The Overlooked Link Between Autism and Hypermobility Explained

Written by Michael Clark, Registered Osteopath and Co-founder of Clarks Healthcare

Autistic individuals are two to four times more likely to have hypermobility than the general population—yet this connection remains largely unrecognised in mainstream healthcare.

Hypermobility presents its own set of challenges (which I’ll explore in this article), but when it occurs alongside autism, it does not just coexist—it interacts, creating a unique set of symptoms that often go unnoticed.

In my 20+ years as an osteopath, I have seen this pattern time and again. Autistic patients visit my clinic describing feeling clumsy, unstable, or wobbly. They may mention being knock-kneed or pigeon-toed, struggling with persistent pain, poor posture, movement issues or frequent injuries. Despite trying various treatments and standard one-size-fits-all rehabilitation plans, nothing seems to work.

The missing piece? Their hypermobility and autistic nervous system interact in ways that standard assessments and treatments fail to address. This crucial link is often overlooked, leading to misdiagnosis and ineffective care.

In this article, I’ll explore hypermobility in depth and how it intertwines with autism in a way that makes treatment and management unique. Drawing from my clinical experience and the latest research, I’ll break down the science, explain key medical concepts in an accessible way, and highlight the impact of this overlooked connection.

Whether you are a patient, parent, clinician, or simply curious, I hope you find this article both informative and helpful.

Let’s get started.

What Is Hypermobility—and Why Does It Matter?

Hypermobility is often misunderstood as simply being “bendy” or double-jointed, but it’s much more than that. It’s a structural difference in how a person’s ligaments are formed, allowing their joints to move beyond the typical range. While this might sound like a harmless quirk, the reality is that hypermobility can significantly impact joint stability, movement control, and overall function.

Ligaments play a vital role in keeping joints stable and guiding movement, but they also serve another crucial function: proprioception—the body’s ability to sense where it is in space and how joints are positioned and moving. Some people naturally have stiff ligaments that resist movement (hypomobility), while others—like those with hypermobility—have looser, more elastic ligaments that stretch too easily. Most people fall somewhere in between, but for the hypermobile, this looseness means joints often move too far, fail to provide adequate support, and struggle to send the necessary joint feedback to the brain. As a result, the body relies more on muscles to stabilise the joints, leading to fatigue, pain, instability and injury.

For some, hypermobility can be an advantage. Dancers, gymnasts, and martial artists, for example, often benefit from their natural flexibility, allowing them to perform movements others simply can’t, no matter how much they stretch. But for many—especially those I see in my clinic—hypermobility causes significant problems. Without proper joint control and proprioception, instability worsens, leading to chronic pain, particularly in weight-bearing joints like the knees, hips, and lower back. Poor joint feedback can make posture difficult to maintain, causing slumped sitting and aching, fatigue, and headaches from muscle overuse. Clumsiness and frequent falls are common, as are partial dislocations, as the brain struggles to interpret joint positioning accurately.

Pain perception in hypermobility varies—some experience heightened sensitivity, leading to widespread chronic pain, while others barely register injuries due to altered pain processing.. This imbalance means some are wrongly labelled as hypochondriacs or diagnosed with chronic fatigue syndrome or fibromyalgia while others fail to recognise injuries until they become serious.

Beyond joint stability and pain, hypermobility can affect multiple systems in the body. The autonomic nervous system, which controls automatic functions like heart rate, blood pressure, and digestion, is often affected. This can lead to symptoms such as dizziness, fatigue, irregular heart rate, postural orthostatic tachycardia syndrome, (POTS), and gut issues like IBS or slow digestion.

When hypermobility causes persistent pain, fatigue, or frequent injuries, it is classified as Hypermobility Spectrum Disorder (HSD). In more severe cases, it may indicate Ehlers-Danlos Syndrome (EDS), a genetic connective tissue disorder that affects skin, joints, and blood vessels.

While these issues can be frustrating and difficult to manage, targeted osteopathy, proprioceptive training, and corrective exercise can help stabilise joints, improve movement control, and reduce pain. I’ll explore these treatment approaches later in this article.

