Hypermobile Singers: From Pretty Impressive to Pretty Painful
Originally published on 17/01/2025 – Last updated on 09/10/2026
Did you know that Billie Eilish is hypermobile? And maybe Maria Callas was too!
(Click here for a long list of elite hypermobile singers and athletes. And me on a soapbox rant 😉)
I’m a hypermobile singer and voice teacher. Many of the singers I work with are hypermobile, and I mentor other voice teachers who support them. The challenges we face are unique. So are our strengths!
Here’s an overview of what’s important to know when you’re (working with) a hypermobile singer. I update this post regularly, so make sure to come back.
Disclaimer: This blog post is educational and not medical advice. If you have concerns about your health, please see a qualified physician.
- Check the agenda for my Online Solo Group Lessons for Hypermobile Singers – You can enroll as an Active Participant or learn from observing the lessons as a Fly-On-the-Wall.
- Subscribe to The singsing! Sofa Library to…
- watch the 2-hour long webinar Teaching Hypermobile Singers: Go from Pretty Frustrating to Pretty Fascinating and learn how to effectively teach hypermobile singers
- watch the 2 webinars led by Christine Schneider, who offers invaluable insights on hypermobility: Core Training for Singers – The Vocal Resilience Cylinder & Core Workout for Singers.
- Of course, you are also very welcome to book Private Voice Lessons & Vocal Coaching and / or Mentoring with me 🙂
Is Hypermobility a Disorder?
Let’s get one thing straight right away: Hypermobility itself isn’t a disease or a medical condition. It’s simply a physical trait, like having flexible – or rather lax – fingers or a double-jointed thumb. Many people have one or more hypermobile joints, whether from past injuries or repetitive movements like playing an instrument. A single hypermobile joint doesn’t mean you have a disorder. It’s just how your body works.
However, when multiple joints are hypermobile, especially in the spine and limbs, we classify it as Generalized Joint Hypermobility – GJH. This doesn’t mean it’s a problem in itself, but it does provide a framework for understanding the body’s mobility and laxity.
The primary focus of this article is Hypermobility Spectrum Disorders – HSD , which occurs when joint hypermobility is accompanied by other symptoms. It is an umbrella term covering various levels of symptom severity, ranging from mild discomfort to significant impairment. Not everyone with GJH has HSD, but everyone with HSD has some form of joint hypermobility.
Hypermobile Ehlers-Danlos Syndrome (hEDS) is a distinct condition in which generalised joint hypermobility is a core feature. Unlike the other twelve EDS types, hEDS still has no confirmatory genetic test, so it relies on a clinical diagnosis.
Up till very recently, HSD and hEDS were seen and treated as two separate conditions. However, findings presented at the 2025 International Symposium in Toronto indicated that no single measurement clearly separates hEDS from HSD. They appear to sit on a shared biological spectrum with overlapping features.
Good to know: the diagnostic criteria for hEDS and HSD are being revised. The new diagnostic framework for all EDS types and HSD will be published on 1 December 2026 in the American Journal of Medical Genetics, replacing all previously published criteria, with a second publication on best-practice care and management pathways following in March 2027. So some of what you read here (and everywhere) may shift as the science develops.
What are Hypermobility Spectrum Disorders (HSD) and Hypermobile Ehlers-Danlos Syndrome (hEDS)?
Connective tissue (for example fascia) provides support to your skin, musculoskeletal system, blood vessels, and organs.
For a long time hypermobility was explained as simply having weaker or less collagen. The current understanding is that the problem is usually not how much collagen there is, but more about how it is built and organised, and how it responds to load.
Due to this, the connective tissue of people with HSD and hEDS is more stretchy and less able to hold everything firmly in place.
For a long time this was assumed to be a collagen defect, but recent research shows the picture is more complex. No single gene or single collagen defect explains hEDS or HSD. It likely involves multiple genetic variants and possibly the immune and nervous systems too. The rarer types of EDS are the exception, since those do have known, specific genetic causes.
Here are some important elements:
- HSD and (h)EDS are poorly understood by the medical world. Studies show an average diagnostic delay of 22 years for hEDS. 94% had been told by a non-psychiatrist doctor that their symptoms were psychological, that they were exaggerating, attention-seeking, or had a conversion disorder. Only 5.6% reached their hEDS diagnosis without passing through some form of psychiatric misdiagnosis first. For many people, being believed is the first hurdle, well before any treatment begins.
- More women than men are diagnosed as hypermobile, and hormonal changes can make symptoms fluctuate. The symptoms tend to be more severe in females than in males.
- Most hEDS/HSD research has been conducted with younger people, so little is known about how the condition manifests and progresses in older people or the factors that contribute to poor health-related quality of life in them.
