Autism is associated with a number of co-occurring conditions and symptoms, such as insomnia, epilepsy and attention deficit hyperactivity disorder (ADHD). One lesser-known co-occurring condition is hypermobility, which has been found to have possible connections to autism for some adults. 

Here, we will take a closer look at what hypermobility is and the symptoms it causes, the conditions that could cause hypermobility, its potential links to autism, how understanding these links can help when seeking support, management strategies, how this co-occurrence can affect daily life, and the importance of seeking professional support for autism.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about autism or co-occurring conditions, we can help.

What is autism? 

Autism is a neurodevelopmental condition affecting how a person interacts with others, understands the world around them, and responds to sensory information. Autistic people might experience certain sensory issues that cause a negative reaction when specific triggers arise. 

These triggers are usually personal to them, so the experience and symptoms of one autistic person will look and feel completely different from another. For this reason, we believe support for each individual should be bespoke. You can read more about autism in our article: What is autism? 

Understanding the symptoms of autism and how its links to hypermobility can impact daily life is important in order to seek the appropriate support from a professional with experience in this area. 

What symptoms does autism cause?

Autistic people may experience difficulties with social communication and interaction, display repetitive or restrictive behaviours or interests, have different ways of learning or paying attention, and more. Some of the most common symptoms of autism in adults include: 

• Difficulty reading social cues
• Difficulty participating in conversations with others 
• Difficulty relating to others’ thoughts and feelings 
• Difficulty regulating emotions 
• Difficulty building and maintaining relationships 
• Difficulty reading body language and facial expressions of others 
• Using a monotone speaking pattern, which makes it difficult to convey emotions
• Difficulty maintaining eye contact in conversations
• Restrictive or repetitive behaviours  
• Discomfort when plans or routines are changed at the last minute 
• Fixation on a favourite subject they care a lot about or are particularly skilled in 
• Sensitivity to sensory input like pain, touch or sound

While these symptoms are common, every autistic person will have their own unique triggers, symptoms, life experiences and more. For some, they may have a co-occurring condition called hypermobility. 

It is not known exactly how common hypermobility is in autistic individuals, but there is growing research to suggest a strong connection between the two. Studies have confirmed rates of hypermobility and its symptoms are more significant in those with a neurodevelopmental diagnosis than in the wider population. One study estimated that a possible two thirds of autistic study participants experienced regular joint pain or back pain, and dislocated their shoulder or knee cap three times more frequently than the control group. 

What is hypermobility?

Hypermobility (sometimes called joint hypermobility or Joint Hypermobility Syndrome) occurs when certain joints in the body move beyond what would be considered typical range of motion. This could look like extremely flexible joints, limbs that move into unusual positions, or having joints that appear loose. Sometimes people who are described as, or describe themselves as double-jointed may actually have hypermobility. 

This is typical in babies and children who are naturally more flexible than adults, but it is thought that in around 20% of people, hypermobility could continue into adulthood. Hypermobility was historically considered a rare occurrence, but in recent years studies have suggested its prevalence should be reconsidered. 

Hypermobility can be a positive thing for some people, such as those who take part in things like gymnastics, dancing or some sports, as the excess flexibility can help them to excel in these activities. However, hypermobility can also cause other symptoms, such as: 

• Pain
• Joint and muscle stiffness
• Fatigue
• Joints that dislocate easily and frequently 
• Clicking joints 
• Frequent injuries
• Thin skin 
• Stomach issues, such as Irritable Bowel Syndrome (IBS)
• Dizziness
• Postural Orthostatic Tachycardia Syndrome (POTS), which causes the heart to beat faster when standing or sitting up 

Hypermobility can be the result of either Joint Hypermobility Syndrome (JHS) itself, or a condition called Ehlers-Danlos Syndrome (EDS). Hypermobility might occur in only one or a select few joints, or it could be more generalised, affecting all joints. The condition is thought to be caused by genetics, or in the case of Ehlers-Danlos Syndrome, the body struggles to form necessary collagen to keep joints strong and supported. 

Is there a link between autism and hypermobility? 

In recent years there has been more research into the connection between autism and hypermobility. Studies have found autistic people tend to be more likely to experience physical health conditions than neurotypical people, which can impact a number of bodily functions, such as the brain, gastrointestinal system, endocrine system, and more. 

Hypermobility has been linked to autism, with one study finding 49% of neurodivergent study participants had hypermobility, and another finding neurodivergent people had a 51% prevalence of hypermobility. In comparison, studies find that generalised hypermobility occurs in around 0.75-2% of the population. 