How Common Is Hypermobility in Autism?

Hypermobility is not exclusive to autism, but it is far more common in autistic individuals than in the general population—often occurring at double or even quadruple the expected rate. A study published in Brain Communications found that 50% of autistic adults were hypermobile, compared to just 20% of neurotypical individuals. Other research suggests the prevalence may be even higher. For example, a study in The American Journal of Medical Genetics reported that up to 80% of autistic individuals met the criteria for hypermobility.

The fact that hypermobility is so frequently seen in autistic individuals suggests there must be an underlying biological connection between the two conditions. It also raises important questions about how this overlap affects movement, pain perception, and sensory processing. Could shared genetic or neurological mechanisms be driving this link? And if so, what does that mean for how we assess and support individuals who experience both?

Hypermobility can affect anyone, whether they are autistic or not, but despite this strong connection, it is still rarely assessed in autistic individuals. As a result, many go undiagnosed, and their symptoms are often misunderstood or mismanaged. Recognising this overlap is crucial—not only for improving diagnosis but also for ensuring individuals with both autism and hypermobility receive the right treatment, support, and strategies to help them manage their symptoms effectively.

Why Has This Link Been Overlooked?

Despite increasing scientific evidence, many healthcare professionals are still unaware of the strong link between autism and hypermobility. This means autistic individuals with hypermobility are commonly misdiagnosed, misunderstood, or not diagnosed at all. Recognising this connection could help ensure that people with both conditions receive the right support, treatment, and care.

So why is this link often missed? The main reason is that autism is traditionally viewed as a neurological condition, while hypermobility is considered a musculoskeletal issue. Because they are studied separately, their combined effects are overlooked, leaving many autistic individuals struggling and undiagnosed.

Yet, the overlap is clear. Many of the symptoms of hypermobility and autism are similar, and instead of being recognised as two conditions interacting, they are often attributed solely to autism. This frequently leads to autistic people being told that their joint problems, frequent injuries, poor balance, and fatigue are simply part of their autism, rather than recognising that hypermobility is a separate but linked issue that needs specific care.

They are often told, “It’s just stress”, “It’s part of being autistic”, “Your scans look fine—there’s nothing wrong”. These individuals are not imagining their symptoms—they are real, physical issues caused by weaker connective tissues, altered pain perception, and difficulties with joint control.

This also explains why standard rehabilitation programmes often fail. Most rehab plans assume the issue is muscle weakness or poor coordination, so they focus on strength training. But autistic individuals with hypermobility need more than just strength—they need exercises that improve proprioception (body awareness), joint control, and sensory regulation. Without this, they often find traditional rehab ineffective, frustrating, or even painful.

By recognising hypermobility in autistic individuals, healthcare professionals can:

Identify affected individuals earlier, preventing years of misdiagnosis and ineffective treatment.
Offer more targeted, effective therapy that addresses their unique movement and sensory challenges.
Adapt rehabilitation strategies to focus on proprioception and neuromuscular control, not just muscle strength.

Raising awareness of this connection could lead to earlier diagnoses, better pain management, and more effective rehabilitation—helping autistic individuals with hypermobility live with less pain, better movement, and improved quality of life.

The Biological Connection Between Autism and Hypermobility

Genetics may hold the key to understanding why autism and hypermobility so often appear together. Both conditions tend to run in families, and emerging research suggests they may share common genetic roots. A study in The Journal of Personalized Medicine found that mothers with Ehlers-Danlos Syndrome (EDS) or Hypermobility Spectrum Disorder (HSD) are more likely to have autistic children. This suggests that the same genes responsible for connective tissue structure might also influence brain development and sensory processing.

Further evidence comes from a 2020 study in The Journal of Autism and Developmental Disorders, which linked hypermobility to motor delays in autistic children. This points to shared neurological pathways that may affect both movement control and proprioception (body awareness). It raises important questions:

Do differences in collagen structure affect brain function?
Does autism influence movement control by altering how the body regulates proprioception?
Could the autonomic nervous system (ANS) be a key factor in both conditions?

