Hypermobility Syndromes

Joint Hypermobility Syndromes

The term Joint Hypermobility Syndromes, JHS, refers to the condition where a person’s joints are unstable because their ligaments are weak and loose (‘hyperlaxity’) and they may have poor muscle tone.  This means that joints tend to bend beyond the typical movement range. The Alexander Technique can help people with this and many of the other problems associated with joint hypermobility syndromes.

There are a number of diagnostic terms used to describe the various manifestations of the condition.  For these terms and further information on joint hypermobility syndromes visit the Hypermobility Syndromes Association, HMSA

Joint hypermobility can be a heritable disorder.  It can also develop through repetitive stretching as can be seen in dance, yoga and athletics training.

Asymptomatic Hypermobility

Roughly 1 in 10 people have some level of hypermobility but only some would call themselves  ‘double-jointed’.    Like many conditions, hypermobility syndromes come over a wide spectrum, from minimal to severe enough to be disabling.  However, most people experience very few problems and they have ‘asymptomatic hypermobility’.

Some Signs of Joint Hypermobility

This photo shows some mild joint hypermobility in the shoulders, elbows and thumbs

Symptomatic Hypermobility

A smaller number of people have ‘symptomatic hypermobility’.  Symptoms include:

  • Joint instability and hyper extension. This can lead to subluxations and even dislocations
  • Constant pain, with a tendency towards sprains and strains
  • Poor proprioception, balance and coordination. People often have flat feet and feel rather clumsy
  • Thin, stretchy skin that bruises easily and takes a while to heal
  • Bowel and bladder problems
  • Autonomic disfunction with dizziness and fainting, particularly when standing up quickly. (PoTS) . they may also have poor temperature regulation
  • Chronic fatigue

Hypermobility Syndromes and the Alexander Technique

Alexander lessons can help many people with hypermobility issues, particularly those to do with proprioception.  Gaining more sense of where our body is in space can help improve our coordination, balance and confidence. Learning how to reduce tension can also reduce our pain and help improve energy levels.

I personally have taught many pupils with general hypermobility syndrome. One pupil could stand with his body facing me but have his toes pointing behind him! An interesting example of unstable joints and hyperlaxity.  I have also taught clients with Ehlers Danlers Syndrome, EDS, and Marfan Syndrome, MFS, which are two of the more severe forms of JHS conditions.

The NHS Consultant Rheumatologist Dr Philip Bull FRCP, who is on the HMSA Medical Advisory Board, is a great advocate of using Alexander Technique lessons for hypermobility patients, often alongside Physiotherapy.  He has seen how hypermobility syndrome patients are helped by learning the Alexander Technique and has written articles on the topic. Dr Bull states that ‘patients with hypermobility found it particularly helpful; some even life changing’ .

You may read and download Dr Bull’s article about Hypermobility Syndromes and the Alexander Technique  here.



Text Neck

Text Neck 

Text Neck is a buzz word used to define the syndrome that causes pain in the head, neck and shoulders, which is brought on because of the over-use and mis-use of smart phones, tablets, laptops and suchlike.

People often use this type of equipment on their laps, so they habitually pull right down towards the screen in order to use them. This means the heavy weight of the head is dragging down and over-stretching the muscles in the neck and shoulders, often for long periods of time. This strains the muscles and interferes with the finely-tuned balance of the head and the neck, which results in pain.

Unfortunately many young children have already been diagnosed with having painful Text Neck and this could continue to cause problems later in life if not addressed. However, if these unhelpful habits are recognised, altered and people can learn how to let go of them, then they can begin to reduce and even stop the pain.

Torticollis or Wryneck

Torticollis – Wryneck is a form of Cervical Dystonia, where a person’s head and neck are twisted by spasms in their neck muscles, which contract down towards one side all the time, often with abnormal rigidity. Torticollis may develop gradually or suddenly and babies may be born with Congenital Muscular Torticollis.

