Joint Laxity or Hypermobility

Are loose and unstable joints a cause or a consequence of osteoarthritis?

Osteoarthritis is a common condition characterized by joint degeneration (wearing down), pain, and stiffness. It has also been associated with excessive joint flexibility, including varying degrees of joint instability, hypermobility, and laxity. These conditions, which are characterized by an increased range of joint motion, can predispose you to joint injuries.

This article discusses joint laxity and hypermobility in relation to osteoarthritis. It also discusses joint instability and flexibility.

A man struggling with knee pain
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If you have osteoarthritis, it is helpful to recognize the signs of joint laxity. Early diagnosis, exercises, and joint stabilization may help protect you from an injury.

Variations in Joint Flexibility

The normal range of joint flexibility varies among individuals and over time. Some people are born more flexible than others, while others may have consciously worked at expanding their range of motion by participating in activities such as yoga or stretching exercises. In general, women have more joint mobility than men, and children are also quite flexible, though flexibility decreases with age.

Joint Laxity

Joint laxity is a connective tissue problem characterized by excessive flexibility of joints. This is also described as joint hypermobility or joint hypermobility syndrome. It usually affects many joints throughout the body and may be due to genetic conditions that cause connective tissue to be abnormal.

Marfan syndrome, Stickler syndrome, and Ehlers-Danlos syndrome are some of the most recognized conditions associated with joint laxity. Each of these medical conditions accompanies other health issues.

Marfan syndrome is associated with aortic root dilation (expansion of a major blood vessel). Stickler syndrome increases the risk of osteoarthritis and altered skeletal development. Ehlers-Danlos syndrome commonly causes skeletal deformities and easy bruising.

While not typically associated with a medical condition, some people describe themselves as "double-jointed," which means that they can bend certain joints in the opposite direction they normally bend in without feeling pain. This is not truly the result of duplicate joints, but it is usually due to hypermobility.

Joint Instability

Joint instability describes a situation in which one or more of the structures that normally stabilizes a joint—cartilage, ligaments, or tendons—is either damaged or has not developed properly. In this situation, the bones of the joint are prone to abnormal movements under load, which over time can accelerate joint degeneration.

Osteoarthritis and Joint Flexibility

Joint instability is fairly common in osteoarthritis due to the breakdown of the structures in the joints. While less common than joint instability, joint laxity can also accompany osteoarthritis.

Joint laxity also may increase the risk of osteoarthritis in certain joints (like the hand), and joint instability may result from osteoarthritis. The joint space narrowing and misalignment that develop as a result of osteoarthritis can contribute to ligament laxity and joint instability. Sometimes, joint instability begins with an injury to the ligaments.

Joint laxity and instability can predispose you to joint dislocation from an injury, while joint dislocation can contribute to joint laxity and instability if the structures do not heal properly.

If you have joint instability or joint laxity, you may notice that some of your joints are more flexible or you might not experience any symptoms at all.

A physical examination, as well as imaging tests such as X-rays and magnetic resonance imaging (MRI), can help confirm a diagnosis of joint laxity.

Treatment of Increased Joint Flexibility in Osteoarthritis

If you have joint laxity or instability, you may be advised to avoid high-impact activity or resistance training. In these cases, low-resistance training is used to help stabilize the joint. Supporting your unstable joint with a brace may be beneficial as well.

Physical therapy, bracing, ice, elevation, and nonsteroidal anti-inflammatory drugs, like Advil or Motrin (ibuprofen) and Aleve (naproxen), are often needed as you recover from an injured joint. Optimal healing can help prevent instability and laxity from developing after an injury.

A Word From Verywell

If you have osteoarthritis, pain and stiffness are the most prominent symptoms you can expect. However, increased joint mobility can also be problematic. Because it doesn't usually cause symptoms, you should maintain moderate physical exercise to keep your muscles strong and improve the stability of your joints. If you experience an injury, be sure to get enough rest and rehabilitation so that your joint will heal optimally.

Frequently Asked Questions

  • How do you strengthen hypermobile joints?

    Very carefully. If you have hypermobile joints, your doctor may recommend physical therapy. Joint laxity associated with hypermobility makes your joints more prone to dislocation and subluxation.

    Strengthening the muscles around the joints helps protect them. However, doing too much too quickly can result in a symptom flare-up.

  • Does hypermobility cause fatigue?

    Hypermobility and joint laxity associated with osteoarthritis cause pain, which may cause fatigue. Hypermobility due to a connective tissue disorder, such as Ehlers-Danlos syndrome, is associated with chronic fatigue.

  • What is Ehlers-Danlos syndrome?

    Ehlers-Danlos syndrome (EDS) is an umbrella term for a group of genetic connective-tissue disorders that can cause hypermobility, stretchy skin, easy bruising, and tissue weakness.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Nishiwaki M, Kurobe K, Kiuchi A, Nakamura T, Matsumoto N. Sex differences in flexibility-arterial stiffness relationship and its application for diagnosis of arterial stiffening: a cross-sectional observational study. PLoS ONE. 2014;9(11):e113646. doi:10.1371/journal.pone.0113646

  2. Cattalini M, Khubchandani R, Cimaz R. When flexibility is not necessarily a virtue: A review of hypermobility syndromes and chronic or recurrent musculoskeletal pain in children. Pediatr Rheumatol Online J. 2015;13(1):40. doi:10.1186/s12969-015-0039-3

  3. Palmer S, Cramp F, Clark E, et al. The feasibility of a randomised controlled trial of physiotherapy for adults with joint hypermobility syndrome. Southampton (UK): NIHR Journals Library; 2016. (Health Technology Assessment, No. 20.47.) Chapter 1, Introduction.

  4. Blalock D, Miller A, Tilley M, Wang J. Joint instability and osteoarthritis. Clin Med Insights Arthritis Musculoskelet Disord. 2015;8:15-23. doi:10.4137/CMAMD.S22147

  5. Reychler G, De Backer MM, Piraux E, Poncin W, Caty G. Physical therapy treatment of hypermobile Ehlers-Danlos syndrome: A systematic review. Am J Med Genet A. 2021;185(10):2986-2994. doi:10.1002/ajmg.a.62393

  6. Cleveland Clinic. Joint hypermobility syndrome.

Additional Reading

By Carol Eustice
Carol Eustice is a writer who covers arthritis and chronic illness. She is the author of "The Everything Health Guide to Arthritis."