- Joint hypermobility is more common among performers such as dancers and musicians.
- There’s a link with neurodivergence. Roughly 39% of autistic people meet HSD/EDS criteria when clinically assessed. Also, autistic people with hEDS and HSD tend to have more symptoms, more co-occurring conditions, and a harder time getting the right support. Check out Bendy Brain / Dr. Jessica Eccles!
- There’s a link with trauma – new blog post is in the making! (For now, check my Insta post on the subject)
- There’s growing research into the link between the brain, the nervous system and hypermobility. I wonder about a link with being a Highly Sensitive Person (HSP), as I recognize this in the hypermobile people I know, including myself. This is my own musing, not something research confirms, but I find it worth wondering about. Is HSD more common in the artist population because of our sensitivity – which I consider a strength?
Potential Physical Symptoms
It’s possible that you are asymptomatic or only have positive symptoms. However, you can become symptomatic later in life. This is what happened to me in perimenopause.
Keep in mind that hypermobility presents differently in every body. If you’re hypermobile, you won’t necessarily have all of these symptoms!
- Excessive range of motion in your joints, which can lead to chronic pain, easy dislocation / subluxation and early-onset degenerative arthritis. It may also give you the talent to do what this dancer is doing. Look at her overextended knees, elegant hands and bendy fingers! Further down, I’ll focus on the impressive skills hypermobile singers can have.
It’s important to note that hypermobility / laxity of the joints and flexibility are not the same! You can be hypermobile and extremely inflexible at the same time.
Additionally, hypermobility often becomes less visible with age. It’s not uncommon for older adults to forget or dismiss past excessive range of motion, which complicates recognition of hypermobility-related conditions in later life. I explain this in depth in my blog post Go From “I’m So Stiff!” to “Could I Actually Be Hypermobile?”.
Assess the laxity of your joints with the Beighton test (general) or the Lower Limb Assessment Score – LLAS (more specific for dancers and athletes). If you know that you are hypermobile, please, be mindful. Sometimes these assessments can make you flare up a little bit.
- When joints do not hold position well, the muscles around them work harder to compensate, and that constant low-level effort is tiring in a way that is easy to underestimate.
- A study found that 98% of participants with hEDS had symptoms of temporomandibular joint disorder, with 90% reporting jaw clicking and 80% reporting jaw pain and / or fatigue.
- Postural Orthostatic Tachycardia Syndrome (POTS), an autonomic nervous system disorder characterized by an abnormal spike in heart rate (by 30+ bpm in adults) upon standing up. Many people with POTS breathe too fast when they stand up, without feeling anxious and often without noticing. This over-breathing lowers the carbon dioxide in your blood, which narrows your blood vessels to your brain and reduces blood flow, causing dizziness, light-headedness, brain fog and fatigue.
- Other breathing problems, for example ribs subluxating, slipping rib syndrome, unconscious breath-holding, paradoxical breathing and air hunger.
- Aside from POTS, poor postural alignment can also contribute to standing up for a long time being challenging. This can lead to compensatory tension and stiffness in various parts of your body, particularly in your neck and surrounding areas, shoulders, jaw and abdominal muscles. If the connective tissue in your ligaments is not able to create some form of stability in your joints, then your muscles are going to try to take over for stabilization, which is why your musculature starts to fatigue and starts to get really overworked.
- Thoracic outlet syndrome, caused by instability and overload. Nerves or blood vessels are compressed as they pass between your neck, collarbone and chest. The signs are arm fatigue and heaviness, pins and needles, and pain in your neck and upper back. These symptoms tend to appear when your arms are raised or held up and depend on your posture, muscle use and fatigue.
- Scoliosis
- An under-regulated vestibular system (balance), which can lead to dizziness and fatigue
. This can also lead to muscles not firing when they’re supposed to during movement, with for example weak glutes or hyperextended knees as a result.
- Hypermobile children might have limited physical control, be “floppy” and have difficulty holding a pen for a long time.
- Hyper-elastic, soft and fragile skin that tears easily. Wounds sometimes heal more slowly with abnormal scarring. If this describes your skin, testing for classical EDS is in order.
- Frequent micro injuries: slight injuries that may not show up on tests or MRIs, but can occur repeatedly in the same area of connective tissue without completely healing.
- Slower healing of connective tissue in general.
- Discoordinated swallowing and / or aspiration of food and drinks.
- Reflux symptoms: A large 2026 study used the most precise testing available and found that in most people with hEDS and HSD the results came back normal, with no measurable excess acid. The most common finding was functional heartburn: real symptoms without the acid burden to match. This does not mean the discomfort is imagined. It points to a throat and gut that register discomfort more readily, rather than tissue straightforwardly damaged by acid or gastro-oesophageal reflux disease (GERD). This was a referral population undergoing testing, so it doesn’t mean an individual hypermobile singer can’t have true GERD, and testing still matters.