Acute Torticollis or Wryneck is the term given when the condition arrives suddenly, in which case the person may wake up to find they have slept in a distorted position and they have such a stiff neck that they cannot move their head from side to side. This problem often resolves itself fairly quickly but a wise person would ask themselves what they might have been doing to bring it on and then find a way of avoiding it happening again.


When severe, torticollis may be associated with damage to the cervical vertebrae and discs. Diagnosis is essential when there are symptoms such as chronic neck pain with numbness in the hands and arms. This numbness not only poses a threat to many careers but indicates an underlying problem where the nerves are being irritated and the cause needs to be known, to check for a prolapsed disc and to rule out problems such as meningitis or other illness, particularly if the person also has a fever.


Torticollis can be caused by accidents, injuries, tissues scarring and shrinkage, plus can be brought about by mental states such as anxiety. 

Habitual movement patterns with poor posture and long-term mis-use of the body that disturbs the natural muscle balance in the neck, such as curling down and twisting over whilst handwriting can lead to the gradual development of torticollis. Unfortunately it is all too frequent to see children hunched over their school books, holding the pen in a contracted, twisted manner whilst writing and this is a habit that they will probably take into adulthood, unless they learn to let go of it. Also babies whose heads are left lolling down to one side as they sleep in pushchairs, must be vulnerable to wryneck developing. Over time the neck muscles can get used to being contracted in this way and they become fixed so that torticollis can develop.  

There are also work situations which require a person to incline their head and possibly their body in one direction constantly. Radiologists for instance, or violinists, often resort to pulling their heads down to one side quite tensely in order to work or hold the violin in place. Dentists often lean down over patients at an angle and twist to look into their mouths – and they do this for hours on end all their working lives. If these activities are performed without due thought as to how to look after the head-neck-back relationship and general body use, then problems such as torticollis are likely to develop.


In extreme cases, botulism can be injected into the muscle to stop the spasm for a few months and surgery to partially cut and release the contracted muscle is sometimes resorted to. Physiotherapy to help stretch out the muscles can be helpful.

Fortunately, it is possible to improve one’s body use by learning the Alexander Technique and in this way stopping habits of twisting and contracting that contribute to the torticollis. Through the gentle guidance of the Alexander Teacher, it is possible to re-educate the muscles so that they can relax and ease out of the neck spasm, therefore putting less pressure onto vulnerable discs and nerves and re-establishing the natural head neck and back relationship. 

Many violinists for instance have been saved from constant pain which could threaten their careers, by applying the Alexander Technique to playing the violin, so that they can hold and use their instrument in a manner which does not cause them harm. They also learn to maintain the freedom and resilient lengthening of their muscles, so that they do not go into spasm as a result of playing and holding the violin.

Related to this, a major research study, the ATLAS Research Trial (2015) has shown that the Alexander Technique produced “clinically relevant reductions in neck pain and associated disability” for people with chronic non-specific neck pain. 



Back Pain

Back Pain


This is a general term that covers many different types of pain and conditions. You may like to explore some of the Glossary entries associated with the spine and with back pain, or read my article on the topic.


Glossary Entries:

Acute Back Pain

Chronic Back Pain

Disc Prolapse – Slipped Disc


Lumbago or Low Back Pain

Prolapsed disc 



Spinal Stenosis




Read my article

The Alexander Technique Can Help Back Pain


Crepitus comes from the Latin for ‘a crackling or rattling sound‘ and it is a medical term that refers to all those little clicks, cracks, pops and grating crunchy noises that can be experienced when we move around. 

Crepitus can occur when bones in our joints rub together as a result of damage to the cartilage, to the bone itself as in osteoarthritis, or sometimes when there is damage to an intervertebral disc which could result in the vertebrae rubbing against each other. It is possible to hear these noises, the grating can very often be felt internally and may or may not be associated with pain. An audible sound of crepitus can be one of the symptoms of bone fracture.

