Yoga guide
Yoga can suit hypermobile people, but only if it builds strength, balance and control rather than more flexibility. The NHS says the main treatment for joint hypermobility syndrome is building muscle strength and fitness, and not to overextend your joints just because you can; the Ehlers-Danlos Society warns that overstretching can make joints unstable; and the Hypermobility Syndromes Association calls yoga that focuses on strength and control worth trying. No trial has tested yoga in hypermobility, so this advice comes from health services, charities and physiotherapy research.
This guide explains the difference between being bendy and having hypermobility spectrum disorder (HSD) or hypermobile Ehlers-Danlos syndrome (hEDS), why hypermobile people often feel a stretch late, which poses to change or leave out, how to practise if you get dizzy when you stand (postural tachycardia syndrome, PoTS), and the signs that need a GP. It ends with a free 25-minute stability-first class with a 3D demo of every move.
Joint hypermobility affects about 1 in 30 people (the NHS) to about 1 in 10 (the Hypermobility Syndromes Association, HMSA), depending on how it's measured. Without symptoms it needs no treatment; trouble comes with unstable joints, pain, tiredness or dizziness.
The NHS: "The main treatment is improving muscle strength and fitness so your joints are better protected", and "do not overextend your joints just because you can". The Ehlers-Danlos Society says overstretching "may lead to instability", and the HMSA suggests "Yoga (focused on strengthening and control rather than increasing flexibility)".
We found no trial of yoga in hypermobility, although more than half of people with HSD or Ehlers-Danlos syndrome (EDS) in one survey had tried it. The advice here comes from health services, charities and physiotherapy trials.
In a small study, hypermobile women's muscles were no less stiff, but they went much further before stopping. The HMSA lists repeated stretching in "yoga enthusiasts and gymnasts" as one route into symptoms. So stop at a position, not a feeling.
About half of adults with hEDS or HSD had PoTS on testing. Start lying and sitting, keep cool, and get up slowly.
See a GP for joints that keep dislocating, ongoing pain, or dizziness and palpitations when you stand. Call 999 if someone faints while exercising or lying down. The full list is in the warning signs below.
The Ehlers-Danlos Society: being "flexible," "bendy," or "double-jointed" "is not usually a problem, and for some, like dancers or gymnasts, it is an advantage... The problem occurs when joints are not just hypermobile but are also unstable." In a survey of 12,853 UK adults, 18.3% were hypermobile. It's more common in women and children, and in gymnasts, dancers and musicians.
Doctors use a 9-point check of the little fingers, thumbs, elbows, knees and spine, including whether you can put your palms flat on the floor with straight knees. A score of 5 or more counts as widespread hypermobility in adults (6 before puberty, 4 over 50). It misses the jaw, neck, shoulders, hips, ankles and feet, and someone can be hypermobile with a low score.
Hypermobile Ehlers-Danlos syndrome is diagnosed from a doctor's history and examination under international criteria from 2017: there's no laboratory test for it. Hypermobility spectrum disorder is the label for hypermobility that causes symptoms but doesn't meet those criteria, and the NHS says it "is treated in the same way as hEDS".
In a review study of 326 people, no single measure clearly separated hEDS from HSD. The Ehlers-Danlos Society expects to publish updated criteria, and says the timing and terms may change, so check with your doctor if you're being assessed.
The NHS gives joint hypermobility as about 1 in 30 people. The Ehlers-Danlos Society estimates HSD and hEDS together at about 1 in 600 to 1 in 900 and thinks that's too low; in Wales, about 1 in 500 people had a diagnosis of EDS or joint hypermobility syndrome.
The NHS lists tiredness even after rest, joint and muscle pain and stiffness, frequent sprains, joints that "pop out", poor balance, thin stretchy skin, and bladder or bowel problems, plus dizziness and a fast heart rate after standing up. Anxiety is more common with symptomatic hypermobility (32 studies), and joint position sense is often poorer.
