Hypermobile Singers: From Pretty Impressive to Pretty Painful
Originally published on 17/01/2025 – Last updated on 05/02/2026
Did you know that Billie Eilish is hypermobile? And maybe Maria Callas was too!
I’m a hypermobile singer and voice teacher; and a big percentage of my clients is as well. The challenges we face are unique, and at the same time, our strengths are too. 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!
Unlike my other blog posts, this article is quite dry with lots of bullet points, so your brain can absorb the info easily.
- 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 â 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 đ
Is Hypermobility a Disorder?
Letâs get one thing straight right away: Hypermobility itself isnât a disease or a medical condition. Itâs simply a physical trait, like for example having flexible fingers or a double-jointed thumb. In fact, most people have at least one hypermobile joint due to past injuries or from repetitive movements, like playing an instrument. A single hypermobile joint doesnât mean you have a disorder. Itâs 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 doesnât mean itâs a problem in itself, but it does provide a framework for understanding the body’s mobility and laxity.
The focus of this article is Hypermobility Spectrum Disorders – HSDâ¨, 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.
There are two conditions that must be clinically diagnosed where hypermobility is one of the key symptoms:
- Hypermobile Ehlers-Danlos Syndrome – hEDS
- Postural Orthostatic Tachycardia Syndrome – POTS
I will mention some symptoms of hEDS and POTS, but if you want to go deeper, scroll down to the resources.
What are Hypermobility Spectrum Disorders - HSD?
Connective tissue (for example fascia) provides support to your skin, musculoskeletal system, blood vessels, and organs. In people with HSD, the connective tissue is weakened & too stretchy due to a defect in collagen production. The tissues donât have the ability to hold everything together as they should.â¨
- We used to think that more women than men are hypermobile, but more recent research suggests that it could be 50 – 50.
- HSD is more common in the artist population.
- There’s a link with neurodivergence.
- This is not supported by research at all – at least not that I know of, but I wonder whether there’s a link with HSP (Highly Sensitive Person) too, as I recognize this in all the people I know who are hypermobile – including myself.
Is HSD is 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.
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 also gives 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 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 flexibility, which complicates recognition of hypermobility-related conditions in later life. I explain this in depth in my blog post Go From âIâm So Stiff!â to âCould I Actually Be Hypermobile?â.
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.
- Scoliosis
- Difficulty maintaining postural alignment & standing for a long time. 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 are 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.
- An under-regulated vestibular system (balance), which can lead to dizziness and fatigueâ¨. This can also lead to muscles not firing when theyâre supposed to during movement, with for example weak glutes or hyperextended knees as a result.
- Breathing problems, for example slipping ribs, unconscious breath-holding or paradoxical breathing.
- 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.
- 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 tissues in general.
- Discoordinated swallowing and / or aspiration of food and drinks.
- Gastrointestinal issues like constipation, acid reflux or gastro-oesophageal reflux disease (GERD).
Make sure to read my 2 blog posts for a detailed explanation on reflux: - Pelvic floor and bladder issues.
- Hormonal issues.
- Sensitivity to allergens and post-nasal drip. Mast cell activation syndrome – MCAS – is found frequently in people with HSD. It’s a disorder where mast cells, which are part of the immune system, are activated inappropriately.
- Higher level of pain and fatigue, both acute and chronic.
- Neuropathic pain like for example allodynia: Feeling pain from things that normally wouldnât 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 accessable multisystemic symptom impact tool that also reviews pain, fatigue, neuromusculoskeletal, cardiac dysautonomia, gastrointestinal, urogenital, anxiety and depression symptoms.
Other potential symptoms
Poor interoception
You might have less awareness of internal body signals, such as hunger, thirst, heart rate, or muscle tensionâ¨. 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-beingâ¨.
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 whatâs 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 are in space, which way is up and what direction you are moving in.
Anxiety
You brain can feel unsafe due to your connective tissue not holding everything together as it shouldâ¨. Your âthreat bucket thresholdâ 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!
But first, 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, HSD 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 lows are just there, waiting for you to use them in your artistic expression. Sometimes 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 consists of a big collection of joints and they can be affected by HSD too, you might have an unusually flexible voice. This makes 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 gives you great stylistic versatility. However, sometimes the extreme opposite presents itself.
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 if you don’t practice enough self-care.
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 human vocal folds – it makes up 43% of the total tissue protein. People with HSD have a weaker collagen production. As a result, up to 74,6% of hypermobile singers face voice problems, as opposed to 45% of singers without HSD. These problems may present 20 to 30 years sooner than in singers without HSD.
- 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 âpushingâ 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 & 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 neckâ¨. 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.
Whatâs Good for You When Youâre 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 isnât broken and doesnât require repair; rather, it just requires understanding.”
So… What’s good for you – and every body, not just the hypermobile ones?
- 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. Hypermobile people often have cranial cervical instability. So be careful with work at the base of the skull, the suboccipital muscles and the myodural bridge. Releasing the suboccipital region could destabilise your whole body.
- Osteopathy
- Craniosacral therapy
- Other therapies that regulate your nervous system
- Somatic approaches – Remember to adapt your practice to your hypermobility! And educate your teachers on your body.
- Alexander technique
- Feldenkrais method
- Tai chi & Qi gong
- Pilates – Especially reformer, tower, chair & cadillac, as they offer a lot of “reference” for your brain.
- Yoga – Be mindful with the kinds of yoga that focus on flexibility, like Yin Yoga.
- 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 thatâs supported by strengthâ. 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 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 – The Vocal Resilience Cylinder by Christine Schneider.
Core Workout for Singers by Christine Schneider
- Read my blog post (Non)sense about training your core as a singer.
- Short-term use of braces / kinesiotape to support unstable joints.
- Since syndromic hypermobility is linked to collagen deficiency, protein consumption is essential.
- People with hypermobility often require higher fluid and salt intake (regarding electrolyte balance) to manage symptoms related to blood pressure and circulation.
- 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.
- Developing your sensory perception, with extra focus on your auditory and visual 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 âbe careful,â âstretch more,â or âmove less.â 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.”
Whatâs Good for You When Youâre 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 âpushingâ / 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.â¨
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 donât demonize it. Itâs 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.
Subscribe to The singsing! Sofa Library and watch the webinar 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 â 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 đ

