Hypermobility and Stiffness

Jennifer Richards, LMT 2026

Many people assume that individuals with hypermobility are always loose and flexible. In reality, many hypermobile people experience the opposite sensation: stiffness, tight muscles, and restricted movement.

This can be confusing for both clients and massage therapists. Understanding why stiffness occurs in a hypermobile body helps guide safe and effective treatment.

Why Stiffness Happens in Hypermobility

Hypermobility often occurs in connective tissue disorders such as hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD). These conditions affect collagen, the protein that provides structure and support to ligaments, tendons, and other connective tissues. 

When collagen is weaker or more elastic than normal:

Ligaments become looser Joints become less stable Muscles must work harder to stabilize the body

Because the joints are unstable, the muscles surrounding them tighten in an attempt to protect the joint.

This protective response is called muscle guarding. Over time, these muscles become overworked and fatigued, which can lead to chronic stiffness and tension. 

In other words:

Loose joints often create tight muscles.

How It Happens (The Biomechanics)

Several mechanisms contribute to stiffness in hypermobile bodies:

1. Joint Instability

Ligaments normally help stabilize joints. In hypermobility, ligaments may be too lax, meaning muscles must constantly compensate. 

2. Muscle Overcompensation

Muscles tighten to protect unstable joints. This constant contraction can cause chronic tension and fatigue. 

3. Altered Proprioception

Many hypermobile individuals have reduced joint position awareness. The nervous system may increase muscle activity to maintain stability. 

4. Protective Nervous System Responses

The brain may increase muscle tension to protect the body from perceived injury, creating persistent stiffness and pain.

How the Client May Feel

Clients with hypermobility-related stiffness often describe sensations such as:

Tight muscles that never seem to relax

Stiffness in the neck, back, or hips

Feeling like their body is working overtime just to stay upright

Limited range of motion in certain areas

Chronic muscle fatigue

Trigger points or tender areas

Morning stiffness or stiffness after activity

Some individuals even feel less flexible than others, despite having hypermobile joints.

Massage Therapy Considerations

Massage therapy can be very beneficial for hypermobile clients, but it must be approached thoughtfully.

Focus on Muscle Support, Not Just Relaxation

Because muscles are working to stabilize joints, the goal is not always to fully “release” tension.

Instead, focus on:

Reducing excessive muscle guarding Supporting healthy movement patterns Improving circulation Decreasing pain

Avoid Excessive Stretching

Hypermobile tissues are already lax. Aggressive stretching may increase joint instability.

Instead:

Use gentle mobilization Encourage controlled strengthening exercises

Moderate Pressure

Deep pressure may feel good temporarily but can sometimes destabilize already vulnerable joints.

Use:

slow myofascial work moderate pressure neuromuscular techniques

Work With the Nervous System

Hypermobile bodies often have heightened nervous system sensitivity.

Helpful approaches include:

slow pace rhythmic techniques diaphragmatic breathing calming the autonomic nervous system

Encourage Stability Between Sessions

Massage therapists may also suggest:

gentle strength training proprioception exercises core stabilization

These strategies help reduce the muscular overcompensation that leads to stiffness.

Reputable Resources

The following organizations provide reliable information about hypermobility and connective tissue disorders:

The Ehlers-Danlos Society

GeneReviews (NCBI) – Hypermobile Ehlers-Danlos Syndrome

NHS – Joint Hypermobility Syndrome 

Cleveland Clinic – Ehlers-Danlos Syndrome 

Key Takeaway

Hypermobility does not mean the body is loose everywhere.

In many cases, stiffness is the body’s attempt to create stability.

Understanding this paradox helps massage therapists provide safer, more effective care for hypermobile clients.

Disclaimer

This article is for educational purposes only and is not intended to diagnose, treat, or replace medical care. Individuals with hypermobility disorders such as Ehlers-Danlos syndrome or Hypermobility Spectrum Disorder should consult a qualified healthcare provider for medical advice. Massage therapy should always be adapted to the client’s individual health needs and performed by a licensed professional.