Vascular EDS is rarer and "often considered to be the most serious" type. With it, keep exercise easy, don't hold your breath, and get specialist advice first.
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Do gentle exercise ("not doing any exercise can make your symptoms worse"), "do not overextend your joints just because you can", and take regular breaks rather than repeating one movement for long. With EDS, it's important to be careful with activities that put a lot of strain on your joints, "But it's also important not to be overprotective".
"Exercises that focus on movement control and strengthening the stabilizing muscles are generally suitable", with a low load, starting "low" and going "slow". "People with unstable joints should avoid... sports that focus on flexibility." Gentle stretching can help muscles that are genuinely tight, but "Overstretching beyond the normal range of motion can be harmful. It may lead to instability".
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"Keep your joints moving without overstretching - Yoga (focused on strengthening and control rather than increasing flexibility), Pilates exercises, and Tai Chi are worth trying." It also suggests static strengthening, balance work, breathing with your diaphragm, and a daily upper-back twist, because keeping movement through your range still matters.
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In 9 women with joint hypermobility syndrome and 9 others, the muscles resisted stretch equally, but the hypermobile women went much further before stopping, which the authors called "a greater subjective tolerance to passive stretch". So "go until you feel a stretch" can take a hypermobile body too far (our reading).
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The HMSA lists "repeated stretching/training (for example in yoga enthusiasts and gymnasts)" among the causes of symptomatic hypermobility, and the Ehlers-Danlos Society lists "repeated or excessive stretching" among the reasons joints slip out. No study has measured this in yoga.
Experts advise working in the middle of your range. That's a sensible starting point rather than a tested rule: the two trials that compared ranges found no harm from going further in strength exercises. Neither tested long, passive end-range stretches.
Our searches found no trial of yoga in hypermobility. One small rehabilitation programme of about 80 hours over 9 weeks, which included yoga among about 9 parts, improved exercise capacity, balance, tiredness and quality of life in 25 people with hEDS, but it had no separate comparison group, so yoga's part can't be separated.
Reviews of 11 and 10 studies found that people improve over time with exercise and physiotherapy, but controlled evidence is weak; across 330 people, one non-serious side effect was reported. In 6 small trials (20 to 57 people each), pain or joint sense improved whatever the type of exercise.
In 100 adults with hypermobile, painful shoulders, 16 weeks of heavier strengthening through the full range improved shoulder function a little more than light work in the middle of the range, but not by a meaningful amount, and the difference had gone at a year. Pain during the exercises stayed below 0.5 out of 10 in both groups. In 38 women, 8 weeks of trunk stability exercise eased pain and improved balance.
In 5 studies (254 people), joint position sense in the legs was poorer in hypermobility syndrome, and hypermobile adults sway more, fall more and fear falling more. In small studies, 8 weeks of joint-sense and balance exercise improved joint sense, pain and balance.
In an online Pilates programme (420 people analysed), the impact of hypermobility on daily life improved more than in the comparison group, and 17.1% of 251 people reported some extra pain or a flare they put down to the Pilates. No study has compared yoga and Pilates. Our Pilates for hypermobility guide has the detail.
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In 94 trials, yoga had no more side effects than usual care or other exercise. Outside trials, among 1,702 people who do yoga, hand, shoulder and head stands were linked with 29.4% of short-term side effects, and practising on your own without guidance raised the risk. Published case reports most often named headstand, shoulder stand, the lotus position and forceful breathing.
Hypermobile athletes had about 3 times the odds of a shoulder injury (low certainty) and more knee injuries in contact sport, but no more ankle injuries. In dancers, 72% of 85 were hypermobile, and hypermobility mostly didn't predict injury; in one small study, poor movement control did.
The Ehlers-Danlos Society says forceful neck and spine manipulation is not safe with EDS or HSD, because of the risks to blood vessels, spinal fluid and an unstable neck. International experts advise avoiding weight on the head when the upper neck may be unstable. No study has tested headstand or shoulder stand in hypermobile people; leaving them out is our reading of this advice.