The ANS, which controls heart rate, blood pressure, digestion, and stress responses, may provide another crucial link. Many people with hypermobility experience dizziness, heart palpitations, and sluggish digestion, while autistic individuals frequently report similar issues. A 2023 study in Frontiers in Neurology on Postural Orthostatic Tachycardia Syndrome (POTS) found these symptoms to be common in both conditions, suggesting they may stem from the same underlying dysfunction. Could lax connective tissues affect how the brain senses movement and regulates the nervous system?

While research is still in its early stages, the more we understand this link the better. Understanding why autism and hypermobility co-occur is key to improving diagnosis, treatment, and support, improving the lives of those affected.

How Hypermobility Feels Different in Autism

Hypermobility and autism don’t just commonly coexist—they intensify each other. The sensory and motor differences seen in autism can amplify the challenges of hypermobility, creating a unique clinical presentation that is often misunderstood. One of the most striking differences is proprioception—the body’s internal awareness of movement and positioning. In hypermobility alone, proprioception is often compromised, leading to clumsiness, poor posture, and instability, but these issues can typically be resolved with the right intervention such as Osteopathy and specific corrective exercise. However, when combined with autism’s sensory and nervous system differences, proprioceptive feedback is already diminished, making these challenges significantly worse. I often hear patients describe feeling disconnected from their own bodies, as though their limbs don’t quite belong to them. Walking can feel unstable, as if the ground itself is shifting beneath them, and movements that should feel automatic require conscious effort.

A young autistic adult came to me with chronic knee pain and constant falls. Using the Rocabado Flexibility Scale, he scored 9/9, marking extreme hypermobility. When I examined his knees, I could gently push his kneecaps sideways to the point of near dislocation, yet he felt nothing. Ordinarily, when a joint is at risk, the muscles automatically contract to protect it, but in his case, his body did not register the danger. What he had assumed was harmless clicking in his knees was actually repeated, partial dislocations. His muscles were not stabilising the patella (knee cap), leaving it vulnerable every time he moved. After a full-body assessment, I found that his fingers and shoulders were just as unstable, yet he was completely unaware. His joints were partially dislocating regularly, but without pain signals or proprioceptive awareness, he did not even realise it. A standard rehab plan focused on knee strengthening would have therefore failed. Instead, his treatment required a complete retraining of his proprioceptive system, teaching his body how to sense, stabilise, and control movement properly.

Another patient, a teenage girl, came in complaining of shoulder pain. She struggled with awkward arm movement when running during football, and her shoulders ached after carrying her school bag. When I examined her, I found that her hypermobile shoulders could sublux—partially dislocate—with little effort, yet she felt nothing unusual and carried on as if everything were fine. Over time, this lack of awareness had caused repeated strain to her rotator cuff. Treatment involved retraining her shoulder stabilisers, developing strength and control to keep her joints in stable and place—something a standard rehabilitation approach would not have fully addressed.

Autistic individuals with hypermobility often experience movement and pain differently from their neurotypical hypermobile counterparts. Their nervous system does not always register joint instability, meaning injuries can build up unnoticed, leading to further complications. This makes early recognition, targeted rehabilitation, and sensory-motor retraining essential in helping them improve both stability and long-term joint health.

How Hypermobility Alters Movement and Pain in Autism

One of the most striking things I have observed is how autistic individuals with hypermobility experience movement and pain differently from their neurotypical hypermobile counterparts. Their joints may be just as lax as anyone else with hypermobility, but the way their nervous system processes movement, pain, and coordination is fundamentally different. My autistic patients describe feeling disconnected from their bodies. They tell me, “I don’t always know where my limbs are,” or “My joints don’t lock into place properly,” or even “When I walk, I feel like I might fall for no reason.”

A classic example is knee hyperextension. Many hypermobile individuals unintentionally lock their knees backwards when standing, but for autistic patients, the problem is compounded further. Their nervous system struggles to register a neutral joint position, making it near impossible for them to correct their posture naturally. Simply telling them to “stand normally” does not work—their body isn’t providing them with the right feedback to make that adjustment. Instead, they require targeted proprioceptive retraining to rebuild their awareness of joint positioning, rather than just being told to “engage their muscles” or “fix their posture.”

