Hyper mobility & NEuro divergence
For as long as I can remember, my father insisted his flat feet prevented him from pursuing athletics and military service. He believed the lack of an arch meant a lack of capability in movement and sport. In typical ADHD fashion, this made me incredibly spiteful.
I have flat feet. The flattest I've ever seen compared. So flat that my biomechanics professor Dr. Hanson, who was also a physical therapist, marveled in front of the entire class. When he asked if anyone had overpronation or flat feet, I volunteered, expecting acknowledgment but not amazement. He couldn't believe how much contact the bottom of my foot made with the floor. I knew my feet were significant, but I hadn't expected a health professional to react with such astonishment.
Throughout my life, it's been one joint after another in my lower body experiencing recurring injury or pain. Knee dislocations. Meniscus sprains. Lower back pain that traveled up to my mid-back and neck. I used my sports medicine and exercise science knowledge to address each issue as it arose. I strengthened my mid-back with rows and reverse flies. Built up my erectors, hamstrings, and glutes with deadlifts, Jefferson curls, and back extensions. Fortified my knees with deep squats, leg extensions, and hamstring curls. Worked my ankles with deep calf raises and tibial raises, exploring both lengthened and shortened positions of each movement.
These exercises brought tremendous relief and strength. Yet as I pursued more athletic goals, knee and back pain persisted. Then right as I was feeling good about my athletic journey I got one that stopped me from playing sports and even climbing stairs.
But I'm stubborn and curious. While dealing with this setback, I began following the growing research connecting neurodivergence with hypermobility. I'd been diagnosed with ADHD in adulthood, and I'd never considered myself hypermobile. I thought my knee dislocations stemmed from weakness and lack of mobility.
Then the realization hit: flat feet are a form of hypermobility. Specifically, hypermobility of the foot's arch. Combined with hypermobile knees, this had created a lifetime of nagging injuries.
I decided to rebuild from the ground up. I began developing toe and foot strength through positions specific to my needs and weaknesses. Many of these muscles extend along the lower leg, reaching toward the knee. By discovering and strengthening these forgotten muscles while continuing my previous strengthening work, I created a program tailored to my specific needs.
This customized approach allows my neurodivergent body to progress pain-free, unlocking greater ranges of strength and mobility safely. My flat feet and hypermobile joints aren't limitations to overcome through spite alone. They're part of a larger picture that, once understood, can be addressed with the right knowledge and approach.
The Science Behind Hypermobility and Neurodivergence: Understanding the Connection
Medical research now confirms what clinicians have long observed: people with unusually flexible joints often have a form of neurodivergence i.e. ADHD and/or autism. This connection, supported by a decade of peer-reviewed studies, is reshaping how we understand both neurodevelopmental and connective tissue conditions.
Understanding Joint Hypermobility
Joint hypermobility means joints that extend beyond typical range which include but aren’t limited to knees that bend backward, thumbs that touch the forearm, flat feet, ankles that frequently roll. For some, it's a harmless genetic trait. However, for others, it signals a connective tissue disorder like hypermobile Ehlers-Danlos Syndrome (hEDS) or Hypermobility Spectrum Disorder (HSD)¹ ². These conditions often include flat feet and other mechanical challenges that turn simple tasks like shoe shopping into frustrating trials.
Neurodivergence encompasses brain differences including autism, ADHD, dyspraxia, and sensory processing variations. The overlap between hypermobility and neurodivergence is consistent and continuous.
What Research Reveals
Large-scale studies have mapped this connection clearly. A Swedish national study found that people with EDS or generalized hypermobility were³:
7 times more likely to have autism
5 times more likely to have ADHD
Studies examining specific populations show:
22-30% of autistic individuals have significant hypermobility (45% in autistic women)¹¹
30-50% of people with ADHD show joint laxity¹³ ²³
31.5% of children with ADHD meet hypermobility criteria (versus 13.9% of neurotypical peers)¹³
Family studies strengthen this link: siblings of hypermobile individuals have double the risk of ADHD, even without sharing physical traits suggesting shared genetic foundations⁴ ¹⁶.
Why This Connection Exists: Five Key Mechanisms
1. Shared Genetic Foundations
Some genes affect both joints and brain development. Conditions like Fragile X and Loeys-Dietz syndromes impact both systems⁴². The genes that build collagen for ligaments may also guide brain architecture.
