This article is part of our comprehensive guide to exercise and rehabilitation for hypermobility.
If you would prefer to listen to this article, please click below.
Hypermobility and Exercise: How I would love you to view it
So, we mentioned about the ingredients to our proprioception cake, and that to increase proprioception, we need to focus on what goes into the cake, rather than the cake itself. This section then, is more focused on the ingredients, and will hopefully give you a different lens to view things through. This is a topic that can get very confusing, very fast though, so I’m going to try my best and keep it close to the main points, without going into too many unnecessary details, going off on a tangent or branching off too much. For more on why “engage your core” can backfire in hypermobility, see our deeper guide on hypermobility core exercises.
However, this article is going to be big. I haven’t written it yet as I write this sentence, but I already know it’s going to be a monster.
But, to you reading at home, my hypermobile friends, Knowledge is power!
I really do implore you to read through the heavy science parts that come next, because it will let you understand your body better, and it will connect a lot of dots about why traditional training doesnt work all that well when you throw hypermobility into the mix.
So, if you are a little nerdy pants and love absorbing knowledge like myself and the rest fo the team, then strap on in sunshine!
What goes into proprioception?
As I mentioned earlier, the brain receives around 11 million pieces of information per second. The types of sensory input can vary wildly, with different nerves and organs carrying very different information to the central nervous system and brain.
An overview of sensory input
Sensory nerves and receptors can be classified based on the type of stimuli they respond to, which include:
1. Mechanoreceptors: These sensory nerves are sensitive to mechanical stimuli such as pressure, vibration, and touch. They are found in the skin, muscles, and various internal organs. Mechanoreceptors help us recognise textures, maintain balance, and detect changes in muscle, tension or blood pressure. Some examples of mechanoreceptors include Merkel cells (responsible for light touch), Pacinian corpuscles (vibration detection), and Ruffini endings (detecting skin stretch).
2. Nociceptors: These sensory nerves are responsible for detecting potentially harmful stimuli, such as extreme temperatures, excessive pressure, or harmful chemicals, and signalling the CNS to generate a pain response. Nociceptors are found throughout the body, including the skin, muscles, and internal organs. They help protect the body from injury by alerting the brain to potentially damaging situations.
3. Photoreceptors: These sensory nerves are found exclusively in the retina of the eye and are responsible for detecting light stimuli. Photoreceptors convert light energy into electrical signals that the brain can interpret as visual information. There are two main types of photoreceptors: rods (responsible for low-light vision) and cones (responsible for colour vision and high visual acuity).
While the categories above cover the main sensory nerves, there are additional subtypes and specialised sensory nerves, receptors, and cells within these categories that perform specific functions. Some of these include:
1. Proprioceptors: A subset of mechanoreceptors, proprioceptors are found in muscles, tendons, and joints. They provide information about the position and movement of body parts, allowing for proprioception or the sense of body position and movement. Key types of proprioceptors include muscle spindles (detect changes in muscle length) and Golgi tendon organs (monitor muscle tension).
2. Auditory hair cells: Found in the cochlea of the inner ear, these specialized mechanoreceptors are
responsible for detecting sound vibrations and converting them into electrical signals that the brain interprets as auditory information.
3. Free nerve endings: These are unspecialized nerve endings found throughout the body that can respond to multiple types of stimuli, such as pressure, noxious stimulus, and temperature. Free nerve endings are considered polymodal nociceptors since they can detect different types of potentially harmful stimuli.
While this list is not exhaustive, it does cover the major types and subtypes of sensory nerves. As you can probably appreciate now, the nervous system is a complex and diverse network, and there are many specialised sensory nerves and receptors that work together to help us perceive and respond to our environment.
Mechano Receptors GTO and Muscle Spindles
Now that we have a good overview of the sensory information coming in, I would like to dive a little deeper into some of the more important receptors we covered, and a good place to start is with the traditional “proprioceptors”.
Golgi Tendon organ
Let’s start with the Golgi tendon organ, and a quick point to note is that the term “organ” can often be confusing, seeing as it is not an organ in the traditional sense. Its name comes from historical context and the structure’s appearance, rather than reflecting its classification as an organ like the heart or liver.
References:
Brittain, M.G. et al. (2024) ‘Physical therapy interventions in generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome: a scoping review’, Disability and Rehabilitation, 46(10), pp. 1936–1953. doi: 10.1080/09638288.2023.2216028.
Eccles, J.A. et al. (2025) ‘Neural processes linking joint hypermobility and anxiety: key roles for the amygdala and insular cortex’, The British Journal of Psychiatry [Preprint]. Available at: Cambridge Core.
Buryk-Iggers, S. et al. (2022) ‘Exercise and rehabilitation in people with Ehlers-Danlos syndrome: a systematic review’, Archives of Physical Medicine and Rehabilitation, 103(6), pp. 1001–1012. doi: 10.1016/j.apmr.2022.03.014.
Palmer, S. et al. (2020) ‘The effectiveness of conservative interventions for the management of syndromic hypermobility: a systematic literature review’, Rheumatology International, 40(11), pp. 1781–1792. doi: 10.1007/s00296-020-04672-8.
Stasiak, M., Woźniak, K. & Woźniak, A. (2025) ‘Rehabilitation and physical activity in Ehlers-Danlos syndrome: a review of interventions and outcomes’, Quality in Sport, 41, p. 60105. doi: 10.12775/QS.2025.41.60105.
Eccles, J.A. et al. (2022) ‘Joint hypermobility links neurodivergence to dysautonomia and pain’, Frontiers in Psychiatry, 13, p. 786916. doi: 10.3389/fpsyt.2021.786916.
Smith, T.O. et al. (2017) ‘The effectiveness of therapeutic exercise for joint hypermobility syndrome: a systematic review’, Physiotherapy, 103(2), pp. 158–167. doi: 10.1016/j.physio.2016.11.004.
Cederlöf, M. et al. (2016) ‘Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome’, BMC Psychiatry, 16, p. 207. doi: 10.1186/s12888-016-0922-6.
Keer, R. & Grahame, R. (2003) Hypermobility Syndrome: Recognition and Management for Physiotherapists. Edinburgh: Butterworth-Heinemann.
Simmonds, J.V. et al. (2019) ‘Exercise beliefs and behaviours of individuals with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type’, Disability and Rehabilitation, 41(4), pp. 445–455. doi: 10.1080/09638288.2017.1398278.