One of the most frustrating aspects of working with hypermobile autistic individuals is how frequently their pain is dismissed by medical professionals. They may have been told “there’s nothing wrong” simply because their pain does not show up on scans. Pain perception is altered in both autism and hypermobility, but in different ways. Some are hypersensitive, experiencing pain far more intensely than neurotypical people, while others have an extremely high pain threshold, meaning they may not notice injuries until they become severe.

I have treated patients who were sent home from A&E, reassured that it was “probably just a strain,” only to later discover they had been unknowingly walking around with a recurring partial dislocation. Others with severe daily pain have been dismissed with “you just need to relax” or misdiagnosed with chronic fatigue syndrome or fibromyalgia.

Understanding how pain, movement, and sensory feedback are uniquely affected in hypermobile autistic individuals is crucial. Without the right interventions, they are left with frustration and struggling with persistent pain, poor stability, and ongoing injuries that could be managed far more effectively with tailored treatment approaches.

How is Hypermobility Diagnosed?

Hypermobility is typically assessed using standard flexibility tests, such as the Beighton Score and the Rocabado 9-Point Flexibility Index, which measure joint mobility in key areas of the body. In my clinical practice, I use these tests frequently for both autistic and non-autistic patients, as they provide a useful baseline for assessing joint laxity. However, hypermobility diagnosis goes beyond just measuring flexibility—a thorough assessment is essential to fully understand how it affects movement, stability, and overall function.

A comprehensive assessment should include:

A detailed case history—understanding symptom patterns by looking at injury history, pain levels, fatigue, general health, exercise habits, and daily movement challenges.
A comprehensive physical assessment, flexibility test and special orthopaedic tests—to accurately diagnose the tissue causing symptoms, and underlying dysfunctions.
Functional movement testing—evaluating how well the patient stabilises their joints under load, rather than just measuring their flexibility.
Neuromuscular control assessments—checking for muscle imbalances, compensatory movement patterns, and proprioceptive deficits that may be causing instability or pain.

For autistic patients, these tests are particularly important, as they reveal how hypermobility interacts with their sensory processing and motor control. This insight allows for tailored treatment plans that address both joint instability and the unique neurological factors at play.

Autistic individuals should be routinely assessed for hypermobility, as research confirms they are significantly more likely to have it. Without proper diagnosis, many go undiagnosed or mismanaged, leading to persistent pain, movement difficulties, and ineffective treatments. Recognising hypermobility in autistic patients is a crucial step toward better care.

The Role of Manual Therapy in Pain Management

Hands-on treatment plays a crucial role in reducing pain, improving joint control, addressing muscular compensation, and enhancing proprioception. An experienced practitioner who understands hypermobility and its link with autism should be able to provide effective treatment by combining manual therapy with a structured corrective exercise programme.

A 2022 study in The Journal of Bodywork and Movement Therapies found that manual therapy, such as osteopathy, combined with individualised exercise programmes improved pain and mobility in hypermobile patients by over 60%. The best results were achieved when hands-on treatment was integrated with exercises targeting both neuromuscular control and joint stabilisation.

Manual therapy techniques, such as osteopathy, physiotherapy, and chiropractic care, are particularly beneficial for:

Reducing pain and inflammation, easing strain on hypermobile joints.
Restoring joint alignment and enhancing proprioceptive feedback, helping patients regain better body awareness and control.
Releasing overactive muscles that compensate for joint laxity, addressing the muscle imbalances that cause discomfort and instability.
Calming an overactive nervous system, reducing fatigue and autonomic symptoms that are common in hypermobility and autism.

However, passive treatment alone is not enough—while manual therapy can relieve pain and improve function, active rehabilitation is essential to build long-term joint stability and prevent recurring issues. The most effective approach combines manual therapy with targeted corrective exercises, ensuring that patients develop the strength, control, and proprioceptive awareness needed to manage hypermobility effectively.

Why Standard Rehab Often Fails

There is no “cure” for hypermobility—it’s simply how some bodies are structured. However, with the right interventions, symptoms like pain, instability, and fatigue can often be resolved or at the least significantly improved.

