03/05/2026
Clinical Insights | The Pain Collective
This week, Carin Terblanche (Biokineticist, with a special interest in hydrotherapy) took us into the complex world of hypermobility and pain — and the disconnect that often exists between what patients feel and what we can observe clinically.
We explored the importance of a comprehensive clinical assessment using validated tools, looking beyond joint hypermobility alone and considering how these conditions can affect multiple body systems. Hypermobility is often misunderstood or misdiagnosed, and many people living with these conditions report feeling unheard or invalidated in their healthcare journeys.
Some key reflections from the session:
• Hypermobility is not just “flexibility” — it is a multisystem condition often associated with chronic pain, fatigue, and overlapping diagnoses
• Pain is influenced by more than joint laxity — proprioception, motor control, and nervous system regulation all play a role
• Movement can feel unpredictable and difficult to trust for many individuals
• Exercise is not only about strengthening muscles — it can support neuroplastic change, improve proprioception, and contribute to functional improvement over time
We also discussed how approaches such as graded strengthening, proprioceptive training, and hydrotherapy can support safer, more confident movement. Hydrotherapy, in particular, may be a useful starting point when land-based exercise feels overwhelming.
Take-home messages:
• Resistance training can be beneficial for symptom management and functional improvement when appropriately guided
• There is often a gap between what patients feel and what clinicians observe — effective care involves recognising and bridging this
• Management needs to be individualised — standard approaches often require adaptation
• A multidisciplinary, person-centred approach is key, supported by education, movement, and ongoing care
Understanding hypermobility requires looking beyond joints alone and recognising the broader systems involved in pain and function.
This content is for educational purposes and does not constitute medical advice.
