Hypermobility in Children: When Should Parents Be Concerned?

Physio&SoleClinic Physiotherapy February 3 2026

Written by Farha Nisha, Senior Partner & Principal Musculoskeletal Physiotherapist at Women & Children Centre and Physio and Sole Clinic

As a clinician working with children and adolescents in Singapore, one of the most common things parents tell me is this:

“My child is very flexible — but is that a good thing or a problem?”

Some parents notice their child sitting in strange positions, bending their fingers backwards, or constantly being called “double-jointed” by teachers and relatives. Others come in because their child complains of knee pain after PE, ankle pain after football training, or seems unusually tired compared to their peers.

So let’s talk about hypermobility in children — what it is, what it isn’t, and when it deserves attention.

What Is Hypermobility?

Let’s clarify this clearly.

Hypermobility is NOT:

• A disease by default
• A reason to stop all sports
• Something to “fix” by stretching more

Hypermobility IS:

• A variation in joint structure
• A need for better strength, control, and awareness
• A reason to move smarter — not less

With the right guidance, hypermobile joints can function safely and efficiently — without pain, fear, or unnecessary limitations. The goal isn’t to restrict your child, but to help their body move with strength, confidence, and stability as they grow.

The Problem: “My Child Is Very Flexible — Should I Worry?”

Hypermobility simply means that a child’s joints move beyond the typical range expected for their age.

And here’s the key reassurance upfront:

• Hypermobility is common in children, especially during growth years.
• Flexibility alone is not a diagnosis.
• Many hypermobile children are completely pain-free and function well.

In Singapore, we often see this in:

• Preschool and primary school children
• Girls more than boys
• Children involved in dance, gymnastics, martial arts, or football
• Children with flat feet or low muscle tone

For many children, joint flexibility naturally reduces as they grow older, develop strength, and mature neurologically.

So no — being flexible does not automatically mean something is wrong.

Where parents get confused (and understandably worried) is when flexibility comes with symptoms. This is where hypermobility can shift from being a benign trait to something that affects daily life.

Is Hypermobility Painful for Kids?

• 

It can be. While some children feel nothing at all, others experience:

• Aching knees, ankles, or wrists
• Pain after PE lessons or CCAs
• Fatigue by the end of the school day
• Pain that worsens during growth spurts

Pain is not something children should simply “tolerate” or “grow out of” without guidance.

What Are the Signs of Hypermobility in Children That Parents Should Watch For?

From a clinical perspective, these are red flags that flexibility may need attention:

• Frequent joint pain (especially knees, ankles, hips, wrists)
• Tiring easily compared to peers
• Poor coordination or clumsiness
• Joints that “give way” or feel unstable
• Recurrent sprains or strains
• Flat feet that collapse when standing
• Sitting in extreme postures (W-sitting, slouching, locking knees)
• Avoidance of sports due to discomfort

When these signs are present, flexibility is no longer harmless — it’s placing extra strain on muscles and joints.

Are Hypermobile Children More Prone to Injuries?

Yes — without proper strength and control, hypermobile children are more vulnerable to:

• Ankle sprains
• Knee pain (especially during running and jumping)
• Muscle strains
• Overuse injuries during sports training
• Poor landing mechanics

This is especially relevant in Singapore, where children often juggle:

• Long school days
• PE lessons
• CCAs (football, netball, dance, taekwondo, etc.)
• Tuition and limited recovery time

A flexible joint without adequate muscular support behaves like a loose hinge — it moves easily, but not always safely.

Will It Affect My Child’s Posture or Walking Pattern?

It can. In clinic, we often see hypermobile children with:

• Knee locking when standing
• Slouched sitting postures
• Flat or unstable feet
• In-toeing or out-toeing during walking
• Reduced endurance when walking long distances (e.g. school excursions)

These aren’t just “bad habits”. Often, they are compensation strategies because the body is trying to find stability.

Will My Child Grow Out of Hypermobility?

This is one of the most common parent questions — and the honest answer is, some children do and some don’t.

Joint flexibility often reduces with age, especially after puberty. However:

• If a child has symptoms now, waiting alone is rarely helpful
• Poor movement habits can persist into adolescence
• Pain patterns can become ingrained if unaddressed

The goal is not to “wait it out”, but to guide the child safely through growth.

Can Hypermobility Cause Long-Term Problems?

On its own, flexibility does not doom a child to future problems. However, untreated symptomatic hypermobility may contribute to:

• Chronic joint pain in teenage years
• Reduced sports participation due to fear or discomfort
• Recurrent injuries
• Poor confidence in movement

Can Hypermobility Lead to Arthritis or Joint Problems Later in Life?

Current evidence suggests that hypermobility does not automatically cause arthritis. But long-term joint stress, poor mechanics, and repeated injuries can increase joint strain over time. This is why early guidance matters — not to restrict movement, but to build strong, stable movement patterns.

What Can Parents Do at Home?

For children experiencing discomfort:

• Encourage regular movement breaks, not prolonged sitting
• Use warm compresses for muscle aches after activity
• Avoid excessive stretching (many hypermobile kids already overstretch)
• Ensure adequate sleep — fatigue worsens symptoms
• Teach children not to lock their knees or elbows when standing

Supporting Hypermobile Children in School, PE, and Sports

During PE & CCAs

• Inform teachers or coaches if your child has pain or frequent injuries
• Emphasise technique over performance
• Gradually increase training load — avoid sudden spikes
• Allow rest days between intense sessions

Footwear matters

In Singapore, many children wear shoes for long hours.

Look for:

• Firm heel counters
• Good midfoot support
• Shoes that don’t twist easily

For some children, a podiatry assessment may help address foot instability that contributes to knee or ankle pain.

When Should Parents Seek Professional Help?

I recommend assessment by a physiotherapist or podiatrist when:

• Pain lasts more than a few weeks
• Pain affects school, PE, or sleep
• Injuries keep recurring
• Your child avoids activity due to discomfort
• You notice poor posture or coordination
• Growth spurts trigger worsening symptoms

Early support is not over-medicalising — it’s preventive care.

What Does Physiotherapy or Podiatry Actually Help With?

A proper assessment focuses on:

• Strength and muscle control
• Movement patterns (running, jumping, walking)
• Balance and coordination
• Joint stability
• Foot posture and load distribution

Treatment usually includes:

• Strength-based exercises (not stretching)
• Proprioception and balance training
• Education for child and parents
• Activity modification — not activity avoidance

The aim is simple: Confident, resilient movement — not fear or restriction.

Long-Term Strategies: Building Strength, Confidence, and Resilience

Children with hypermobility thrive when they:

• Build muscular strength early
• Learn good movement habits
• Stay active in a supportive way
• Understand their bodies without fear

Many go on to excel in sports, dance, and physical activity — when guided appropriately.

Final Reassurance for Parents

If there’s one thing I want parents to take away, it’s this:

• Flexibility is not the enemy.
• Pain, fatigue, and repeated injuries are signals — not weaknesses.
• Early guidance can make a lifelong difference.

If you’re unsure whether your child’s flexibility is simply part of normal development — or something that needs support — a professional assessment can bring clarity and peace of mind.

At our physiotherapy clinic in Singapore, we work closely with children and adolescents to help them move stronger, safer, and more confidently through school, sports, and growth.

Reach out to us for a physiotherapy or podiatry assessment — and let’s support your child’s movement journey together.