Read my 2 blog posts for a detailed explanation on reflux:
- Other gastrointestinal issues like constipation.
- Pelvic floor and bladder issues.
- Hormonal issues – The webinar Hormones, menopause and connective tissue disorders (The Ehlers-Danlos Support UK interviews Dr Linda Bluestein) is a MUST WATCH.
- Sensitivity to allergens and post-nasal drip. Mast cell activation syndrome – MCAS – is found frequently in people with HSD / hEDS. It’s a disorder where mast cells, which are part of the immune system, are activated inappropriately.
- Higher level of fatigue, both acute and chronic. Managing a body that behaves unpredictably takes real mental bandwidth. It’s why you might feel wiped out in a way that seems out of proportion. It is not. Your body has been doing more jobs at once than it should.
- Neuropathic pain like for example allodynia: Feeling pain from things that normally wouldn’t hurt.
If you want to review your hypermobility symptoms that are possibly due to underlying Ehlers-Danlos syndrome: Fill out the Hypermobility Screening Tool – HST. created by Callahan, Squires and Greenspan.
The Spider is a very accessible multisystemic symptom impact tool that also reviews pain, fatigue, neuromusculoskeletal, cardiac dysautonomia, gastrointestinal, urogenital, anxiety and depression symptoms. It’s available on the Ehlers-Danlos Society App.
Other potential symptoms
Poor interoception
You might have less awareness of internal body signals, such as hunger, thirst, heart rate, or muscle tension
. This makes it difficult for you to recognize physical or emotional states. It’s maybe challenging for you to be aware of your limits regarding your body, stress regulation, and overall well-being
.
Interestingly, while your interoceptive accuracy may be low, your interoceptive sensibility (how much you feel internal sensations) can be high, which may contribute to emotional dysregulation or sensory overload. To put it simply: Your body reacts to what’s happening inside, but you might not be consciously aware of it. So you feel overwhelmed or anxious without knowing why.
Poor proprioception
This is the sense of self-movement, force, and body position. Your brain responds to signals coming from your connective tissue. When the tone of that tissue is not organized well enough, your brain has difficulty knowing where you and your body parts are in space, which way is up and what direction you are moving in.
Anxiety
Your brain can feel unsafe due to your connective tissue not holding everything together as it should
. This affects how your emotions are regulated, which may help explain why you experience anxiety and emotional overwhelm so often. Your “threat bucket threshold” is possibly lowered. Because your brain is constantly scanning the world for threat, you might be hyper-vigilant.
Vocal challenges
Scroll down to learn more on how hypermobility can affect your voice. I will already share this: In August 2026, I presented the workshop Teaching Hypermobile Singers: Turning Frustration into Fascination – subscribe to the Library to watch the recording. I was prepared to meet open-minded teachers who wanted to help the singers in front of them. I was not prepared for what two of them asked: “Should a hypermobile person even want to become a singer?” Read my rather passionate reply here: Every Body Deserves the Stage.
Here’s a quote by Celest Pereira:
“Hypermobile people are like the canary in the coal mine.
They feel if something is bad for EVERYBODY before others feel it:
- Not eating well
- Too much stress
- Not resting enough
- Pollution
- Not enough hydration
We need to listen to them to give us guidance!”
Can Hypermobility be a Strength for Singers?
Yes – Just like the dancer in the pictures above, hypermobile singers can have unique talents. But remember, hypermobility presents differently in every body!
- You might notice that you have an extended vocal range without having to train hard for it. The extreme highs and /or lows are just there, waiting for you to use them in your artistic expression. Maybe you have easy access to whistle register.
- It may be very easy for you to sing softly and with a breathy voice, thus creating an intimate atmosphere. In case you didn’t know, this can be a challenging skill to acquire for other singers and they might be jealous of you. Celebrate your talent!
- Because your larynx also consists of joints and they can be affected by hypermobility too, you might have an unusually flexible voice. This can make it easy for you to perform riffs and runs.
- Changing vocal qualities / registers / vocal modes throughout your range can be easy peasy for hypermobile singers, which would give you great stylistic versatility.
However, don’t forget that due to compensatory tension – as described above, sometimes the extreme opposite presents itself: an extremely inflexible, tense voice.
The Possible Challenges for Hypermobile Singers
Unfortunately, I also have bad news. First, I’ll repeat this disclaimer:
It’s possible that you are asymptomatic or only have positive symptoms. However, you can become symptomatic later in life.
