# Hypermobility and the voice Hypermobility "is excessive joint movement due to loose or lax connective tissue," affecting stability and function of the joints, not just flexibility.[^1] When joints are unstable, the muscles around them work harder to compensate, resulting in fatigue and tension.[^2] So we can see this clearly affects the muscles and joints in the larynx too. HSD and hEDS are not caused by one single thing, but may be the result of genetic factors as well as immune and nervous system function. There is some link to neurodivergence and trauma too. It's also more common among performers.[^2] Research shows singers with hypermobility disorders may have more range or dexterity, "with many participants describing their voices as having beneficial qualities such as an unusual or interesting tone, enhanced flexibility or a wide range for singing and speaking. However, singing across their full range or in specific parts could trigger symptoms of voice dysfunction."[^3] ## Common issues According to one study of individuals with hEDS and HSD, 22.5% reported hoarseness, 33.9% reported swallowing difficulty, 27% reported breathing issues. [^4] Another study says, "Our findings show that singers with HSD and h-ESD may be at increased risk of voice difficulties and early assessment and tailored support are paramount to reducing the impact it can have."[^3] "Hypermobile singers experience vocal fatigue, hoarseness, loss of stamina, voice-related pain and hypofunction
 more rapidly," says hypermobile singer and voice teacher Sarah Algoet. It's more difficult for hypermobile individuals to adduct the vocal cords. Compensatory tension around the larynx can also lead to muscle tension dysphonia.[^2] Vocal issues can sometimes be the first sign that one is going to have a flare.[^4] Moreover, developing and regulating intra-abdominal and subglottic pressure is important for breath control, but this may be more difficult for hypermobile singers.[^1] The diaphragm may take a stabilizing role instead of functioning for breathing. Hypermobile people may experience air hunger as well.[^2] Circulatory adaptations (like pooling blood in the lower extremities) can cause singers fatigue. TMJ, shifting ribs, and joint discomfort can lead to tension in the neck, tongue, or jaw, as the body compensates for joint instability. And be wary of excessive head movement, since many hypermobile individuals have cranial-cervical instability. On top of it all, hypermobile individuals often have difficulty with proprioception, affecting coordination and tension.[^1] Developing proprioception for the mechanisms of the voice is key. ## How to recover Sarah Algoet recommends a few practices that may help, including Alexander technique, Feldenkrais method, and tai chi and qi gong. Be mindful of going to extremes in vocal range, loudness, and jaw openness for example. Reduce vocal fry if it's something you rely upon too much, but don't demonize it—it's okay in balance.[^2] Too much vocal rest may stiffen the voice, so instead practice regularly, taking vocal "naps" and hydration breaks. Do not pull in your belly, as some teach, as the pelvic floor is not meant to be gripping all the time. Foster lumbar stability with movement, not a constantly engaged core.[^2] Developing mask resonance (resonance in the face and nasal passages) can have a positive effect on phonation and breathing.[^4] I recommend humming nasal consonants such as "m," "n," and "ng." The \[i] vowel (that is, long ē) is also helpful. ## Some recommended exercises Sarah Algoet recommends semi-occluded vocal tract exercises such as straw-in-water singing, in short bursts, just 15-30 seconds, eight times a day, or fewer in case of fatigue. Deep breathing exercises with a prolonged exhale (as well as any deep rest) can induce parasympathetic nervous system response, resulting in less stress on the body and activating the vagus nerve, which innervates the larynx.[^4] See [[Singing and the vagus nerve]] for more on this. [^1]: [Hypermobility and the Voice – What You Might Not Realize](https://www.thevisceralvoice.com/newsletters/tvv-insider/posts/hypermobility-and-the-voice) [^2]: [Hypermobile Singers: From Pretty Impressive to Pretty Painful - The singsing! Sofa](https://www.singsing.be/onlinecourses/2025/01/17/hypermobile-singers-from-pretty-impressive-to-pretty-painful/) [^3]: [Research shows how hypermobility can negatively impact singing ability \| Lincoln Bishop University](https://www.lincolnbishop.ac.uk/news/research-shows-how-hypermobility-can-negatively-impact-singing-ability) [^4]: [Clinical Insights from a Voice Therapist Who Specializes in Hypermobility - The singsing! Sofa](https://www.singsing.be/onlinecourses/2025/09/19/clinical-insights-from-a-voice-therapist-who-specializes-in-hypermobility/)