It is also possible to have little popping noises occurring in our lungs or soft tissues when there is an abnormal area of air or gas under the skin. This type of crepitus does not concern us here as it tends to occur in various severe conditions that require medical intervention, which is not the remit of the Alexander Technique. 

However, the crunches that are experienced in our joints are very relevant to Alexander lessons. If we contract our muscles and increase the tension around our joints with our habits of contracting down into ourselves with mis-use, then crepitus is more likely to occur. Also, when we hear those crunchings, they can be a useful reminder and warning that we need to allow our muscles to unwind and free up. If crepitus is persistent or severe, it may be wise to seek a medical diagnosis as to the cause.

When we can learn how to allow our musculature to be more elastic and freely lengthening, it is possible to reduce the pressure around our joints so that the bones are less pushed together. This process can allow the joints to move more freely, which often reduces the crepitus and helps us to avoid creating further damage to our bones and joints. 

Orthostatic or Postural Hypotension

Orthostatic Hypotension or Postural Hypotension

Orthostatic Hypotension is the somewhat uncomfortable dizziness or ‘head rush’ sensations some people experience upon standing up.

When we move into an upright position too quickly, our blood can remain pooled in the lower part of the body, so there is not enough blood being pumped up to the brain, making us experience dizziness and other symptoms, usually on a temporary basis. 

Mild symptoms of Postural Hypotension often happen when people stand up abruptly and this is caused by a temporary drop in their blood pressure. It is more common in the elderly, in someone with low blood pressure, or possibly as a side effect of drugs but it can also be present in certain illnesses and physiological conditions that may need treatment.

If you experience symptoms of Postural Hypotension on a regular basis, this indicates that you need to visit a doctor in order to have your blood pressure checked and to see if there is an underlying condition which may be contributing to the problem. 

Postural Hypotension Symptoms are variable : 

Dizziness; Faintness; Nausia; Visual disturbances.


Similar symptoms may be experienced with shock, so it may be necessary to diagnose the cause of the symptoms if they are experienced strongly or frequently. Physiological shock can be life threatening and needs immediate treatment.  Profound psychological shock can leave us with symptoms that are experienced for some years, for instance in Post Traumatic Stress Disorder (PTSD). 


Less worrying and more common is the light-headedness and occasional other temporary symptoms, that can sometimes happen if people get up too quickly, for instance after practising the AT lying down procedure – so it is important to remember not to end gain and rush into getting up but to bring yourself back up to standing in a measured and thoughtful manner. If you are concerned about frequent dizziness or other symptoms, do visit your doctor.

Chronic Back Pain

Chronic Back Pain is the term given to an ache or pain in the lower back that lasts for over three months, causing the person ongoing or potentially long term problems. The pain experienced may be mild, or quite severe if the condition is serious, perhaps as the result of sickness or injury for instance. It is advisable to seek a diagnosis from a doctor for serious back pain conditions.

However, most lower back pain is non-specific back pain and X rays frequently show no organic problems. This type of chronic pain is also called simple back pain and can have many possible causes, such as high stress levels, muscle strains, poor posture and general mis-use which can compress the musculoskeletal structure and irritate the spinal nerves, particularly in the lumbar region of the spine. The condition often develops over time but then one particular incident, such as sneezing whilst in a tense and awkward position, can trigger sudden acute back pain.

Sometimes the pain will recede of its own accord but if it has come about through mis-use in the way a person uses their body, the pain will usually continue until the damaging movement habits are stopped. This can also lead to further deterioration, if people do not know how to help themselves and the causes of the condition are not addressed.

The Health and Safety Executive, HSE, states that back pain afflicts approximately 49% of the adult population in the UK, creating a huge drain on the economy and the NHS, and that some 4.9 million work days were lost in one year, because of absences caused by back pain.

The Alexander Technique is a very effective tool that people can learn to use to help reduce the number of days they experience lower back pain. This fact, which has been known by Alexander teachers for many years, has now been given the support of the scientific and medical communities. The results of the ATEAM Research Trial, published in August 2008, showed that 1:1 lessons from a registered Alexander Technique teacher, offer long term benefits for patients with chronic and recurrent back pain.