Keep in mind that hypermobility presents differently in every body. If you’re hypermobile, you won’t necessarily have all of these symptoms!
Collagen is a major component of the vocal folds. It makes up around 43% of the total protein in the vocal fold lamina propria (the vibrating layer). It gives the tissue the tensile strength and structure it needs to vibrate and withstand impact during phonation.
In hypermobile bodies, connective tissue behaves differently, and the tissues of the larynx and vocal folds are no exception. Research on singers reflects this: in one study of professionally trained singers with HSD or hEDS, 74.6% reported voice difficulties, across all age groups and Beighton scores.
There are still no official guidelines for treating voice, breathing and swallowing problems in people with hEDS and HSD. But there’s good news! Stacey Menton, a speech-language pathologist and singer at Mayo Clinic, has brought together an international group of speech and language therapists to develop treatment guidelines for these issues, working with laryngologist Dr Martin Birchall and the Ehlers-Danlos Society towards an international ENT consortium. Until that work is published, care rests on individual clinical experience and a small body of research, which means the singers I work with often have to explain their own condition to the professionals treating them.
More good news and it’s a first! A 2026 scoping review mapped all available evidence on voice and laryngeal manifestations in adults with EDS, covering thirteen studies searched up to March 2026.
Here’s a non-exhaustive list of possible challenges I’ve created over the years:
- Overuse can more quickly lead to voice pathology.
- Hypermobile singers experience vocal fatigue, hoarseness, loss of stamina, voice-related pain and hypofunction
more rapidly.
- It’s more difficult to make the vocal folds approach, which can lead to “pushing” and / or unwanted vocal fry or creak. The combination with under-regulated interoception (recognizing tension in your body) is quite unhelpful.
- It might be harder for you to sing loudly, powerfully and intensely. Some hypermobile singers have big or powerful voices, but in that case, it might be challenging to control.
- Your voice might feel unstable and you might experience sudden loss of function and / or progress. This unreliable and inconsistent nature of your singing can lead to performance anxiety and stress.
- You maybe have a hard time changing vocal qualities / registers / vocal modes, although some hypermobile singers experience the extreme opposite (see above).
- Producing and sustaining your desired pitch might be troublesome.
- Maybe you experience skeletal-muscular issues like TMJD (tension in your jaw) and / or postural imbalances in your back and / or neck
. Compensatory tension in the muscles around your larynx (MTD – Muscle Tension Dysphonia) and tongue can lead to changes in the soft tissues of your throat and muscles that raise your larynx. This has an impact on your vocal control and resonance.
- Breath management might feel like a constant challenge, because your diaphragm might be taking on a stabilization role rather than functioning for respiration. You might also be dealing with slipping ribs (subluxations).
- Just like any other joint in your body, the cricoarytenoid joints (which allow your vocal folds to swing open for breathing and close for speaking / singing) can “slip” or sublux, mimicking vocal fold paresis or paralysis. Traditional stroboscopy may miss these subluxations due to the camera angle and the limited set of vowels typically tested by general ENTs.
What’s Good for You When You’re Hypermobile
I’ll start with repeating the quote by Celest Pereira and adding the second part of it:
“Hypermobile people are like the canary in the coal mine. They feel if something is bad for EVERYBODY before others feel it. We need to listen to them to give us guidance!
- Not eating well
- Too much stress
- Not resting enough
- Pollution
- Not enough hydration
They can do fascinating things with their bodies. They thrive if given the right foundation:
- Enough proprioceptive stimulation
- Enough neuromapping of where their body is in space
- The right tools to manage anxiety
- Being taught that they are a superhero and resilient, not that they are fragile.”
And how about this quote by Adam, The Fibro Guy?
“Your body isn’t broken and doesn’t require repair; rather, it just requires understanding.”
So… What’s good for hypermobile bodies?
I’ll start with what’s helpful for hypermobile people in general. In the next chapter, I’ll share more specific tips about voice and breath.
- Make sure that all the therapists, trainers, teachers and health care professionals you’re working with understand hypermobility. What’s good for a non-hypermobile body might be unhelpful or even damaging for a hypermobile body. Maybe send them this blog post?
Regular physical therapy – A good physiotherapist for a hypermobile body works actively: strength, proprioception and motor control in ranges you can govern, with hands-on techniques as support rather than the main course. And loading is not the enemy! Your joints do not need more range; they need control over the range that is already there.
One region deserves extra care: your neck. Hypermobile people can have upper cervical instability (UCI, also called craniocervical instability or CCI). So be careful with work at the base of the skull, the suboccipital muscles and the myodural bridge. Releasing the suboccipital region without building control first could destabilise your whole body.
