Hypermobility: How to Identify It (and Why the Trifecta Matters)
When people think of hypermobility, they often picture “party tricks”: touching your thumb to your forearm, bending into splits without warming up, or folding your fingers backward. While bendy joints can be a part of the picture, hypermobility is far more than just flexibility. For many, it’s an entire system issue that affects the body in ways most people (and even many clinicians) don’t expect.
And here’s where it gets interesting: hypermobility often shows up with two very close friends—mast cell activation syndrome (MCAS) and dysautonomia. This trio is commonly called the trifecta.
So how do you know if you might be dealing with it? Let’s break it down.
What Hypermobility Actually Is
Hypermobility means that your joints move beyond what’s considered a typical range. This can be harmless in some people (we all know that one friend who can still sit cross-legged like a kindergartener at age 40), but in others, it can be a sign of underlying connective tissue differences.
Connective tissue is the body’s scaffolding—it holds everything together. If it’s extra stretchy or fragile, the “give” shows up not just in joints but also in skin, blood vessels, the gut, and even the nervous system.
Signs you might be hypermobile:
Your elbows, knees, or fingers bend backwards easily.
You’ve had recurrent sprains, subluxations (joints partly slipping out), or dislocations.
You bruise easily or have thin, fragile skin.
You’ve been told you’re “double-jointed.”
Stretching doesn’t feel like stretching—it just feels like moving into another normal position.
There are screening tools like the Beighton Score and the 5-Point Questionnaire that clinicians use to get a sense of your mobility, but diagnosis is always more nuanced than a number.
Why the Trifecta Matters
Hypermobility rarely travels alone. Many people with symptomatic hypermobility also experience:
1. Dysautonomia
This is a fancy word for when your autonomic nervous system (the part that controls heart rate, blood pressure, and digestion without you thinking about it) isn’t regulating smoothly.
You might feel dizzy or faint when standing (hello, POTS—postural orthostatic tachycardia syndrome).
You may struggle with temperature regulation (always freezing or overheating).
Brain fog and fatigue are daily battles.
2. Mast Cell Activation Syndrome (MCAS)
Mast cells are part of your immune system, helping defend against allergens and pathogens. In MCAS, they misfire—releasing histamine and other chemicals too often or at the wrong times.
This can look like unexplained rashes, hives, itching, flushing, or swelling.
It can also cause gut upset (bloating, nausea, diarrhea), headaches, and even anaphylaxis-like reactions.
Triggers are often inconsistent: a food you tolerate one day might send you spiraling the next.
3. Hypermobility
The connective tissue piece we already covered, which forms the foundation of this trio. When tissue is too lax, it stresses joints, muscles, and organs in ways the nervous and immune system often react to.
Putting It All Together
For many women (especially those diagnosed later in life), these three conditions overlap in ways that make daily life confusing:
“Why do I faint in hot yoga?”
“Why do I feel exhausted after eating?”
“Why do my joints hurt even when scans look fine?”
It’s not “all in your head.” The trifecta explains how seemingly unrelated issues—joint pain, dizziness, gut symptoms, allergies—can actually be connected by the underlying fabric of your body.
What To Do If This Sounds Familiar
Track your symptoms: Write down when you notice dizziness, rashes, food reactions, or joint pain. Patterns often emerge.
Find a clinician who knows hypermobility: Many physiotherapists, physicians, and specialists are becoming more aware of connective tissue conditions- all of us at the clinic can help you identify if you may have signs of hypermobility.
Support your body daily: Gentle strength training, pacing, hydration with electrolytes, and stress management can make a big difference.
Advocate for yourself: These conditions are often dismissed, especially in women. If something feels off, it’s worth investigating.
Hypermobility is not just a quirky trick—it’s often a sign of deeper connective tissue differences. When combined with dysautonomia and MCAS, it creates a constellation of symptoms that can affect almost every system in the body.
The good news? Understanding the trifecta is the first step toward better care, more compassion for yourself, and strategies that actually help.