Hypermobility and Cardiovascular Health

By Jennifer Richards, LMT 2026

When people think about hypermobility or Ehlers-Danlos Syndrome (EDS), they usually picture flexible joints. However, connective tissue is also a key structural component of the heart, blood vessels, and circulatory system.

Because connective tissue provides support and elasticity to blood vessels, changes in collagen can sometimes affect how the cardiovascular system functions.

Not everyone with hypermobility experiences cardiovascular symptoms, but some individuals may notice circulation or autonomic nervous system differences.

Blood Vessel Elasticity

Blood vessels rely on connective tissue to maintain their shape and regulate blood flow.

In hypermobility conditions, vessel walls may be more elastic. This can sometimes contribute to:

lightheadedness blood pooling in the legs fatigue difficulty regulating blood pressure

When blood vessels expand more easily, the body may need to work harder to maintain circulation.

The Autonomic Nervous System

Many individuals with hypermobility also experience dysregulation of the autonomic nervous system.

One commonly associated condition is Postural Orthostatic Tachycardia Syndrome (POTS).

POTS affects how the body regulates heart rate and blood pressure when changing positions, particularly when moving from sitting or lying down to standing.

Symptoms may include:

dizziness when standing

rapid heart rate

fatigue

brain fog

exercise intolerance

These symptoms occur because the body must compensate for changes in blood flow and circulation.

Heart Structure

In some types of EDS, mild structural differences in the heart may occur.

Examples sometimes monitored by healthcare providers include:

mild mitral valve prolapse

changes in connective tissue supporting heart valves

These findings are not present in everyone with hypermobility but may be monitored by physicians as part of routine care.

Why This Matters for Bodywork

Massage therapists frequently work with clients who report symptoms such as fatigue, dizziness, or feeling faint when getting off the table.

Understanding the possible cardiovascular and autonomic factors in hypermobility can help therapists adapt sessions appropriately.

Massage Therapy Considerations

Massage therapists do not diagnose cardiovascular conditions, but certain adaptations may help support client comfort.

Slow Position Changes

Clients with circulation or autonomic symptoms may feel dizzy when sitting up quickly.

Allow extra time when transitioning from:

prone to supine supine to seated seated to standing

Hydration Awareness

Some clients with autonomic symptoms benefit from adequate hydration before and after massage sessions.

Moderate Pressure

Very deep pressure can sometimes cause lightheadedness in individuals with dysautonomia.

Moderate, calming techniques may be more comfortable.

Bolstering and Positioning

Supporting the body with bolsters can reduce strain on joints and help improve comfort during treatment.

Nervous System Regulation

Massage techniques that support relaxation may help calm the nervous system and support parasympathetic activity.

Many hypermobile individuals benefit from sessions focused on nervous system regulation rather than aggressive tissue work.

Awareness Helps

Because connective tissue exists throughout the body, hypermobility can influence systems beyond the joints.

Understanding these connections allows individuals to recognize symptoms, seek appropriate care, and communicate effectively with healthcare providers.

Helpful Resources

For more information about cardiovascular involvement in hypermobility and EDS, visit The Ehlers-Danlos Society:

Cardiovascular involvement in Ehlers-Danlos syndromes

https://www.ehlers-danlos.com/cardiovascular-autonomic-dysfunction/

This resource explains autonomic dysfunction, circulation changes, and cardiovascular considerations in people with EDS.

Educational Disclaimer

Hypermobility and Ehlers-Danlos Syndrome exist on a spectrum. Every individual experiences connective tissue disorders differently, and not everyone will experience the symptoms or challenges discussed in this article.

The information shared here is intended for educational and awareness purposes only. It is not intended to diagnose, treat, or replace medical advice from a qualified healthcare professional.

Massage therapists do not diagnose medical conditions. If you are experiencing cardiovascular symptoms such as dizziness, fainting, or rapid heart rate, please consult an appropriate healthcare provider.

— Jennifer Richards, LMT