Joint Hypermobility in Dancers: Assessment, Performance-Related Aspects and Musculoskeletal Consequences – A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.67.74352Keywords
joint hypermobility, generalized joint hypermobility, Beighton score, dancers, bellet, injuries, flexibility, performance, rehabilitationAbstract
Background: Large ranges of movement are important in dance, especially in demanding choreography. Joint hypermobility is common among dancers, but its interpretation is complex, as increased mobility may relate to both performance demands and health concerns.
Aim: This narrative review summarizes current evidence on joint hypermobility in dancers, focusing on assessment methods, prevalence, performance-related aspects, musculoskeletal and functional consequences, and management considerations.
Material and methods: A targeted literature search used terms related to joint hypermobility, generalized joint hypermobility, Beighton Score, dance, ballet, contemporary dance, injuries, pain, fatigue, balance, and physical fitness. Original quantitative and qualitative studies, prospective cohorts, randomized controlled trials, reviews, and relevant background papers were included.
Results: Prevalence of joint hypermobility in dancers varies substantially depending on population, assessment tool, and cut-off used, but appears common and possibly more frequent than in non-dancers. Hypermobility may offer aesthetic and choreographic value, yet is also linked to arthralgia, instability-related injuries, fatigue, reduced physical fitness, and psychological distress. Direct evidence on management in hypermobile dancers is limited, though broader rehabilitation literature suggests exercise-based interventions may improve pain, proprioception, quality of life, and function in symptomatic cases.
Conclusions: Joint hypermobility in dancers is neither purely beneficial nor purely harmful, but a performance-related trait with variable consequences. Management is mainly relevant when hypermobility is symptomatic. Future research should use consistent definitions and cut-offs, distinguish asymptomatic from symptomatic hypermobility, and evaluate dance-specific management strategies.
References
[1] Koutedakis Y, Smith A, Wyon M. A Comparison of Strength and Stretch Interventions on Active and Passive Ranges of Movement in Dancers: A Randomized Controlled Trial. J Strength Cond Res 2013;27:3053–9. https://doi.org/10.1519/JSC.0b013e31828a4842.
[2] Castori M, Tinkle B, Levy H, et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet 2017;175:148–57. https://doi.org/10.1002/ajmg.c.31539.
[3] Chan C, Hopper L, Zhang F, et al. The prevalence of generalized and syndromic hypermobility in elite Australian dancers. Phys Ther Sport 2018;32:15–21. https://doi.org/10.1016/j.ptsp.2018.02.001.
[4] McCormack M, Briggs J, Hakim A, et al. Joint laxity and the benign joint hypermobility syndrome in student and professional ballet dancers. J Rheumatol 2004;31:173–8.
[5] Siev-Ner I, Rothschild B, Zeev A, et al. Joint Hypermobility and Joint Range of Motion in Young Dancers. JCR J Clin Rheumatol 2016;22:171–8. https://doi.org/10.1097/RHU.0000000000000420.
[6] Amir Sobhani-Eraghi, Mohsen Motalebi, Siavash Sarreshtehdari, et al. Prevalence of joint hypermobility in children and adolescents: A systematic review and meta-analysis. J Res Med Sci 2020. https://doi.org/10.4103/jrms.JRMS_983_19.
[7] Malek S, Reinhold EJ, Pearce GS. The Beighton Score as a measure of generalised joint hypermobility. Rheumatol Int 2021;41:1707–16. https://doi.org/10.1007/s00296-021-04832-4.
[8] Foley EC, Bird HA. Hypermobility in dance: asset, not liability. Clin Rheumatol 2013;32:455–61. https://doi.org/10.1007/s10067-013-2191-9.
[9] Skwiot M, Śliwiński G, Milanese S, et al. Hypermobility of joints in dancers. PLOS ONE 2019;14:e0212188. https://doi.org/10.1371/journal.pone.0212188.
[10] van Rijn RM, Stubbe JH. Generalized Joint Hypermobility and Injuries: A Prospective Cohort Study of 185 Pre-Professional Contemporary Dancers. J Clin Med 2021;10:1007. https://doi.org/10.3390/jcm10051007.
[11] Armstrong R. RELATIVE JOINT CONTRIBUTION TO JOINT HYPERMOBILITY IN RUGBY PLAYERS, NETBALLERS AND DANCERS: THE NEED FOR CAREFUL CONSIDERATION OF LUMBAR FLEXION. Int J Sports Phys Ther 2018;13:676–86.
[12] Day H, Koutedakis Y, Wyon MA. Hypermobility and Dance: A Review. Int J Sports Med 2011;32:485–9. https://doi.org/10.1055/s-0031-1273690.
[13] Timmons WM, Sproule J, Mulholland R. Is the health risk and consequence of generalised joint hypermobility understood within a classical ballet narrative? Concerns for dance practitioners. Res Dance Educ 2023;24:262–82. https://doi.org/10.1080/14647893.2021.1940916.
[14] Zikan FE. Relationship between the joint mobility index and the presence of injury and pain among ballet students in Brazil. Fisioter Bras 2019;20:77–83. https://doi.org/10.33233/fb.v20i1.2554.
[15] Armstrong R. The Beighton Score and Injury in Dancers: A Prospective Cohort Study. J Sport Rehabil 2019;29:563–71. https://doi.org/10.1123/jsr.2018-0390.
[16] Ambegaonkar JP, Cortes N, Caswell SV, et al. LOWER EXTREMITY HYPERMOBILITY, BUT NOT CORE MUSCLE ENDURANCE INFLUENCES BALANCE IN FEMALE COLLEGIATE DANCERS. Int J Sports Phys Ther 2016;11:220–9.
[17] Scheper MC, de Vries JE, de Vos R, et al. Generalized joint hypermobility in professional dancers: a sign of talent or vulnerability? Rheumatology 2013;52:651–8. https://doi.org/10.1093/rheumatology/kes220.
[18] van Die-de Vries J, Verbunt J, Ramaekers S, et al. Generalized Joint Hypermobility and Anxiety Are Serious Risk Factors for Dysfunctioning in Dance Students: A One-Year Follow-Up Study. Int J Environ Res Public Health 2022;19:2662. https://doi.org/10.3390/ijerph19052662.
[19] Pacey V, Tofts L, Adams RD, et al. Exercise in children with joint hypermobility syndrome and knee pain: a randomised controlled trial comparing exercise into hypermobile versus neutral knee extension. Pediatr Rheumatol 2013;11:30. https://doi.org/10.1186/1546-0096-11-30.
[20] Reychler G, De Backer M-M, Piraux E, et al. Physical therapy treatment of hypermobile Ehlers–Danlos syndrome: A systematic review. Am J Med Genet A 2021;185:2986–94. https://doi.org/10.1002/ajmg.a.62393.
[21] Buryk-Iggers S, Mittal N, Santa Mina D, et al. Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl 2022;4:100189. https://doi.org/10.1016/j.arrct.2022.100189.
[22] Daman M, Shiravani F, Hemmati L, et al. The effect of combined exercise therapy on knee proprioception, pain intensity and quality of life in patients with hypermobility syndrome: A randomized clinical trial. J Bodyw Mov Ther 2019;23:202–5. https://doi.org/10.1016/j.jbmt.2017.12.012.
[23] Sanches SB, Oliveira GM, Osório FL, et al. Hypermobility and joint hypermobility syndrome in Brazilian students and teachers of ballet dance. Rheumatol Int 2015;35:741–7. https://doi.org/10.1007/s00296-014-3127-7.
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