Narrative: Joint hypermobility is common and frequently under-recognised in Chiropractic practice. This review defines joint laxity and hypermobility, presents mobility as a clinical spectrum, outlines major conditions associated with symptomatic hypermobility, and summarises evidence-based assessment and management strategies relevant to chiropractors.
Hypermobility exists on a continuum from asymptomatic increased range to disabling instability. Reliable tools include the Beighton score, validated screening questionnaires, and limb-specific assessments. Hypermobility predisposes to recurrent dislocations, patellar instability, chronic ankle sprains, and secondary overload syndromes such as rotator cuff tendinopathy.
Spinal laxity also occurs in connective tissue disorders and degenerative lumbar instability. Evidence supports rehabilitation focused on strengthening, proprioception, pacing, and education.
Spinal manipulation may provide short-term analgesia but repeated thrust techniques in unstable joints may worsen symptoms and disability trajectories over time. Chiropractors play an important role in recognising hypermobility, avoiding inappropriate mobilisation of unstable segments, and delivering evidence-based care centred on functional stability.
Author keywords: Chiropractic; joint hypermobility; hypermobility spectrum disorder; Ehlers-Danlos syndrome; manipulation; adjustment, rehabilitation; instability.
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