An investigation of movement in people with Joint Hypermobility Syndrome. Do they move differently?

REC REF: 13/LO/0270


This project aims to explore aspects of kinematics (motion of joint) and kinetics (forces) of the knee joint during activities of daily living in patients with JHS compared to healthy people with and without hypermobility, and people with normal flexibility and knee pain.

Hypermobility analysis skeleton gait


Joint Hypermobility syndrome (JHS) affects approximately 1 in 10,000 people. It is an inherited connective tissue disorder characterized by excessive flexibility of joints; people with JHS tend to have joints that easily move beyond what would be considered normal. There are a wide spectrum of symptoms, the most common of which is widespread chronic pain. One of the reasons that people with JHS are thought to experience pain, is that the extra flexibility of the joints causes more wear and tear, the pain may also be caused by the extra flexibility causing nerve-ending compression.

What is interesting is that having flexible joints is actually very common; approximately 1 in 5 people have multiple hypermobile joints (a term labelled Generalised Joint Hypermobility) and do not experience pain. It is not understood why some people with flexible joints experience problems, whilst some people with flexible joints don’t. It might be that some people are able to retain a normal pattern of movement even though they are flexible. If we can determine movement patterns we might gain an understanding of the differences between people in pain and people not in pain. This study aims to determine patterns of movement in a variety of day to day tasks, and see if they differ between people that have JHS, people that are flexible but do not have pain, and people who have normal flexibility. We hope that the results will help inform future treatments using physical therapy.

To measure people’s movement, we are using 3D movement analysis, a technique similar to that used to produce special effects and animations in films. Volunteers visit our lab, where we affix reflective markers to the skin on their legs and hips. The position of these markers is then recorded by a system of 10 infra-red cameras, allowing us to estimate the position of the underlying skeleton whilst someone is moving. Examples of the data produced can be seen below.

If you have any questions about the study, please contact Alex Bates (

Research publications

Bates AV, McGregor AH, Alexander CM, 2015, Reliability and minimal detectable change of gait kinematics in people who are hypermobile, Gait & Posture, Vol:44, Pages:37-42 DOI

Bates AV, Alexander CM, 2015, Kinematics and kinetics of people who are hypermobile. A systematic review, Gait & Posture, Vol:41, ISSN:0966-6362, Pages:361-369 DOI


The video is an example of some of the data produced from a 3D motion analysis session.

Joint Hypermobility Syndrome Motion Analysis

Joint Hypermobility Syndrome Motion Analysis