Hypermobility in Babies: Understanding Its Impact on Gross Motor Development

Hypermobility in babies is a common condition that is often overlooked since babies are naturally more flexible, and will often be diagnosed as low muscle tone.  While some infants with hypermobility develop gross motor skills within typical timeframes, many experience delays. I hope to shed a little light on understanding how hypermobility affects early movement patterns and provide the right support to promote optimal motor development.

What is Hypermobility? Hypermobility is an increased range of motion in the joints due to laxity in the connective tissues, particularly ligaments. In babies, this is often a normal occurrence as their bodies are naturally more flexible. However, for some infants, excessive joint mobility may lead to challenges in achieving gross motor milestones such as rolling, sitting, crawling, and walking. Recent studies also suggest that joint hypermobility causes stress on the nervous system. 

How Does Hypermobility Affect Gross Motor Development?

1. Delayed Milestones: Due to reduced joint stability, babies with hypermobility may take longer to develop core strength and postural control, which are essential for gross motor skill progression.
2. Difficulty Maintaining Positions: Infants with hypermobility may struggle to maintain positions such as sitting or standing because their muscles must work harder to compensate for the lack of joint stability.
3. W-sitting Preference: Many hypermobile toddlers adopt a W-sitting posture, where their legs are positioned outward in a “W” shape.  This helps them feel more stable since they are using their joints for support instead of their core muscles.  You can encourage better alignment in sitting by having them side sit or sit cross-legged.  
4. Increased Fatigue: Because their muscles must work harder to stabilize their joints, hypermobile babies may tire quickly during activities that require sustained effort.

Supporting Babies with Hypermobility

While hypermobility in infancy is often not a cause for major concern, early intervention and targeted activities will help strengthen muscles and improve motor function:

• Tummy Time: Encouraging frequent tummy time helps develop core and shoulder strength, which is crucial for rolling and crawling.  Start small, on a parent’s chest or slightly elevated over a rolled-up blanket. Babies with hypermobility tend to resist tummy time.   
• Encouraging Weight-Bearing Activities: Encourage rocking back and forth on hands and knees (pre-crawling) or playing in standing using a table or cruising (side stepping). This helps to develop deep core and hip strength.
• Avoiding Prolonged W-Sitting: Encouraging alternative sitting positions, like cross-legged or side sitting, promotes better core activation and hip alignment.
• Sensory and Balance Activities: Activities like bouncing on an exercise ball or a soft surface enhances proprioception and postural control.  Massage is a great sensory approach to help your baby’s brain to map out the body.
• Physiotherapy Intervention: If a baby is experiencing delays, a pediatric physiotherapist will provide tailored exercises and strategies to support motor skill development.

If a baby with hypermobility is significantly behind on motor milestones, has difficulty weight bearing through their limbs (on hands and knees, or in standing), or shows signs of pain or discomfort, consult a pediatric physiotherapist or occupational therapist.. Early support will make a significant difference in promoting strong, functional movement patterns and preventing long-term motor difficulties.