- Osteopathy – Gentle, hypermobility-aware osteopathy can be a valuable part of your team. Skip the cracking: high-velocity manipulation is designed to create motion in a joint, and your joints already travel too far. That goes double for your neck.
- Craniosacral therapy – Very gentle touch that many hypermobile people experience as deeply calming. Safe, regulating input for your nervous system rather than structural correction.
- Other therapies that regulate your nervous system – Same principle: their gift is downregulation. Calming input helps your brain feel safe, and that makes them a valuable support around your strength and control work, never a replacement for it. hypermobile bodies.
- Somatic approaches – Remember to adapt your practice to your hypermobility! And educate your teachers on your body. The name of the method matters less than how it is taught and by whom: the same class can build you up or flare you up, depending on whether it trains control or chases range.
- Alexander technique – Gentle awareness work on posture and habitual effort.
- Feldenkrais method – Slow, novel movements that refine your brain’s map of your body.
- Tai chi & Qi gong – Slow, controlled weight shifts and constant balance work. It reduces falls and improves lower-limb proprioception.
- Pilates – Especially reformer, tower, chair & cadillac, as they offer a lot of “reference” for your brain. Ask for heavier spring settings: they resist the carriage, limit how far you travel and give your brain richer feedback. Light springs, a fast tempo and “go a little further” cueing invite you into exactly the end ranges you want to avoid. And if your instructor cues you to grip your core at all times, find another instructor.
- Yoga – Be mindful with the kinds of yoga that focus on stretching, like Yin Yoga. Sinking deep into a pose takes a hypermobile joint past the point where your muscles govern the movement, and you end up hanging in your ligaments and joint capsule. You achieve the shape by sacrificing stability. Choose muscularly active positions well inside your end range, build strength before depth and skip the postures that exist to show off how far you can bend. Skip hot yoga altogether: in a 40-degree room your joints glide further still, while the protective resistance drops away.
- Massages are proprioceptive stimulation for your brain, so a good thing! Experiment with what works best: deep tissue / light touch / vibration / hot / cold/ sharp / dull.
- Be mindful about going to all kinds of extremes like the limits of your strength and flexibility. Low and slow is your mantra! Start with low level of challenge and progress slowly.
- Strength training of your whole body, with a focus on the muscles around your vulnerable joints.
Train reflexive stability (context-dependent activation of your muscles) and avoid rigid core-training. If you’ve been taught by certain teachers or trainers that you should be holding in your belly at all times: The pelvic floor is not evolved to be lifted and gripping all the time! A constantly engaged core is not a more stable structure. We create better lumbar stability with movement.
Train a lot in mid-range. When your body is ready, also train toward the end range of active motion, but against resistance (an isometric) and with a reference like for example the wall (closed-chain).
Focus on slow, controlled movements. The goal is to shrink the gap between the active and passive ranges of motion, as this lowers threat for your brain. A muscle isn’t just about how it contracts and shortens to strengthen something, it has to have the appropriate length-tension relationship.
Do not go for passive stretching. Instead, work on active and dynamic stretching. Active stretching focuses on muscle engagement rather than ligament stress, providing flexibility that’s supported by strength. Dynamic stretching is repeated, controlled movements (e.g. gentle leg swings). This improves flexibility without destabilizing joints.If you want more explanation on all of these concepts of appropriate training for your hypermobile body and get right to work:
- Read my 2-part blog post:
5 Stretches for Singers Whose Breath Is Stuck High (Part 1)
5 Stretches for Singers Whose Breath Is Stuck High (Part 2) - Read my blog post (Non)sense about training your core as a singer.
- Or dive right into these exercises, subscribe to The singsing! Sofa Library and watch the recordings of these 2 webinars:
Core Training for Singers by Christine Schneider.
Core Workout for Singers by Christine Schneider
- Read my 2-part blog post:
- Short-term use of braces / kinesiotape to support unstable joints – A brace or tape can get you through a flare, a long performance day or the early stages of learning a new skill, while you build the strength and motor control that gradually make the support less necessary. Kinesiotape gives sensory input: tape on your skin feeds your brain extra information about where the joint is, and that is exactly what a hypermobile body is missing. Use supports strategically, ideally fitted and taught by a therapist who understands hypermobility.
- Adequate protein supports muscle and tissue recovery, which is important given all the strength work your body is doing.
- If you have POTS or blood-pressure symptoms, you might require higher fluid and salt intake (regarding electrolyte balance) to manage symptoms. Do this under medical guidance since salt loading isn’t for everyone.
- Monitoring by a medical team to prevent and / or manage complications.
- Psychological counseling
- Find strategies to deal with anxiety.
Read my blog post Psychological Flexibility: Use ACT to Reduce Performance Anxiety for an explanation on Acceptance and Commitment Training.