Ehlers-Danlos Syndrome and autism share similar characteristics, such as difficulties with motor skills, hypersensitivity to sensory stimuli, and dysfunction of the autonomic nervous system. One study found Ehlers-Danlos Syndrome could be more common in autistic women than neurotypical women. 

While the exact links between hypermobility-related conditions and autism are not yet understood due to a lack of research, it is clear there is an underlying connection that makes hypermobility more of a significant issue for many autistic people.

It is believed that genetics could be a potential reason for this comorbidity, which is supported by a 2020 study that found over 20% of mothers with Ehlers-Danlos Syndrome or hypermobility reported having autistic children. 

Although there is a lack of research into the links between these two conditions, recognising that they can be connected is important for managing symptoms effectively and addressing any concern you have over your joint health, or any symptoms you may be experiencing. Remember, hypermobility can cause pain to develop over time, so addressing this as early as possible will be the best way to obtain an accurate diagnosis and manage symptoms before they become more severe. 

Both of these conditions are typically treated separately, and you may find you need to visit an autism specialist to discuss autism symptoms, as well as a rheumatologist or another type of specialist to discuss connective tissue and hypermobility-related disorders. 

Keep in mind that not everyone with hypermobility will have a heightened risk of autism. It is also important to note that an autistic person could suffer from hypermobility symptoms that can be confused with a condition called Amplified Musculoskeletal Pain Syndrome (AMPS) which can cause localised pain in the body, fatigue, intense pain that builds over time, or pain in response to very gentle touch. 

How does co-occurring autism and hypermobility impact daily life? 

The combination of any autism-related symptoms can be difficult to manage, but as autism is considered to be a neurodevelopmental disorder, and hypermobility is a physical issue, this combination can be challenging. There are a number of ways this can impact your daily life. For example: 

• Fatigue can result from excessive strain on joints and muscles, which can impact motivation and have a negative impact on everything from work to relationships 
• Hypermobility symptoms can lead to the development of chronic pain, poor posture and more, and this can make everyday life more difficult 
• Pain and discomfort can make it difficult to participate in enjoyable activities, which can have a negative effect on socialising 
• Limited mobility can impact self-care and personal care activities, so a person with this comorbidity may require more help from others 
• Poor posture as a result of chronic pain could lead to pain in other areas of the body, such as back or neck pain 
• Being unaware of how symptoms will feel from one day to the next can affect plans and lead to feelings of anxiety  
• Studies have found that posture has strong links to confidence and self-esteem, so poor posture caused by hypermobility could affect confidence and social skills
• Chronic pain can lead to persistent low mood, which can have negative consequences for a person’s long-term mental health

There are several other overlapping factors in autism and hypermobility, with studies identifying similarities in mental health features such as anxiety and depression, as well as conditions like bipolar disorder or eating disorders. 

Both groups also regularly experience sleep disorders, immune dysregulation, and trouble with coordination and sensory stimuli. For these reasons, it is important to understand the potential intersection between autism and hypermobility conditions so the appropriate interventions can be made, and symptoms can be managed effectively throughout life. 

How can someone with co-occurring autism and hypermobility manage their symptoms? 

There is no cure for co-occurring autism and hypermobility, so managing this can be difficult depending on how severe the symptoms are. For example, someone with mild autism and some hypermobility symptoms may be able to manage this effectively on their own to maintain quality of life, whereas someone with severe autism and severe chronic pain from hypermobility may require support from multiple caregivers and medical professionals.

The everyday management of these co-occurring conditions involves finding personalised strategies that work for each individual’s pain and discomfort. A number of things have been found to help, including: 

Tracking symptoms and health changes

Every autistic person will have their own unique traits and symptoms, and in the same way they will usually have a unique set of symptoms pertaining to hypermobility. If you are able, it can help to track symptoms and any changes to your health as they arise, so you can start to identify circumstances that exacerbate your hypermobility symptoms, and know when/if your symptoms have increased to a point where medical intervention should be sought. 

Physical therapy

Physical therapy, when tailored to your exact needs, can help to strengthen certain muscles. This can offer more support to nearby joints and alleviate some of the pressure on them. You can speak to your GP about accessing physical therapy, and ideally they will refer you to a physical therapist who specialises in hypermobility. When undergoing this treatment option, you will likely be offered a tailored exercise regime focused on specific exercises to improve joint stability and strength. This can help to reduce pain over time and improve quality of life.

