Hypermobility in babies and children

How is hypermobility assessed?

Health professionals often use simple screening tools to assess joint mobility, one of the most well-known being the Beighton score. This score looks at how easily certain joints move and helps give an overall impression of joint flexibility.

The Beighton score includes gentle assessments such as:

• how far the little finger and thumb can move
• whether the elbows or knees extend slightly beyond a straight position
• whether the hands can reach towards the floor with straight knees

A higher score suggests increased joint mobility, but it is only one part of a broader clinical picture. A full assessment also considers how the child moves in everyday play, their strength, coordination and comfort.

It is also important for health professionals to distinguish between:

• increased mobility in one or a few joints
• generalised hypermobility
• hypermobility as part of a broader connective tissue pattern

In some cases, increased joint mobility can be associated with hereditary connective tissue conditions. Examples include syndromes such as Ehlers-Danlos, Marfan or Osteogenesis Imperfecta. These conditions are diagnosed by medical specialists, as they involve additional characteristics beyond joint flexibility.

If parents have concerns about their child’s movement, comfort or flexibility, they should consult a healthcare professional for guidance.

What signs might parents notice?

Parents of children with increased joint mobility may observe:

• Flexible or flat feet
• Knees that tip inward or extend further than usual
• Elbows or finger joints that appear very flexible
• A preference for sitting in a “W” position
• Occasional challenges with balance or coordination
• Getting tired more quickly during active play
• Periods of discomfort or fatigue after physical activity
• More frequent slips, stumbles or minor twists during movement

These signs can vary widely from child to child and are not always a cause for concern.

When should you seek help?

If your child experiences ongoing discomfort, fatigue or reduced confidence in movement, especially during or after physical activity, it may be helpful to speak with a healthcare professional for guidance.

What can you do as a parent?

Good shoes
Supportive, well-fitting footwear can help children feel more stable and comfortable. A good shoe typically has:

• A firm heel cup
• A flexible sole
• Width that matches the foot
• A secure and comfortable fit

For young children (0–2 years)

Encourage motor development by helping your child explore a variety of sitting and play positions that support joint stability. For example:

• Offer alternatives to the W-position, such as long sitting or side sitting
• Provide gentle support around the hips or knees during crawling or transitional movements
• Create playful opportunities for your child to shift weight from side to side

For older children (2+ years)

Encourage regular play and age-appropriate sports or movement activities. Varied use of the body helps build balance, coordination and endurance.

It can also be helpful to teach children to listen to their body – pausing, resting or changing activity when they feel tired or uncomfortable.

Support options for children with increased joint mobility

Pediatrician

Paediatricians specialise in the medical assessment of children and young people. If there is concern that hypermobility may be part of a broader hereditary connective tissue pattern, a paediatrician or medical specialist can provide further evaluation and guidance.

Paediatric physiotherapist

Paediatric physiotherapists focus on children’s movement, strength and coordination. They can help create play-based exercises, everyday activity ideas and strategies that support confidence, stability and motor development. They may also advise on suitable equipment or additional services if needed.

Osteopath

Osteopaths use gentle, hands-on techniques to support comfort and ease of movement. They can help explore how the child uses their body, identify areas that may feel tight or overworked, and offer guidance on encouraging balanced, confident movement through everyday play and activities.