The Unexpected Connection: ADHD and Hypermobility Disorders

For many adults with ADHD, the discovery that their seemingly unrelated physical symptoms might connect to their neurodevelopmental condition comes as a revelation. Among these connections, the relationship between ADHD and hypermobility disorders represents one of the most fascinating yet underrecognized associations in current research.

The Emerging Research Landscape

Recent studies have revealed a striking pattern: individuals with ADHD are significantly more likely to experience hypermobility—a condition characterized by joints that stretch further than typical. This connection, once considered coincidental, now appears supported by robust scientific evidence.

A 2021 systematic review published in the Journal of Attention Disorders found that hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos Syndrome (hEDS) occur in ADHD populations at rates 3-6 times higher than in neurotypical controls. This pattern persists across age groups, genders, and geographic regions.

"We initially noticed this connection in clinical practice," explains Dr. Jessica Eccles, neuroscientist at Brighton and Sussex Medical School and leading researcher in this field. "Patients with hypermobility were disproportionately reporting attention difficulties, while ADHD clinics saw unusual rates of joint hypermobility. The statistical correlation proved too significant to ignore."

Understanding Hypermobility

Before exploring the connection further, it's helpful to understand what hypermobility involves:

Hypermobility exists on a spectrum ranging from benign joint flexibility to more complex conditions:

• Generalized Joint Hypermobility (GJH): Increased range of motion in multiple joints

• Hypermobility Spectrum Disorders (HSD): Hypermobility plus symptoms like pain or instability

• Hypermobile Ehlers-Danlos Syndrome (hEDS): A heritable connective tissue disorder with hypermobility as a primary feature

While some degree of hypermobility can benefit dancers, gymnasts, and certain athletes, more pronounced forms often involve chronic pain, joint instability, fatigue, and autonomic nervous system dysfunction.

The ADHD-Hypermobility Connection: What We Know

Research has proposed several mechanisms potentially explaining this connection:

1. Shared Genetic Factors

Studies investigating family patterns suggest certain genetic variants may contribute to both conditions. A 2022.multi-center study identified several candidate genes affecting collagen formation that appear with higher frequency in individuals with both ADHD and hypermobility.

"The genetic picture is complex," notes Dr. Alan Hakim, rheumatologist specializing in hypermobility disorders. "But we're seeing patterns suggesting shared heritable factors that affect both connective tissue development and neurodevelopmental pathways."

2. Autonomic Nervous System Dysfunction

Both conditions show associations with dysautonomia—dysfunction in the autonomic nervous system that regulates unconscious bodily functions.

"The autonomic nervous system provides a compelling link," explains Dr. Eccles. "Many hypermobile patients experience postural tachycardia syndrome (POTS) and other autonomic symptoms, which research now connects to attention regulation and sensory processing challenges seen in ADHD."

A 2023 study published in Frontiers in Psychiatry demonstrated that individuals with both ADHD and hypermobility showed more pronounced autonomic nervous system irregularities than those with either condition alone.

3. Sensory Processing Differences

Both populations frequently report sensory processing differences—experiencing sensory information more intensely or differently than neurotypical individuals.

"Proprioception—our sense of body position—depends partly on feedback from connective tissues," notes occupational therapist Rachel Martinez. "When connective tissue functions differently, as in hypermobility, it affects how sensory information reaches the brain, potentially influencing attention and activity regulation."

4. Interoception and Embodied Cognition

Emerging research explores how interoception—our awareness of internal bodily states—influences cognitive function. Studies indicate both ADHD and hypermobility may involve altered interoceptive processing.

"The way we think is profoundly connected to how we experience our physical bodies," explains Dr. Laura Taddio, pediatric rheumatologist researching developmental disorders. "Differences in how hypermobile individuals sense their internal state may influence cognitive processes including attention regulation."

Common Symptoms Across Both Conditions

The symptom overlap between these conditions can make diagnosis challenging:

• Fatigue: Both populations report profound fatigue that doesn't improve with rest

• Pain sensitivity: Heightened pain responses appear in both conditions

• Sleep disturbances: Difficulty falling asleep, staying asleep, and achieving restorative rest

• Anxiety: Higher rates of anxiety disorders occur in both populations

• Executive function challenges: Planning, organization, and task completion difficulties

• Sensory sensitivity: Heightened responses to sounds, lights, textures, and other sensory input

"These overlapping symptoms create diagnostic challenges," notes neuropsychologist Dr. Samantha Peters. "Fatigue from hypermobility may be misinterpreted as ADHD-related executive dysfunction, while ADHD-related sensory processing issues might be attributed solely to hypermobility."

Identification and Diagnosis: What to Look For

For adults with ADHD wondering about hypermobility, several signs warrant attention:

Physical Indicators

• Double-jointedness or unusual flexibility

• Frequent sprains, subluxations, or dislocations

• Chronic unexplained pain, especially in joints

• Easy bruising or slow wound healing

• Stretchy or unusually soft skin

• Digestive issues like IBS alongside joint symptoms

The Beighton Score

Healthcare providers often use the Beighton Score to assess hypermobility. This 9-point system evaluates specific joint movements, with scores of 5+ (or sometimes 4+ in adults over 40) suggesting generalized hypermobility:

1. Touch thumb to forearm (1 point each side)

2. Bend little finger back beyond 90° (1 point each side)

3. Hyperextend elbows beyond 10° (1 point each side)

4. Hyperextend knees beyond 10° (1 point each side)

5. Place hands flat on floor with knees straight (1 point)

However, this scoring system has limitations, particularly for adults who've already developed compensatory mechanisms or experienced joint changes.