If you want to dive right into these exercises, subscribe to The singsing! Sofa Library and watch the recording of the webinar Acceptance & Commitment Training for Improved Mental Health & Enhanced Performances by Dr. David Juncos.
- Help your brain feel safe by:
- Developing your sensory perception, with extra focus on your auditory and visual system.
- Training your interoception, with extra focus on your kinesthetic feedback.
- Training your proprioception, with extra focus on your vestibular system.
Read my blog post Is it Safe to Sing? Hack Your Brain and Sing with Ease! for a more detailed explanation on all of this!
If you want to dive right into these exercises, subscribe to The singsing! Sofa Library and watch the recording of the webinar Is It Safe to Sing? Brain-Based Exercises for More Ease, Stability, and Efficiency in Your Voice.
- Last, but certainly not least, another quote by The Fibro Guy:
“Many people with hypermobility find it frustrating when they are told to “be careful,” “stretch more,” or “move less.” However, those general suggestions completely miss the mark. They ignore the delicate equilibrium your body is attempting to preserve, where flexibility, strength, and stability must all coexist.”
What’s Good for You When You’re a Hypermobile Singer?
Obviously, all of the above. And if you’re also experiencing hypermobility in your voice or are working with hypermobile singers, the following advice will be helpful:
- Activate your whole body through movement while singing.
- Be mindful about all kinds of extremes like going to the limits of your volume, range, opening your jaw, etc.
- If you can sing with high volume, be mindful about how long you do so.
- Higher up, I said that you need to be doing strength training of your whole body. That includes your voice! So with my above statements about extremes and volume, I don’t mean to say that you should AVOID singing loudly or going to the extremes of your range at all times. On the contrary. You need to train the muscular engagement required for high volumes, also in your larynx, because it will help you find stability in your voice. However, build that stamina gradually and mindfully. Your progress will probably be slower than in a non-hypermobile voice. But that does not mean that you can’t reach the same goals.
- Adjust your repertoire and genre, as well as the duration of your rehearsals and performances.
- If necessary, see specialists such as a Speech-Language Pathologist, voice therapist and laryngologist. Make sure they understand hypermobile voices!
Sending them the blog post Clinical Insights from a Voice Therapist Who Specializes in Hypermobility will be very helpful, as there are no official guidelines yet for voice, breathing and swallowing in hEDS / HSD.
- Reduce excessive tension around your larynx and jaw with manual therapy. Tell the therapist you’re hypermobile, so they can be cautious of dislocation and / or subluxation.
Subscribe to The singsing! Sofa Library and watch the 3rd webinar of Releasing a Tense Voice: Releasing the Larynx, Tongue and Jaw to learn stretches and massages that you can safely do by yourself!
- Avoid “pushing” / too much air pressure due to challenged interoception with good microphone technique and monitoring.
Subscribe to The singsing! Sofa Library and watch the webinar Microphone Technique, led by Beo Van Haver!
- Extra focus on vocal hygiene and Semi-Occluded Vocal Tract Exercises (SOVTs). Straw-in-water is very effective for encouraging airflow, reducing tension and doing a voice reset. Skip the Blowfish, as it can create too much back pressure for hypermobile larynges.
Subscribe to The singsing! Sofa Library and watch the 3 webinars of SOS Voice to learn everything about taking care of your voice and SOVTs!
- Reduce vocal fry / creak, but don’t demonize it. It’s OK to use it once in a while, if balanced.
- Reduce tongue-base tension, but skip tongue-out-speech and singing as it can worsen symptoms in hypermobile people.
- Address breathing issues:
- Because your diaphragm is taking on a stabilization role rather than functioning for respiration, you need to help it come back into some respiratory state. I have created an Instagram Reel on this: Part 1 & Part 2
- Here’s my blog post When You Can’t Get a Full Breath: An Exercise for Air Hunger
- Subscribe to The singsing! Sofa Library and watch the webinar on Breath Management!
Most of all: Keep on singing! Use it or you lose it… Home alone? Talk to your pets or chat with the TV. Too much voice rest will actually make your voice more stiff because of deconditioning. But integrate regular vocal naps, voice resets and hydration breaks.
- Check the agenda for my Online Solo Group Lessons for Hypermobile Singers – You can enroll as an Active Participant or learn from observing the lessons as a Fly-On-the-Wall.
- Subscribe to The singsing! Sofa Library to…
- watch the 2-hour long webinar Teaching Hypermobile Singers: Go from Pretty Frustrating to Pretty Fascinating and learn how to effectively teach hypermobile singers
- watch the 2 webinars led by Christine Schneider, who offers invaluable insights on hypermobility: Core Training for Singers – The Vocal Resilience Cylinder & Core Workout for Singers.