Autistic hypermobile patients visit at my clinic often frustrated and exhausted after trying one-size-fits-all rehabilitation programmes that simply don’t work for them. They’ve been prescribed typical strength exercises—squats, lunges, resistance bands, core work, hip raises—or turned to yoga or Pilates, hoping to build core strength. Some attend sports clubs in an effort to improve their movement. Yet, despite their efforts, they see little to no improvement. In fact, many report feeling worse—more unstable, in more pain, and more fatigued—after following well-intended but poorly adapted treatment plans.

Standard rehabilitation assumes that joints move predictably, protective muscles activate when needed, and pain feedback warns of potential injury. However, for hypermobile autistic individuals, these assumptions rarely hold true. Their movement is shaped by their sensory differences—their brain interprets proprioception, pain, and motor control differently. This means that simply pushing through standard exercises does not fix the problem—it misses the underlying issue entirely.

One autistic teenage girl I treated had persistent knee pain and worsening ankle issues from the lunges and wobble board exercises prescribed by her NHS physiotherapist. Instead of getting stronger, she felt shakier, not steadier. The problem? Her knees and hips rolled in and dropped during movement due to a femoral torsion and Trendelenburg dysfunction. The exercises were not addressing why she was unstable—they were reinforcing the faulty movement patterns. Strength and balance were not the solution—joint control was. Once we shifted focus to retraining her joint sense and alignment, her pain eased, and for the first time, she was stable on her feet.

From my experience—both as a clinician and someone with marked hypermobility myself—the best outcomes come from a multi-faceted approach, combining hands-on therapy, proprioceptive training, myofascial stretching, ELDOA and strength conditioning.

Proprioceptive Training: The Missing Link in Most Rehab Plans

Standard one size fits all exercise sheets and rehabilitation programmes typically prioritise strength-building—but overlook proprioception. This is a critical mistake. A strong joint without good proprioception is still a weak joint. Many hypermobile autistic patients end up with strong but “dumb” joints—they may build strength, but their body still lacks the ability to stabilise properly when it matters.

Research published in Rheumatology has shown that proprioceptive deficits in hypermobility significantly impact joint stability, increasing the risk of injury. Another study in The Journal of Applied Physiology found that proprioceptive training before strength work leads to better motor control and reduced fatigue in hypermobile individuals. This means that if proprioception is not addressed first, strength training alone won’t be as effective and may fail—patients will continue to feel unstable, at risk of injury, and unable to trust their movements.

To effectively improve proprioception, training must be structured and specific to the individual. A study in Rheumatology International found that targeted proprioceptive training can improve joint stability by 30-40% over six months, significantly reducing the risk of sprains and subluxations.

In my clinical opinion, effective proprioceptive training should include:

Joint and ligament-specific proprioceptive exercises, tailored to the individual’s movement patterns.
Balance training that challenges joint stability in controlled conditions, engaging righting, and tilting reflexes both statically and dynamically.
Slow, controlled resistance training, with a focus on joint positioning and preventing compensatory movements.
Tactile feedback techniques, such as taping, palpation, or external cues, to improve sensory awareness of limb placement.
Integration into functional movement patterns, such as squatting, bending, and dynamic weight shifts—helping to bridge the gap between isolated control and real-life daily movement.

By implementing these principles, healthcare providers can move beyond generic, oversimplified solutions and offer rehabilitation that is:

Precise—tailored to the individual’s unique movement and sensory challenges.
Practical—focusing on real-world function rather than generic exercise prescriptions.
Effective—helping individuals feel more stable, confident, and in control of their bodies.

Proprioception exercises must come before a heavy focus on strength. They are more technical and requires time to develop the movement skills, but the results are worth the effort. The nervous system must first learn how to sense and control movement accurately. When this foundational work is done correctly, everything else—strength, endurance, and functional movement—becomes far more effective.

ELDOA and Myofascial Stretching: Reinforcing Stability and Control

We must next address stability before mobility. Standard strength and flexibility programmes miss a critical piece-fascial integrity and segmental spinal control. This is where ELDOA and myofascial stretching become invaluable, offering a targeted approach to improving joint function, posture, and neuromuscular control.

