Knee Hyperextension and Hypermobility: What to Work On in Rehabilitation
Updated: 21 hours ago
Knees that repeatedly lock backwards can feel stable in the moment but may rely heavily on passive structures. Rehabilitation can build better active control.
Why hyperextension can become a habit
Some people stand with the knees pushed backwards because the position feels secure and requires less active muscular effort. The trade-off is that the joint may rely more heavily on passive structures rather than on controlled muscle activity.
The aim is not to hold the knee bent all day
Constantly trying to keep the knees visibly flexed can be tiring and unnatural. A more useful target is awareness of end range and the ability to control the knee during walking, stairs, sit-to-stand and exercise.
Train the whole lower limb
Quadriceps, hamstrings, gluteal muscles, calf strength and pelvic control all contribute to how the knee is loaded. Rehabilitation should therefore look beyond the knee itself and consider the whole movement pattern.
Functional exercises are useful
Sit-to-stands, supported squats, step work, calf raises and controlled standing exercises can all be useful when performed through a range that remains stable. Progress should be based on control and recovery rather than how deep or difficult the exercise looks.
A more detailed physiotherapy resource
For a more complete physiotherapy resource, see the Complete Hypermobility Spectrum Disorder & Hypermobile Ehlers-Danlos Syndrome Physiotherapy, Rehabilitation & Self-Management Guide. It brings symptom management, practical self-management and 39 adaptable exercises across four pathways together in one 227-page digital guide.
Related reading
This article provides general physiotherapy education and does not replace individual assessment, diagnosis or treatment. New, severe or rapidly changing symptoms should be assessed by an appropriate healthcare professional.
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