- Of course, you are also very welcome to book Private Voice Lessons & Vocal Coaching and / or Mentoring with me 🙂
She couples this with her techniques that allow one to manage things like performance anxiety with much greater ease. It’s a win- win as I have in the past 6 months started to perform at jam sessions and more. I love it!
Kim, Avocational Singer
Pieter Van Hecke, Vocational singer
Janet Wilson - Vocational singer
Esther De Bièvre - Recovery therapist
Breg Horemans - Vocational singer
Maud Retter - Speech therapist
Stella Handley, Avocational singer
Susanne Vahle - Vocational singer
Singer & Voice Teacher
Amy Bebbington - Director of Training bij Association of British Choral Directors
Ariane De Dom, Avocational singer
Bec Tilley, Voice Coach & Singer
Nele Willekens - Library youth worker
Haike D'haese - Singer & Actress
Manon Campens - Singer
Bec Tilley, Voice Coach & Singer
Diane Speirs - Singer & Voice Teacher
Jess Blatchley, Singing Teacher and Jazz Singer
Jess Blatchley, Singing Teacher and Jazz Singer
Kenneth Ottoy, Singer of Plagiaat & Piron
Kim, Avocational Singer
Kelly Van Hove - Entertrainer focused on Soft HR & communication workshops / Vocational Musical Theatre Singer
You learn to look for a solution and deal with your struggles yourself. It's not pre-made shit, it's to the point.
Esther De Bièvre - Recovery therapist
What I also appreciate very much is her respect for every one of her clients / students.
Singer
I leave our lessons feeling inspired and with new tools to use with my voice students. I particularly love that I now have language to identify and describe with more specificity the different kinds of sounds that live in pop/rock styles. Working with Sarah has made me a better teacher for my students!
M.J. Johnson, Singing Teacher and Vocal Coach
I highly recommend Sarah if you are looking for a voice specialist!
Gwendy - Vocational singer
Stella Handley, Avocational singer
Dr. Tracy Smith Bessette - Singer, Voice Instructor, Early Music Coach & Course Lecturer
Susanne Vahle - Vocational singer
Nele - Singer & Youth Library Worker
RESOURCES
Research Papers:
- Characterising Vocal Function and Laryngeal Structural Alterations in Ehlers–Danlos Syndromes: Insights from a Scoping Review – Carmen Morales-Luque et al. (2026)
- Health-Related Quality of Life in Midlife and Older Women With Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders – Linda K Anderson (2026)
- Esophageal Dysmotility and Gastroesophageal Reflux Disease Risk in Hypermobile Ehlers-Danlos Syndrome – Butt et al. (2026)
- Health experiences and outcomes of autistic and non-autistic adults with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder – Crompton et al. (2026)
- Postural Orthostatic Tachycardia Syndrome: A State-of-the-Art Review – Lau et al. (2026)
- The Incidence of Misdiagnosis in Patients with Ehlers–Danlos Syndrome –Chanbin Lee and Pradeep Chopra (2025)
- Defining the Chronic Complexities of hEDS and HSD – Daylor et al. (2025)
- Autism in the context of joint hypermobility, hypermobility spectrum disorders, and Ehlers–Danlos syndromes – Baeza-Velasco et al. (2025)
- Defining the Chronic Complexities of hEDS and HSD: A Global Survey of Diagnostic Challenges, Life-Long Comorbidities, and Unmet Needs –Victoria Daylor et al. (2025)
- The HEDGE (Hypermobile Ehlers-Danlos Genetic Evaluation) Study 2025 Update, Ehlers-Danlos Society, the Broad Institute of MIT and Harvard (2025)
- Voice Disorders in Ehlers–Danlos Syndrome, Venkatraman et al. (2025)
- Proteomic discoveries in hypermobile Ehlers-Danlos syndrome reveal insights into disease pathophysiology, Griggs et al. (2025)
- Non-Traumatic Arytenoid Subluxation in a Patient With Hypermobile Ehlers–Danlos Syndrome, Menton et al. (2025)
- A model linking emotional dysregulation in neurodivergent people to the proprioceptive impact of joint hypermobility – Eccles et al. (2024)
- Risk factors associated with symptoms of temporomandibular disorders among women with hypermobile Ehlers-Danlos syndrome – Yekkalam et al. (2024)
- Laryngological Complaint Prevalence in Hypermobile Ehlers-Danlos or Hypermobility Spectrum Disorders – Menton et al. (2024)
- Impact of hypermobility on the voice – Research paper by Alien Partljič (2024)
- Self-reported throat symptoms in Ehlers–Danlos syndromes and hypermobility spectrum disorders: A cross-sectional survey study – Williams et al. (2023)
- Laryngological Symptomatology in Patients with Ehlers-Danlos Syndrome – Sharma et al (2023)
- Research shows how hypermobility can negatively impact singing ability – Tracy Jeffrey (2022)
- Joint Hypermobility Links Neurodivergence to Dysautonomia and Pain –
- Postural orthostatic tachycardia syndrome: A respiratory disorder? – Stewart & Pianosi (2021)
- Throat and voice problems in Ehlers–Danlos syndromes and hypermobility spectrum disorders – Birchall et al (2021)
- The Beighton Score as a measure of generalised joint hypermobility – Sabeeha Malek et al (2021)
- Pain management in the Ehlers–Danlos syndromes – Pradeep Chopra et al (2017)
- Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility – Mallorquí-Bagué et al (2013)
Other resources:
- Hypermobility Syndromes Association
- BAPAM Factsheet: Hypermobility
- The Zebra’s Voice – Substack by Stacey Menton , a hypermobile SLP.
