Strategies & Advice

Everyday activities need your child to be able to make sense of the world around them and use their motor skills. This information is aimed at children who are having difficulties with these.

Joint Hypermobility

Everyday Life

Hypermobility often improves with age. Families should be aware that its main risk comes from preventing children to live normal lives. Children should be encouraged to maintain a normal level of activity, including playing any sports they are interested in. Keeping active and strong is important and helps reduce joint pain as fitness and balance improve over time.


Cracking Joints

Research studies have shown that cracking joints does not cause arthritis in the joints. For example, Dr Donald Unger cracked the knuckles of his left hand every day for 60 years, but did not crack the knuckles of his right hand. At the end of 60 years both hands were the same with no arthritis. He won the Ig Nobel Prize for Medicine in 2009.

Sports and Activities

Keeping active and strong is important and helps reduce joint pain as fitness and balance improve over time. Make sure you warm up and cool down when playing sports. It is good to encourage children to have a variety of different sports and activities rather than concentrating on just one sport.

Joint Protection

  • The stronger you are the more your muscles can protect your joints, get active, get physical, find a hobby you love and have fun!
  • Avoid doing "party tricks", showing friends and family how much you can bend, as this may over stretch your joints.
  • Think about ways to protect your joints. E.g. To avoid knee pain - stand with your knees straight - not in the over extended position.
  • Use your body to push open doors and not using their hands if wrists and elbows are painful.


It is easier to use thicker style pens/pencils or buy pen/pencils grips as this relieves pressure on fingers and thumb joints and can help to prevent hand pains.

  • The triangular pencil grip is thought to give better control of the pen or pencil whilst allowing your hand to relax more.


  • Stabilo Easy Graph pencils are designed for both right- and left-handed users. The triangular shape and moulded grip zones are great for encouraging children to hold the pencil correctly.



  • Ergonomically friendly pen/pencils can ease writing stress and fatigue e.g. PenAgain / Twist ‘n Write Pencils.


Writing is easier with a gel pen as the ink flows easily over the paper, avoid scratchy ball point pens which will take more effort to write with.

Writing on a sloping surface helps to relieve pain and achiness in the wrist and hand. This will also help your posture and shoulder position in writing. It may be useful to try this at home as well as at school. You can buy writing slopes to go on top of tables from a number of different suppliers. An empty arch lever file serves the same purpose and is light and easy to carry and will not make you look any different from your friends at school. However, buy one with a matt surface as a glossy surface will make your paper slip on it as you are trying to write.


Good posture is important at all times. A slouched posture may hurt your back and leads to weak muscles around your central core. This then affects the way you can use your shoulders and hips. Think about sitting and standing “tall”. 

For further information see: Choosing the Right School Bag


Children should try to wear supportive trainers and shoes, especially when their feet or knees are achy. A good foot position can help to relieve knee and leg pain. It may be helpful to wear trainers for PE instead of plimsolls (school pumps). The trainers should have a firm back at the heel, and offer good support. A good shoe cannot be bent in two. Slip on shoes may be too big. You may benefit from a fastening shoe which offers a deeper style and more support for your feet.

For further information see: Choosing Footwear in Children

Flat Feet

This is very common in children with or without Hypermobility. Some children complain of their flat feet having an achy pain. They would benefit from supportive shoes described above. However, in the home they should be encouraged to walk in bare feet (or slipper socks with the grippy soles) as this will strengthen their feet.

For further information see: Flat Feet in Young Children

Paediatric and Adolescent Rheumatology Team Royal Hospital for Children Glasgow 2019