No style has been tested. Choose slower, strength-based classes with props and a teacher who works with hypermobility (our suggestion). Take care with yin yoga's long passive holds and fast flows with lots of weight on the hands, and avoid hot yoga if you get dizzy.
Say that you're hypermobile and which joints give you trouble, and ask not to be adjusted, especially at the neck. In a study of 354 yoga students, about 1 in 10 had pain caused by yoga over a year, and the authors suggest telling teachers about any injuries.
Two or 3 times a week, starting with about 20 minutes, and notice how you feel over the next 48 hours, as our Pilates for hypermobility guide suggests. The physiotherapy trials ran for 4 to 16 weeks; give it 8 to 12 weeks before judging it (our exercise for hypermobility guide's suggestion), and with PoTS, PoTS UK says it can take 6 to 12 weeks to notice a change.
In 32 hypermobile adults, cues that focus on something outside the body, such as "press the floor away", improved balance more than cues about the body itself. Stop at a position (knees over the middle of your feet, a soft bend in every joint) rather than at a feeling.
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The 15 to 20 seconds is the lower part of our yoga for flexibility guide's editorial 15 to 30 seconds for control poses. The soft-joint and mid-range cues follow the NHS, the Ehlers-Danlos Society and the HMSA.
See the movement on the 3D figure: Warrior II (Virabhadrasana II)
48% of 102 adults with hEDS or HSD had PoTS on testing, and at a UK fainting clinic, 82% of 218 hypermobile patients had an abnormal tilt test. The NHS says PoTS is more likely with joint hypermobility syndrome: your heart rate rises when you get up, often making you dizzy or light-headed.
Exercise on the floor, seated or lying tends to suit people with PoTS better. Drink two glasses of water first, wait an hour after a meal, keep cool, avoid standing still for long or stopping suddenly, and lie with your legs raised afterwards. Getting too hot is a recognised trigger, so skip heated classes.
In 30 people with PoTS, breathing at 6 breaths a minute during a 10-minute tilt cut the rise in heart rate by about 7 beats a minute and eased symptoms. It was one session, alongside standard care.
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In 19 people with PoTS, 3 months of exercise training improved quality of life, while a heart rate medicine (propranolol) didn't. The study was small and people weren't randomly assigned to exercise.
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Slow breathing: at least 5 minutes, done regularly (the move's page), or 2 minutes at the start of a session (our editorial starting point). Let the breath be easy rather than strong.
Heel slides: 10 each side (the move's page). Dead bug heel taps: 8 each side; bridge: 10 slow lifts with a 2-second squeeze, only as high as your back stays still (our hypermobility strength and control routine). Belt press: 3 to 5 holds of 5 to 10 seconds at a light effort (the move's page).
Cat-cow: 6 slow, small rounds (our editorial starting point, within the move's page's 8 waves). Bird dog, one limb at a time: 6 each, 3-second hold; knee plank: 3 holds of 15 seconds (our hypermobility strength and control routine). Elbows soft, and fists or forearms if your wrists bend back too far.
Mountain pose: 5 to 10 slow breaths, knees soft (the move's page). Chair pose, warrior II, warrior III (hands on a wall or chair) and locust: hold each for 15 to 30 seconds with your joints soft rather than locked (our yoga for flexibility guide's editorial starting point).
Single-leg stand: 2 holds of 20 seconds each leg, next to a counter; semi-tandem stance: 20 seconds with each foot forward (our hypermobility strength and control routine). Tree pose: 3 to 5 breaths each side, foot on your ankle or calf, hand on a wall (our yoga for stress class).
Thoracic rotation: 6 each side, hips still (the move's page). Strap hamstring stretch: only if the backs of your thighs feel genuinely tight, about 30 seconds to a mild pull (our exercise for hypermobility guide). Reclining bound angle: 2 to 5 minutes with a support under each thigh (the move's page). Corpse pose: at least 5 minutes, up to 10, calves on a chair if you get dizzy on standing (the move's page).