ELDOA, are highly specific postural exercises designed to create space between spinal vertebra and joints. Unlike general stretching, which is passive, ELDOA actively reinforces neuromuscular stability, helping hypermobile individuals manage excessive joint movement and poor proprioception. A study published in The Journal of Bodywork and Movement Therapies found that segmental decompression techniques like ELDOA can enhance spinal stability and reduce pain, particularly in individuals with chronic postural dysfunctions. This makes ELDOA particularly beneficial for autistic individuals with hypermobility.

Myofascial stretching, on the other hand, targets the connective tissue network that influences movement patterns, sensory feedback, and joint support. Unlike conventional stretching, which focuses on just lengthening muscles, myofascial stretching works to restore balance in the fascial system, helping to distribute mechanical forces evenly across joints. Research in the Journal of Musculoskeletal and Neuronal Interactions supports that myofascial stretching significantly improves proprioceptive control, leading to greater joint stability and more efficient movement mechanics, which is critical for those with lax connective tissue (such as hypermobility) and altered sensory feedback.

In clinical practice, I regularly integrate ELDOA and myofascial stretching into treatment plans for hypermobile patients (with or without autism), as they provide a tremendous benefit. I combine hands-on therapy to reduce pain, release compensatory tension and restore alignment, but it is only part of the solution. By incorporating ELDOA and myofascial stretching it allows my patients to take an active role in their rehabilitation, giving them the tools to stabilise their bodies, gain better postural control, improve balance, and move with greater confidence.

Movement Must Feel Safe

Something to consider is if the autistic individual is hypersensitive to noise and stimulating environments or have any deep-rooted anxiety around exercise.

A study in Autism Research found that autistic individuals with hypermobility are more likely to experience fear of movement (kinesiophobia), leading to avoidance behaviours that worsen deconditioning. Another study in Neuroscience & Biobehavioral Reviews highlighted that an overactive autonomic response to exercise is common in both autism and hypermobility, making movement feel disproportionately exhausting.

This means forcing exercise onto these individuals without addressing sensory regulation first is counterproductive. Instead, rehab must:

Start in controlled, quiet environments, where sensory overload is minimised.
Use predictable, structured movement patterns that don’t feel chaotic.
Incorporate breath work and autonomic regulation to prevent fatigue crashes.

Taking a slower, calmer approach, helps the patient rebuilds confidence through carefully managed progressions.

Strength Training for Joint Stability: Why Generic Workouts Fail

Next, I suggest addressing strength deficits and build support for hypermobile joints. A study published in The Journal of Applied Physiology found that isometric and eccentric strength training produced superior pain reduction and joint stability compared to traditional resistance exercises. The key however is not just building muscle, but training the right muscles in the right way, ensuring stability and control across a full range of motion under load.

In clinical practice, strength training must be tailored to the individual, accounting for injuries, pain levels, age, and overall movement ability. The focus should be on controlled, structured progressions, rather than generic strength-building routines. Isometric exercises (holding static positions under tension) form the initial stages, as they help reduce pain and enhance joint stability without excessive movement. From there, free weights and body exercises encourage more control, next comes eccentric loading (slow, controlled lowering movements) which builds even greater tissue resilience and neuromuscular coordination and finally progressing to integrated full functional movement patterns.

A well-structured programme should emphasise:

Proprioception-based strength training, ensuring muscles engage appropriately to support hypermobile joints.
Core and hip stability, as these regions play a crucial role in overall movement mechanics.
Postural control, ensuring joints remain aligned throughout movement.
Gradual progression, moving from isolated muscle activation to full-body functional patterns such as squats, lunges, twists, pushes, and pulls—exercises that mimic real-world movements like sitting, stepping, opening doors, and lifting etc.

The Danger of Stagnation: Why Progression is Important

Lack of progression is one of the biggest mistakes in all rehabilitation (not just for hypermobility). While starting with gentle exercises is sensible, particularly for those experiencing pain or instability, staying at the same level for too long leads to stagnation. Exercises are chosen to force the body to adapt to the demands placed on it, so if those demands never increase, neither does strength, stability, or control.