- ENT Symptoms & Treatment for EDS & Hypermobility Disorders: A Speech & Language Therapist Perspective – Lecture by Gary Wood for The Ehlers-Danlos Society
- Thoracic Outlet Syndrome in Hypermobility: Why Your Shoulders, Nerves, and Nervous System Are Under Pressure – article by Ines Illipse (2025)
- Hypermobility and singing – What every voice teacher and hypermobile singer needs to know – Presentation by Dr. Dana Lynne Varga
- Voice, breath and Ehlers-Danlos syndrome – Webinar by Imogen Roux for Ehlers-Danlos Support UK
- Anatomy Nerds, webinars hosted by The Visceral Voice (Christine Schneider):
- Hypermobility and the Voice by Andrew Byrne (The Singing Athlete)
- Yoga for Hypermobility by Jamie Terry
- Hypermobility Care in Performing Arts: Early Detection in Dance Medicine – Integrating Contemporary Screening Tools and Lived Experience in Hypermobility Management – Webinar by Dr. Tina Wang, Dr. Clifton Chan & Bonnie Southgate for PAMA
- Hypermobility Care in Performing Arts: Supporting the Musical Performer – Integrating Hypermobility Knowledge and Neurodivergent Understanding in Performance Care
Webinar by Dr. Shelly-Anne Li (CA), Kathrin A. Blum (CH) & Alexandra Palma (CA) for PAMA - Celest Pereira:
Webinar: Flexible Thinking – Understanding Hypermobility and Neuroanatomy
Book: Too flexible to feel good - Working with Singers with Hypermobility Spectrum Disorders, Hypermobile Ehlers-Danlos Syndrome and Postural Orthostatic Tachycardia Syndrome – Poster Presentation at Pan-European Voice Conference 2025 in Santander by Joanne Bozeman, BM
- Exploring Hypermobility and Its Impact on the Voice: Christine Schneider interviews Alien Partljic for The Visceral Voice podcast
- Hypermobility and the Voice: Finding Stability
Speakers: Christine Schneider (US) interviews Mairin Srygley (US) and Jamie Terry (US) for The Visceral Voice podcast - Rare and Most Common Types of EDS, Focusing on the Most Common-Hypermobility Christine Schneider interviews Eloise Stager, craniosacral therapist, for The Visceral Voice podcast
- Working with Singers with POTS – Christine Schneider interviews Marita Stryker for The Visceral Voice podcast
- Hypermobility and the Voice – What You Might Not Realize – blog post by Christine Schneider
- Cleveland clinic: Postural Orthostatic Tachycardia Syndrome (POTS)
- Chronically Singing seeks to gather and share the stories of singers who are navigating invisible and dynamic chronic health conditions, such as postural orthostatic tachycardia syndrome (POTS), Ehlers-Danlos Syndromes (EDS), and hypermobility spectrum disorders (HSD)
- Het syndroom van Ehlers-Danlos (EDS) – Article by Gezondheid.be
- Z-Health, a brain-based approach to movement and rehabilitation developed by Dr. Cobb. Z-Health focuses on integrating neuroscience, proprioception, and motor control to improve physical performance and address issues like balance, stability, and tension.
- The Fibro Guy has the mission to help those with chronic pain and hypermobility syndromes take back control over their health.
- Dr. Linda Bluestein, The Hypermobility MD specializes in treating hypermobility and chronic pain particularly in artistic athletes.
- Hormones, menopause and connective tissue disorders, The Ehlers-Danlos Support UK interviews Dr Linda Bluestein
As always, feel free to send me your thoughts, questions, and feedback in the comments below this blog, via the contact form or in the singsing! online community 
Cordially,
Sarah