These rest on expert advice rather than trials. Most poses can be swapped for a supported, mid-range version.
Front splits, deep pigeon, deep forward folds with locked knees, lotus and half lotus, and deep kneeling with your heels beside your hips (hero pose). Our yoga for flexibility guide already says to avoid deep splits, deep backbends and long passive yin holds.
In triangle, forward folds, downward dog, plank and arm balances, keep a soft bend and push the floor away. If your wrists bend back too far, use fists or your forearms, as our yoga for wrists guide says.
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Leave out headstand, shoulder stand and plough. Our Pilates for hypermobility guide leaves out weight on the neck for the same reason.
Choose bridge pose instead of wheel, skip binds and deep shoulder openers, and don't hang in downward dog. Our yoga for swimmers guide gives the same advice for shoulders.
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Stay in the middle of your range, keep your muscles lightly working and keep holds short, as our yin yoga guide says.
Heat is a recognised trigger for PoTS, and more range is the wrong goal for hypermobile joints.
Say no to adjustments, especially at the neck. Keep breathing easy rather than holding your breath or forcing it.
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Start with our 25-minute stability-first yoga class 2 or 3 times a week, on days that aren't back to back (our editorial starting point). The Pilates class and the strength and control routine cover the same ground; the balance routine and chair yoga suit days when the floor or long standing is hard. With PoTS, the lying and seated session follows our exercise for PoTS guide.
A 25-minute yoga class for hypermobile joints, HSD and hEDS: supported lying work, all-fours control, standing poses with soft joints, balance and a legs-up rest.
25 minBeginner15 movesA band, A wallA 20-minute Pilates class for hypermobile joints, HSD and hEDS: supported positions first, mid-range control, slow changes and steady breathing.
20 minBeginner17 movesOther / check instructions, A bandA 25-minute low-load routine for hypermobile joints: hip, trunk and shoulder control plus balance, done slowly in the middle of your range.
25 minBeginner15 movesA bench or box, A wallBalance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.
10 minBeginner7 movesA wall, A bench or boxA free 20-minute chair yoga class for older adults: slow breathing, gentle seated stretches and twists, standing poses holding the chair, and a calm finish.
20 minBeginner18 movesA bench or box, Something with weightA 30-minute PoTS session that never asks you to exercise standing: easy intervals on a bike and rowing machine, lying leg strength, then legs up the wall.
30 minBeginner8 movesCardio machine, Other / check instructionsThese follow our exercise for hypermobility guide word for word. This is general information, not a diagnosis. A&E means accident and emergency.
Call 999 if someone:
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Go to A&E after an injury if any of these apply, and call 999 if you can't get there yourself:
After a knee injury, if:
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Get advice from NHS 111 now: the knee locks, gives way or clicks painfully. Painless clicking is normal.
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Talk to them about high pain, pain in new areas, other symptoms getting worse, or changes in what you can do. After a diagnosis, a GP can refer you to physiotherapy, podiatry or pain management.
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Lie down with your legs raised. If you can't, sit with your head lowered between your knees. Crossing your legs while standing, rocking up and down on your toes, clenching your fists, or, with PoTS, clenching your buttocks and tummy muscles can help.
Stop a move, or make it smaller, if a joint feels about to slip. Sore muscles for a day or two are normal when you start; sharp joint pain, pain in new places or a joint slipping are not.
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It's the other way round: build strength and control, and stretch only what's genuinely tight. The NHS says don't overextend your joints, and the Ehlers-Danlos Society says overstretching may lead to instability. This rests on consistent expert advice rather than trials, as our exercise for hypermobility guide says.
Hypermobile people tolerate more stretch before they feel it, repeated stretching is one route into symptoms, and in one dance study, movement control, not flexibility, predicted injury. Control is the skill.