"The Beighton Score alone isn't sufficient for diagnosis," cautions Dr. Hakim. "A thorough assessment considers historical flexibility, related symptoms, and family history."

Managing Dual Diagnoses: Integrated Approaches

For those navigating both conditions, comprehensive management strategies show the most promise:

Physical Therapy with Neurodiversity Awareness

"Traditional physical therapy often fails these patients," explains physical therapist Maya Johnson, who specializes in neurodivergent populations. "Effective programs account for ADHD-related challenges with routine establishment, body awareness, and consistent practice."

Successful programs typically include:

• Short, engaging exercise sessions

• Visual guidance and reminders

• Clear connections between exercises and symptom relief

• Regular feedback and progress tracking

ADHD-Informed Pain Management

Dr. Peters emphasizes that pain processing works differently in ADHD. "The ADHD brain may hyperfocus on pain signals or alternatively completely miss bodily warnings. Pain management must address these attention-related factors."

Effective strategies often combine:

• Mindfulness practices adapted for ADHD

• Movement breaks during sedentary periods

• Body scanning techniques with external reminders

• Cognitive behavioral approaches addressing pain catastrophizing

Medication Considerations

Both conditions require careful medication management:

"Some ADHD medications may affect heart rate and blood pressure, which are already concerns in hypermobility-related dysautonomia," notes Dr. Eccles. "Likewise, pain medications for hypermobility symptoms may interact with ADHD treatments."

Working with healthcare providers familiar with both conditions helps navigate these complexities.

Lifestyle Management Strategies

Research supports several lifestyle approaches for managing both conditions:

Regular, Appropriate Movement

"Exercise is crucial but must be approached differently," explains Johnson. "High-impact activities can worsen joint issues, while proper conditioning helps stabilize joints and regulate attention."

Recommended activities often include:

• Swimming and water therapy

• Modified Pilates focusing on proprioception

• Tailored strength training with proper alignment

• Walking with appropriate footwear and support

Sleep Hygiene With Dual Awareness

Both conditions impact sleep quality, creating a challenging cycle where poor sleep worsens symptoms of both ADHD and hypermobility.

"Sleep interventions must address both the physical discomfort of hypermobility and the circadian rhythm differences common in ADHD," notes sleep specialist Dr. James Chen.

Effective approaches typically include:

• Appropriate mattress support for hypermobile joints

• Consistent sleep scheduling addressing ADHD-related delayed sleep phase

• Strategic pillow placement for joint support

• Sleep environment modifications addressing sensory sensitivities

Nutrition Considerations

While no specific diet treats either condition, certain nutritional approaches show promise:

"Anti-inflammatory nutrition patterns may benefit both conditions," suggests dietitian Sarah Williams. "Foods supporting connective tissue health while addressing ADHD-related nutritional challenges can be particularly helpful."

Focus areas typically include:

• Adequate protein for tissue repair

• Vitamin C for collagen production

• Omega-3 fatty acids for reducing inflammation

• Regular eating patterns to support executive function

• Hydration strategies addressing autonomic dysfunction

Finding Knowledgeable Healthcare Support

Perhaps the greatest challenge for those with both conditions is finding healthcare providers knowledgeable about this connection.

"Medical education rarely addresses this overlap," notes Dr. Taddio. "Patients often need to educate their providers or seek specialists familiar with both conditions."

When seeking care, consider:

• Rheumatologists with interest in hypermobility disorders

• ADHD specialists open to exploring physical comorbidities

• Physical therapists with neurodevelopmental expertise

• Interdisciplinary pain management programs

• Support groups addressing both conditions

Looking Forward: Research Directions

This field continues evolving rapidly, with several promising research directions:

• Genetic studies examining shared heritability patterns

• Neuroimaging research exploring interoception in both conditions

• Development of screening tools specifically addressing this overlap

• Clinical trials of targeted physical therapy approaches

• Investigation of how ADHD medications affect hypermobility symptoms

"We're just beginning to understand these connections," explains Dr. Eccles. "The next decade will likely transform how we conceptualize and treat both conditions."

The Validation of Connection

For many adults with both ADHD and hypermobility, learning about this connection provides significant validation.

"Discovering this research was life-changing," shares Melissa, who was diagnosed with ADHD in her 30s after years of unexplained joint pain. "I'd spent decades being told my symptoms were unrelated or imagined. Understanding they share common origins has completely changed my approach to self-care."

This sentiment echoes across patient communities, where recognition of the ADHD-hypermobility connection often marks a turning point in effective management.

Conclusion: Integrating Understanding

The growing body of evidence connecting ADHD and hypermobility disorders represents an important shift toward more holistic understanding of neurodevelopmental conditions. Rather than viewing the mind and body as separate domains, this research highlights their profound interconnection.

For adults navigating both conditions, this emerging research offers not just explanation but hope—that with integrated approaches addressing both neurological and physical aspects, better management becomes possible.

As research continues advancing, the recognition of this connection will likely improve diagnostic processes, treatment approaches, and ultimately quality of life for those experiencing this significant but underrecognized overlap.