Acute Back Pain

Acute Back Pain is the term given to back pain that has a short duration and lasts for less than three months. The pain may be mild or severe.

Acute back pain may have a sudden onset, perhaps as the result of illness, accident or injury. For these reasons it is wise to have a severe condition checked out with your doctor, in order to obtain a good diagnosis of the problem.

However, this type of pain may have no obvious organic cause, in which case it is called simple back pain, or non-specific back pain. Simple back pain often tends to arise from the way we mis-use our bodies during our activities, putting strain on our muscles, connective tissues, nerves and the intricate structure of the spinal column.

If no medical intervention is required, the pain may go away on its own but if the conditions of mis-use that led to the back pain remain unaltered, the pain may continue for longer than three months without easing, at which point it is considered to be chronic back pain. It has been shown, in the ATEAM Research Trial, that the Alexander Technique is particularly helpful for people to learn, to help themselves reduce chronic and recurrent back pain.

As NHS Direct indicates, the Alexander Technique offers a good method to use for both preventing and treating back pain – although to be correct, the Alexander Technique is not a treatment as such, but a learning process. An Alexander teacher will not offer you a medical diagnosis, unless also trained as a GP.

In Alexander Technique lessons, you will learn to develop a tool that you can use to improve the way you use your body, reduce and manage back pain and help speed up the process of recovery – plus you can learn to prevent back pain developing in the first place and help to avoid it recurring in the future.

You can see an illustration of the sort of mis-use which can contribute to back pain in my Blog.


Tinnitus is a condition in which a person hears various noises in the ears. These sounds come from an internal source in the body, rather than from sounds in the outside world and include ringing, hissing, whistling, clicking and buzzing noises. 

Tinnitus may be occasional or continuous, temporary or permanent, in which case it can impair a person’s hearing and quality of life.

Causes of Tinnitus

There are many different causes of tinnitus, some of which are medical conditions that might require a Doctor’s diagnosis and treatment, so it is wise to get checked out by your Dr.

Continuous exposure to loud noises can contribute to tinnitus, so musicians and people who constantly hear music and other loud sounds can become affected. Other causes of tinnitus are damage to the ear or ear infections, head and ear injuries, the onset of hearing loss, plus high stress and anxiety levels. Many people with tinnitus find the condition distressing and become even more tense and upset because of the continual noises interfering with their hearing. This is likely to make the condition worse.

Treatments for Tinnitus

There is no medical treatment available for tinnitus, although people can be referred to Tinnitus Clinics where Cognitive Behavioural Therapy (CBT) and other techniques are used to help people relax and reduce the emotional distress they experience, which helps them reduce and cope with the tinnitus.

Alexander Technique and Tinnitus

The Alexander Technique can be of great help to tinnitus sufferers. The main learning in the Alexander Technique is to allow the muscles around the head, neck and back to work in a coordinated and free manner, so that habitual patterns of tension and mis-use are reduced or eliminated. This freeing-up of the head and neck muscles has an impact on the levels of tension around the ears and often reduces or even stops the irritating sounds that people experience. 

The Alexander Technique also uses the ‘Whispered Ah’ procedure, which specifically works with freeing up the muscles around the head and neck, plus the throat and jaw, which hinges just next to the ears, so tensions here can impact on the function of the ears. The whispered ah procedure can be very helpful for tinnitus sufferers to learn and use, as it often produces an immediate lessening or cessation of the tinnitus.

Importantly, Alexander Technique pupils also learn to stop getting back into the habits of tightening up around the head, jaw and neck, so that they gain a tool with which to avoid the tensions which can contribute to the creation of tinnitus.  Various pupils that I have worked with who have had tinnitus, have found that their Alexander Technique lessons have helped them to reduce and have some control over the problems associated with this condition, in a way that they have not been able to do so before.