Occupational therapy 

As well as physical therapy, your GP could recommend occupational therapy which is focused more on making sure you can perform functional movements that enable you to continue living life the way you want to. For example, if you work in an office setting where you are sitting down for most of the day, an occupational therapist may recommend specific exercises to help you avoid excess pain from this.  

Assistive devices

If the pain of hypermobility is severe, your doctor may recommend using certain assistive devices to make everyday actions easier. These could be things like braces, splints and other joint support devices which are designed to provide extra stability to joints. This could alleviate some of the pain and discomfort. There may be some assistive devices available to buy online or in pharmacies, but it is always best to speak to your doctor first as they can refer you to the appropriate medical professional or recommend devices that would work for your situation, so you are not spending on devices that will offer no support or relief. 

Maintaining a healthy lifestyle

Although autism and hypermobility cannot be cured, by living a relatively healthy lifestyle you could keep symptoms at bay for longer, and reduce the impact they have on your life. For example, eating a balanced, vitamin-rich diet with foods that help to maintain a healthy weight, and keeping stress levels under control through mindfulness techniques. Also, making sure you get enough sleep at night can be trickier since sleep apnea is more prevalent in those with hypermobility symptoms, but it is worth focusing on this and prioritising as much restful sleep as possible. Maintaining a healthy lifestyle can help to make sure your body is in the best shape possible, as this can reduce the pain of hypermobility and improve your overall health and wellbeing. 

Listening to your body

Autistic people with hypermobility may find they can become fatigued easily due to a combination of factors, such as the pressure of masking (trying to appear as neurotypical) during social interactions, and the physical exertion of trying to alleviate hypermobility pain by overcompensating with other muscles. If you find yourself becoming easily exhausted, remember it is vital to take your symptoms into account and not try to do too much. While it is important to stay active, give yourself plenty of rest too. 

Finding support 

Living with both hypermobility and autism can be challenging, and no matter how severe your symptoms are, you could likely benefit from support in the form of medical professionals, therapists, rheumatologists, support groups, friends and family. Create a support network that can help with the spectrum of symptoms both autism and hypermobility bring, and remember you may need a number of support providers to manage all of your symptoms.

How can professional support for autism and hypermobility help?

Although some co-occurring autism and hypermobility symptoms can be managed at home without help from others, the benefits of having access to professional support cannot be overstated. Every person’s specific combination of symptoms will be entirely unique to them, and although you likely know your body and mind best, having an outside perspective and professional medical knowledge can help to assess the nuance of these overlapping conditions in the context of your own life, and find interventions that will help you the most.  

As autism and hypermobility are often diagnosed and treated by a different department of medical professionals, a comorbidity may not be easily recognised, which could lead to misdiagnosis or underdiagnosis. Spending time speaking to the appropriate clinical teams can help you to achieve the correct diagnosis, and as a result, the correct support that could significantly change your life. For autistic people with any sort of pain issue, this could mean challenging the wrongful assumption that autistic people do not experience pain, and finding ways to convey pain symptoms if you find it difficult to explain how you feel. 

If you are supporting an autistic loved one, be aware of behaviours that may indicate hypermobility-related pain or discomfort, encourage them to keep detailed records of their symptoms, and help them to seek the support of medical professionals who specialise in hypermobility, such as a rheumatologist. Remember, symptoms of hypermobility can mean an autistic person becomes more easily frustrated, angry or upset – try to practise patience, understanding and empathy when discussing their pain and what they might need. 

If you think you or a loved one may have co-occurring autism and hypermobility, you may be wondering where the best place is to turn for support to better understand the condition, obtain a diagnosis and get ongoing treatment. You can speak to your GP about symptoms, and they will usually be able to point you in the direction of an appropriate specialist who can help. For autism support, many people find wait times are particularly long when trying to gain a diagnosis of autism through the NHS and access support. To speed up this process, you could choose to seek help elsewhere by getting a private adult autism assessment through specialists and organisations like Augmentive.

We believe advice and support for those with autism should be tailored to the individual and their symptoms, so we can take into account how your hypermobility symptoms and autism impact your life, and provide tailored support with this in mind. You can read more about this process in our guide: What to expect from an adult autism assessment 

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from a private adult autism assessment or AuDHD assessment, to help finding an autism specialist near you to support you on your journey.

If you have a question about mental health, like the differences and similarities in OCD vs autism, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.