2. Collagen's Role in the Brain
Collagen supports not just joints but also brain blood vessels and structural scaffolding⁴³. MRI studies show structural differences in hypermobile individuals' brains, particularly in regions linked to neurodivergent disorders which include the amygdala, anterior cingulate cortex, and temporal lobes⁴⁴ ⁴⁵ ⁴⁶.
3. Body Position Confusion
Loose joints send unclear signals about body position to the brain⁴⁷. This creates coordination challenges and motor delays common in both hypermobility and neurodivergence⁴⁸ ⁴⁹. The brain's struggle to track body position may fuel the restlessness seen in ADHD and sensory-seeking behaviors in autism.
4. Autonomic System Dysfunction
Both groups commonly experience dysautonomia—problems with automatic body functions⁵⁰. Conditions like POTS (rapid heart rate upon standing), chronic fatigue, and digestive issues appear frequently⁵¹ ⁵². Fragile connective tissue in blood vessels may contribute to these symptoms, affecting focus and energy regulation²⁷ ⁵³.
What This Means for Patients
If You Have ADHD and/or Autism:
Consider evaluation for hypermobility if you experience:
Chronic joint pain or frequent injuries
Extreme fatigue
Dizziness when standing
Digestive problems
Identifying hypermobility can guide treatment toward physical stabilization and energy management¹⁹.
If You Have Hypermobility:
Consider screening for ADHD or autism if you struggle with:
Attention and focus
Sensory sensitivities
Emotion Regulation
Task prioritization
Restlessness
Working memory
Time blindness
Executive function
Social communication
Recognizing neurodivergence prevents mislabeling physical symptoms as behavioral problems.
Treatment Approaches That Help Both Conditions
Effective interventions often address both aspects:
Physical Support:
Targeted strength training for joint stability
Balance and proprioceptive exercises³⁰
Supportive footwear and orthotics
Cognitive and Sensory Support:
Energy pacing strategies⁵⁴
Sensory regulation techniques³⁴
Pain and fatigue management⁵⁵ ⁶³
Executive function supports
This integrated approach recognizes that pain, sensory overload, and cognitive fatigue interconnect through shared biology⁶¹ ⁴².
Through proper programming, these joints and their newfound ranges can unlock a new area of strength and stability. Scaling from low-impact joint mobilizations, to isometric loading, and eventually dynamic strength and power. This can create a wider foundation for neurodivergent bodies to build strength and stability around which in turn can prevent injuries and improve physical performance.
Looking Forward
Ongoing research continues exploring the genetic and neurological pathways linking these conditions. For those living at this intersection, scientific validation provides crucial context: the combination of flexible joints, sensory sensitivity, and exhaustion reflects real biology, not personal failure.
As understanding deepens, healthcare must evolve. A child with ADHD who can't sit still might need joint support⁷⁰. An autistic adult's exhaustion might stem from dysautonomia rather than just sensory stress. Recognizing this complexity enables more accurate and compassionate care and all-encompassing treatment.
Conclusion
The link between hypermobility and neurodivergence represents a breakthrough in understanding the body-brain connection. The evidence is substantial¹¹ ⁶⁸, the mechanisms are becoming clearer, and the clinical relevance is illustrated.
If this resonates with your experience, Comprehensive evaluation from a physician leads to better outcomes and, most importantly, better understanding.
For many, this research validates what their bodies have long communicated: brain and body are inseparable, and healing begins when medicine, strength, and movement address both.
This article synthesizes peer-reviewed research on joint hypermobility and neurodivergence. Individual experiences vary. Consult qualified healthcare professionals for personalized evaluation and treatment.
Understanding the Connection
Key References:
Cederlöf et al. (2016)³ ⁴ ¹⁶ - Nationwide Swedish cohort study
Glans et al. (2022)¹ ⁵ ⁶ - Adult autism and hypermobility
Baeza-Velasco et al. (2025)¹¹ ¹² ⁶⁸ - Systematic review and meta-analysis
Romeo et al. (2023)⁷ ⁸ ⁹ - Pediatric autism study
Ozturk et al. (2011)¹³ ¹⁴ ¹⁵ - Pediatric ADHD and hypermobility
Kindgren et al. (2021)¹⁷ ¹⁸ ¹⁹ - Pediatric HSD/hEDS and neurodevelopment
Glans et al. (2021)²⁰ ²¹ ²² - Adult ADHD and hypermobility
Csecs/Eccles et al. (2022)²³⁻²⁷ - Neurodivergence and dysautonomia
