There is a link between attention deficit hyperactivity disorder (ADHD) and hypermobility. The two conditions often occur together. Scientists are still learning how they are connected.
Joint hypermobility, on its own, is not always a medical problem. Not everyone experiences symptoms. If they do, they may have hypermobility spectrum disorder (HSD) or another condition that causes hypermobile joints, such as Ehlers-Danlos syndrome (EDS).
This article looks at what the relationship is between ADHD and hypermobility. It also discusses the effects of hypermobility, exercises to help, and other conditions that can occur in people with ADHD and hypermobility.
Yes, there is evidence of an association between adult ADHD and joint hypermobility.
A 2021 study of 431 adults with ADHD and 417 without ADHD found that those in the former group were much more likely to have general joint hypermobility. Of those with hypermobility, those with ADHD were also more likely to report having symptoms because of it, such as pain.
In a Swedish-based matched cohort study from
People sometimes discuss hypermobility, HSD, and EDS interchangeably. However, they are different things.
Hypermobility refers to the general ability of joints to extend beyond a typical range of movement. For some people, this is just a feature of their bodies and does not cause any problems.
When hypermobility causes other problems, doctors may diagnose HSD. This is the medical term for when hypermobile joints also comes with other symptoms, such as pain. People can have HSD that affects all their joints, or only some of them.
EDS, on the other hand, refers to
There are numerous types of EDS. The most common type, hypermobile EDS (hEDS), is similar to HSD. Experts are not sure whether hEDS represents a more severe form of HSD or whether it is a separate condition.
It is not yet clear why ADHD and hypermobility often occur together, but there are several things these conditions have in common that may provide clues, such as:
- Genetic factors: Both EDS and ADHD have a genetic component. It may be that the same genes that contribute to one condition also contribute to or cause the other, directly or indirectly.
- Proprioception: Proprioception is a person’s sense of where their body is in space. It is important for brain development, but in both people with ADHD and those with hypermobility, this sense tends to be less accurate. It is unclear if this results from one or both conditions or is a potential cause.
- Dysautonomia: Dysautonomia is a dysfunction of the autonomic system dysfunction, which is the part of the nervous system that governs involuntary bodily functions, such as digestion and heart rate. Dysautonomia is common in people with ADHD
and also EDS or HSD. Again, it is unclear if it is a cause or a consequence of these conditions. - Chronic pain: Having frequent pain due to hypermobility may make it harder to concentrate. However, this does not explain ADHD in people who do not have pain or hypermobility.
Hypermobility, in itself, does not always cause symptoms. For some, the only noticeable sign is very flexible joints. Some may also have soft or stretchy skin.
When people do have symptoms as a result of hypermobility, there can be a range of symptoms depending on the cause, according to Versus Arthritis. These include:
The Ehlers-Danlos Support UK provides exercise recommendations for those with HSD or EDS.
Strengthing exercises
Strengthening exercises can improve the health of muscles, ligaments, tendons, and bones. This helps reduce the risk of injuries and provides additional support to joints.
Strengthening exercises generally involve using some kind of resistance, such as weights. The movements are controlled and slow rather than fast. Examples of strengthening exercises include:
- lifting weights
- bodyweight exercises, such as pushups
- using resistance bands
- basic pilates
Stability and balance
Impaired proprioception can affect balance, which, in turn, can result in more injuries. Exercises that improve balance and awareness of body position may help. People can try:
- tai chi
- standing balance exercises or yoga postures
- gym ball exercises
Stretching
Stretching can be both beneficial and harmful for those with hypermobility. People who are already flexible may not need to stretch much, and doing it excessively could stress the joints.
However, stretching can be useful for relieving muscle aches, which people with HDS or EDS may experience if their muscles are working hard to keep joints stable.
A physical therapist may be able to advise on which stretches can help depending on where muscle aches are in the body. Otherwise, it is a good idea to:
- be mindful of posture when sitting or standing
- avoid staying in the same position for long periods
- do yoga, although it is important not to overextend the joints in the process
A knowledgeable yoga instructor can help people avoid overextending.
Aerobic exercise
Aerobic exercise increases cardiovascular health and stamina. However, it can be a challenge for people with symptoms such as fatigue. Fast, high impact aerobic exercise can also put stress on the joints, and some may have exercise intolerance.
As a result, it is best for people with hypermobility to try low impact aerobic movement instead to determine what they can tolerate, such as:
- walking
- swimming
- using a stationary bike
- using cross trainers
Ehlers-Danlos Support UK suggests splitting aerobic exercise into 30-minute sessions five times per week, ideally. This can include household activities, such as gardening or cleaning.
If it is difficult to do this much exercise, people can start slowly, with 5 or 10 minutes at a time. Building up gradually may help with fatigue. However, if it makes symptoms worse every time, stop and speak with a doctor.
Learn more about exercises to avoid with hypermobility.
According to a
- Dysautonomia: A
2021 study of people with hEDS and HSD notes that 70% of participants also had dysautonomia. This was more common in those with hEDS than HSD. - Postural orthostatic tachycardia syndrome (POTS): POTS is a form of dysautonomia that specifically causes a rapid increase in heart rate when standing up.
- Mental health conditions:
Research from 2019 suggests those with hypermobility and EDS were significantly more likely to experience mood and anxiety disorders than the general population. - Digestive conditions: Both dysautonomia and mental health conditions can play a role in digestive problems and may cause symptoms similar to irritable bowel syndrome.
- Autism: In addition to ADHD, autism also has an association with HSD and EDS, which may be on a genetic level.
There is an association between ADHD and joint hypermobility. People with one of these diagnoses are more likely to have the other, but the reasons for this are not yet clear.
ADHD and hypermobility have several things in common, though. Both have links to dysautonomia and an impaired sense of proprioception, which can affect physical coordination.
Exercise and physical therapy can help people with hypermobility to strengthen and stabilize joints. It may also reduce pain.