Without symptoms, it needs no treatment. With HSD or hEDS, it can bring pain, tiredness, dizziness on standing, gut and bladder problems and anxiety.
Exercise improves strength, control and joint sense, not the ligaments themselves. Our Pilates for hypermobility guide grades "Pilates will tighten loose joints" the same way.
The HMSA calls strength-and-control yoga worth trying, and PoTS UK lists yoga among types of exercise. No study shows harm or benefit specifically. The style and the teacher matter.
Heat is a recognised PoTS trigger, and more range is the wrong goal for hypermobile joints.
The Beighton score is a screening check. hEDS needs the full criteria and other conditions ruled out, and a joint can be hypermobile and still look "normal".
Sore muscles for a few days are normal, and the NHS says not exercising can make symptoms worse. In the shoulder trial, pain during exercise stayed low even with heavier loads. Sharp joint pain or a joint slipping is different: change the move.
Experts advise avoiding weight on the head when the upper neck may be unstable, forceful neck manipulation isn't safe with EDS or HSD, and hand, shoulder and head stands were linked with the most side effects in a large survey of people who do yoga.
It can be good if it builds strength and control rather than flexibility: the Hypermobility Syndromes Association calls that kind of yoga worth trying. Classes that reward going deeper into stretches are the problem, because overstretching can lead to unstable joints. No trial has tested yoga in hypermobility.
Most people with hypermobile EDS or HSD can, with changes: keep your joints in the middle of their range, keep knees and elbows soft, use support, and leave out weight on the head and neck. With unstable joints, start with physiotherapy-led strength work. Vascular EDS needs specialist advice first.
Only what's genuinely tight, gently. The Ehlers-Danlos Society says gentle stretching can help tight muscles but overstretching beyond the normal range can be harmful, and the bendy part should be held still. Keeping your upper back moving with a daily twist is still worthwhile.
No style has been tested. Choose slower, strength-based classes with props and a teacher who knows hypermobility. Take care with yin yoga's long passive holds and fast flows with lots of weight on the hands, and avoid hot yoga if you get dizzy.
No study has compared them. Pilates has one larger trial in hypermobility and yoga has none, and the Hypermobility Syndromes Association suggests both, and tai chi, if they focus on strength and control. Choose the one you'll keep doing.
End-range stretches such as the splits, deep pigeon, lotus and deep kneeling; locked knees or elbows; headstand, shoulder stand and plough; deep backbends such as wheel; and binds that wrench the shoulders. This rests on expert advice rather than trials, and most poses can be swapped for a supported, mid-range version.
Hypermobile people often feel a stretch late, so stop at a position rather than a feeling: knees over the middle of your feet, a soft bend in every joint, and well short of your end range. Cues like "press the floor away" also helped balance in hypermobile adults.
Gentle yoga can be, if you start lying and sitting: PoTS UK says floor-based and seated exercise suits people better, with water first, a cool room and your legs raised afterwards. Slow breathing at about 6 breaths a minute eased the rise in heart rate on standing in one study. Get up slowly, and skip hot classes.
The Hypermobility Syndromes Association lists repeated stretching or training, for example in yoga enthusiasts and gymnasts, as one route into symptomatic hypermobility. No study has measured this in yoga, but it's a reason not to chase ever-deeper stretches.
It isn't a good fit. Heat is a recognised trigger for PoTS, which is common with hypermobility, and extra range is the wrong goal for hypermobile joints.
No: there's no cure, and the NHS says the main treatment is improving muscle strength and fitness so your joints are better protected. Yoga can be one way to build that strength and balance, and physiotherapy-led exercise has the most evidence.
See a GP for joints that keep dislocating, ongoing pain, frequent sprains, tiredness after rest or poor balance, and if you feel dizzy or faint when you stand up. Go to A&E for a shoulder that looks out of place, and call 999 if someone faints while exercising or lying down.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition such as glaucoma, high blood pressure or osteoporosis, or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
