Monday, August 10, 2009

Hypermobility in the Lower Body - Pictures

Below you will find pictures that demonstrate Hypermobility in the lower body, mainly the legs, and in posture. The red lines represent the proper/correct/natural alignment the body should have - in other words, the red line should intersect three joints, for example, the ankle, knee, and hip. On the left hand side you will see an example of correct alignment, as would be found with a non-Hypermobile person. On the right you will see an example of improper alignment, as would be found in a Hypermobile person. You can see that on the right hand side, the red line only intersects two joints, namely the ankle and hip. This occurs because the third joint, mainly the knee, is being extended past its intended range of motion (past 180 degrees).

There are two main explanations for this phenomenon. First, the body of a Hypermobile person is different from that of non-Hypermobile people because their connective tissues have a different genetic makeup, which allows joints to have a greater range of motion, extending further than they are intended to do. In other words, the first explanation is a genetic one. The second reason is a bit more subtle, and it has to do with the way in which the brain perceives the physical body. Humans have a sense called proprioception, which is the perception of one's physical body in space. This sense allows us to navigate through 3D space accurately, knowing instinctively where each point of our body is at any given moment. For example, if you were to ask your friend to close their eyes, and then moved their hand to the left 4 inches, your friend would know exactly where their arm was without opening their eyes (even if they can't tell you 4 inches, that is irrelevant - the brain knows where the arm is). If you were to do this to a Hypermobile person, you would have less accurate results; this is because, for whatever reason, people with Hypermobility have an impaired or diminished sense of proprioception. This causes them to be more clumsy, accident prone, and/or uncoordinated. For example, it is common for a Hypermobile person to run into the corner of a coffee table with their knee, despite the fact that they walk past that exact same coffee table in the exact same position every day. For a non-Hypermobile person with perfect proprioception, the brain has a correct vision of space and location, allowing them to navigate around the coffee table without having to think about it. That is another important point about proprioception, it is not an active sense like vision or taste, but an inactive or instinctual sense - you don't have to think about proprioception, or 'turn it on,' your body just does it. Therefore, the hypermobile person is not aware of thier incorrect posture or the overextension of thier joints - that is just how thier body naturally functions. In other words, the brains of both the Hypermobile and non-Hypermobile person, think they are standing in the same position and in the same alignment; it is the Hypermobile person's impaired sense of proprioception coupled with thier innate flexibility that leads to the marked difference between the two.


  1. Hi Chelsea, I am thrilled to discover your blog, and am writing one myself

    I was particularly interested in your photographs and can Identify myself as doing all of them except the sitting in a W on the floor. I am actually almost completing a Masters thesis on the physical and psychological characteristics of JHS dancers, and want to conduct some qualitatitve research observing how dancers (and patients) with JHS behave. Your photographs would be fantastic in my future work. Would you allow me to have copies of them? In fact one or two would be good to illustrate my latest blog entry. I will add your blog link to mine immediately. Well done for getting a newspaper article about JHS.

    If you would like to email at anytime my email is

    You are doing a great job or writing, and I will try and follow your blog.

    Isobel Knight

  2. Just immitated your pictures and can do them all...hmmm maybe this explains my years of joint pain, bursitis and if only I could find a doctor!

    Great site, very helpful!

  3. I just found your blog when looking at some pictures of hypermobile joint syndrome on google. I had noticed a marked change in the appearance of the joints in my left hand and wrist over the past couple of months and was curious if there could be something besides known issues going on. Ten years ago I was diagnosed with an autoimmune disease centered around my joints, but before that, I never realized that it wasn't normal to be able to do things like you picture. Especially the one where your legs form a "W" shape when you sit. I sat like that all my life, more comfortably than sitting cross legged. It always creeped my mom out when I was young but I always chalked it up to her not being very flexible. Makes me wonder if the hypermobility brought on the autoimmune issues or if the autoimmune issues brought on the hypermobility issues or if the two are totally independent and I just won the joint disorder lottery. I'm going to have to bring this syndrome up to my Rheumatologist and show him some of the pictures. Since I'm always in considerable pain I usually don't try to show him how far I can move the joints out of the normal realm so he may not even have thought to check for that. I'm not quite able to complete the hands meeting behind your back one, but after 10 yrs of my joints being attacked by my immune system and being destroyed, that could be a part of it. I haven't had a chance to fully explore your blog so you might have answered this elsewhere, but are you hypermobile in any other joints not pictured? My fingers and wrists, especially the left side are. Here I thought it was just a fun party trick that I could slide my hands out of

  4. Wow. I can do all of these, but I didn't realize it was something serious. I can also put my foot in my mouth, not forwards, but backwards.This actually explains alot of the joint pain I get and how I'm such a weakling.

  5. I'm going through a pain period at the moment (wake up in pain and can't get back to sleep because of pain) and I've been surfing HMS websites in search of comfort, and I've noticed that quite a lot of people do seem to have HMS plus something else. I've got HMS plus relatively bad allergies and food intolerances which between them mean that a lot of things "normal" people do are out of the question for me unless I want to face all sorts of pain and suffering. I think it is very possible that at least some HMS could have a connection to autoimmune problems.

    I too can do all the things in the pictures, although I have learnt that it's best not to because it just keeps the joint looser, so even though those positions are very comfortable at the time, I try and avoid them. I get my husband to tell me every time he spots me sitting in a creepy/weird/looks like I've been in a car crash position, then I complain that surely that position is normal, then I make an effort not to use it any more. The hardest thing is not noticing that you're in an abnormal position, because they all feel fine to us.

    I find the arms one particularly disgusting looking. I always thought it was normal to be able to hold hands behind your back and had no idea what I looked like doing it.

  6. Wow, I've had a pt send me this link after he saw he doing squats in a class. I can almost reach my thumbs to arms (always used to but haven't tried in 10 years), my fingers all bend backwards further than straight and I can even lock the top joint of my fingers perpendicular (party trick). I can reach my arms behind my back and I can sit in the W shape even with my bum flat on the floor and my calves almost perpendicular to my quads! I am slow to heal, bruise easily and always run into things that I shouldn't. But I don't have any pain. I am 29. Does the pain start early, or do the other symptoms start first? Can I expect that I will be in a lot of pain soon? I have been like this ever since I can remember (I am also pigeon toed and can bend my feet inside past 180 degrees and walk. Like a demented backwards ballerina).

    Any advice?

  7. I can do alllll that stuff (except the reaching behind my back and holding my hands. Probably because of fatness...I can make them touch but not hold like that). Now I've come to discover that my hypermobility is probably the reason I'm suffering from a MCL tear for the second time in my life. Well, this time its much more severe. Ugh. Very good blog, great info.