Also, I felt a great sense of connectedness to the other participants having been with them on several occasions now.
Kim, Avocational singer
Kim, Avocational singer

Stella Handley, Avocational singer
Stella Handley, Avocational singer

Frederik Rambout - Vocational singer
Frederik Rambout - Vocational singer

You also learn so much from the lessons that the other participants receive.
Susanne Vahle - Vocational singer
Susanne Vahle - Vocational singer

Esther De Bièvre - Recovery therapist
Esther De Bièvre - Recovery therapist

We have some unique ways of learning from one another via your amazing guidance!
Kim, Avocational Singer
Kim, Avocational Singer

Pauline Kaczmarek - Singer-songwriter & music teacher
Pauline Kaczmarek - Singer-songwriter & music teacher
RESOURCES
Research Papers:
- Laryngological Complaint Prevalence in Hypermobile Ehlers-Danlos or Hypermobility Spectrum Disorders –Â Menton et al. (2024)
- Self-reported throat symptoms in EhlersâDanlos syndromes and hypermobility spectrum disorders: A cross-sectional survey study – Williams et al. (2023)
- Throat and voice problems in EhlersâDanlos syndromes and hypermobility spectrum disorders – Birchall et al (2021)
- Laryngological Symptomatology in Patients with Ehlers-Danlos Syndrome – Sharma et al (2023)
- Research shows how hypermobility can negatively impact singing ability – Tracy Jeffrey (2022)
- Impact of hypermobility on the voice – Research paper by Alien PartljiÄ (2024)
- Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility – MallorquĂ-BaguĂŠ et al (2013)
- Pain management in the EhlersâDanlos syndromes – Pradeep Chopra et al (2017)
- The Beighton Score as a measure of generalised joint hypermobility – Sabeeha Malek et al (2021)
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
- 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 –Â Christine Schneider interviews Marita Stryker for The Visceral Voice podcast
- Hypermobility and the Voice â 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.
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