Most hypermobile individuals are given basic one-size-fits-all exercises but never guided on how to progress. They remain stuck in low-load, low-challenge movements, fearing that pushing further might lead to injury. While caution is necessary, the absence of challenge prevents the body from developing.

Research in The Journal of Orthopaedic & Sports Physical Therapy emphasises that progressive overload—the gradual increase in resistance, complexity, and neuromuscular demand—is critical for joint stability and long-term pain reduction in hypermobility. Another study in The American Journal of Sports Medicine found that hypermobility-related instability improves significantly when exercises are regularly progressed in intensity and movement complexity, rather than remaining static.

A well-structured programme should:

Select specific exercises for the individual—no generic exercise sheets.
Start at the right intensity—not too difficult but challenging enough to promote adaptation.
Have a clear end goal—whether it is pain-free movement, improved joint stability, better posture or enhanced functional strength.
Gradually increase complexity—progressing from simple, controlled exercises to multi-joint, functional movements.
Monitor progress and adjust accordingly—ensuring that once an exercise becomes easy, it is progressed in load, range, control, or endurance.

A lack of progression isn’t just a missed opportunity—it’s a key reason why many hypermobile individuals continue to struggle. Strength, stability, and proprioception must evolve over time to create real-world usefulness and resilience.

Fatigue and Energy: A Smarter Approach

For some autistic hypermobile people severe fatigue is a recurring theme, even in those who appear physically capable. They describe feeling fine one moment, only to crash the next, leaving them drained after short bursts of movement. This is not just deconditioning or a lack of fitness—it’s an issue with neurological energy regulation. The autonomic nervous system (ANS), which manages energy distribution, blood flow, and recovery, often functions differently in both autism and hypermobility.

Traditional advice to “push through” fatigue not only fails but can make symptoms worse. Hypermobile autistic individuals may experience:

Sudden energy crashes—feeling fine one moment, then utterly exhausted the next.
Post-exercise dizziness or nausea—as their ANS struggles to regulate blood pressure and circulation.
Delayed recovery—experiencing muscle soreness for days after even light activity.

Expecting them to tolerate high-intensity exercise without accounting for these challenges is like revving a car with no fuel—it simply does not work. Instead, movement needs to be strategic and sustainable. A structured approach that focuses on gradual exposure allows their nervous system to adapt without triggering excessive fatigue and slowly but continually build over time.

Breath work and work ‘IN’ exercises are immensely helpful in calming autonomic dysfunction, helping to steady the nervous system and keep energy levels more consistent.

By pacing activity appropriately and respecting energy limits, individuals can slowly improve stamina without the boom-and-bust cycle of overexertion and collapse.

Final Thoughts and What’s Next

The connection of hypermobility and autism isn’t just an overlooked link—it’s a vital missing piece in the treatment and rehabilitation puzzle. When managed correctly, individuals can move better, hurt less, and regain confidence in their bodies. But when ignored, they remain trapped in cycles of pain, injury, and frustration. Too many autistic individuals are left struggling simply because this connection is not considered in their care.”

For many, treatment has fallen short because its one-size-fits-all approach failed to recognise how hypermobility and autism interact. Without addressing how these individuals process movement, pain, and stability, even well-intentioned treatment plans can leave them feeling worse, not better.

This is why it is vital to work with professionals who understand the unique challenges of both conditions. The right approach does not just manage symptoms, when approached in the right way, these individuals feel stronger, move better, experience less pain, and regain trust in their body’s ability to function well.

If you or someone you know struggles with these challenges, consider seeking out a practitioner who understands both conditions. Early intervention and the right approach can make a profound difference.

I hope you have found this article informative, engaging, and helpful.

Warm regards,

Michael Clark
Registered Osteopath
Rehabilitation and Corrective Exercise Specialist
Co-founder of Clarks Healthcare

For personalised support regarding the issues discussed in this article, if you wish to reduce pain, or improve your health, consider consulting with me or my team at Clarks Healthcare. You can reach us at 01268795705

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