a direction you want to explore.