Hypermobility and Cooler Weather: Understanding Your Body and Staying Active This Season
As the leaves change and temperatures drop here in Western North Carolina, many of us are pulling out our sweaters, planning fall hikes, and preparing for shorter days. But for people with joint hypermobility, the transition into cooler weather can sometimes come with additional challenges.
Maybe your joints feel stiffer in the morning, your muscles seem to work harder to keep you comfortable, or you're noticing changes in your energy levels. If you're managing other conditions alongside hypermobility, seasonal changes may add another layer of complexity.
The good news? Understanding how your body works and making a few adjustments to your routine can help you stay active, comfortable, and confident throughout the colder months.
What Is Joint Hypermobility?
Joint hypermobility means your joints move beyond the range typically expected for that joint. Some people are naturally flexible and experience no problems. For others, that increased range of motion comes with pain, instability, fatigue, or recurring injuries.
Two conditions you may hear about are:
Hypermobility Spectrum Disorder (HSD): Symptomatic joint hypermobility that doesn't necessarily meet the diagnostic criteria for a specific connective tissue disorder.
Hypermobile Ehlers-Danlos Syndrome (hEDS): A heritable connective tissue disorder associated with joint hypermobility, instability, pain, and other symptoms throughout the body.
While they're not identical diagnoses, people with HSD and hEDS can experience similar challenges. [1]
One of the biggest misconceptions about hypermobility is that it's simply about being extra flexible. In reality, hypermobility is often less about needing more flexibility and more about developing strength, stability, and control within the range of motion you already have.
Hypermobility Is Often More Than a Joint Problem
Our connective tissue is found throughout the body, not just around our joints. People with symptomatic hypermobility can also experience conditions affecting the nervous system, digestive system, and other parts of the body.
Not everyone with hypermobility will develop these conditions, but understanding some of the common overlaps can help you better recognize and manage your symptoms. [1, 2]
1. Dysautonomia and POTS
Your autonomic nervous system helps regulate functions like heart rate, blood pressure, digestion, and temperature regulation. Dysautonomia occurs when this system doesn't regulate certain functions as effectively as it should.
One form, Postural Orthostatic Tachycardia Syndrome (POTS), involves an excessive increase in heart rate when moving into an upright position, along with symptoms of orthostatic intolerance.
Common symptoms may include:
Dizziness or lightheadedness when standing
Racing heart or palpitations
Fatigue and brain fog
Exercise intolerance
Difficulty regulating body temperature
What about cooler weather?
Heat tends to be a more common trigger for POTS symptoms, but winter brings its own considerations. Cold weather can change blood vessel responses, and people may drink less water when they aren't feeling hot or thirsty. Indoor heating, hot showers, and transitions between temperatures can also affect symptoms.
Maintaining consistent hydration, following your healthcare provider's recommendations for electrolytes or compression, and adapting exercise to your tolerance can be helpful. [2, 4]
2. Mast Cell Activation and Histamine-Related Symptoms
Mast cells are immune cells involved in allergic and inflammatory responses. Some individuals with hEDS or HSD report symptoms associated with mast cell activation. Mast Cell Activation Syndrome (MCAS) is a specific condition that requires appropriate medical evaluation and diagnostic criteria.
Potential symptoms include:
Flushing
Itching
Hives
Gastrointestinal upset
Episodes involving multiple body systems
Although associations between hypermobility and mast-cell-related symptoms have been reported, the underlying relationship is still being investigated. Having hypermobility alone does not mean someone has MCAS. [2]
What about cooler weather?
Temperature changes can trigger mast-cell-related symptoms in some individuals. Moving between cold outdoor air and heated indoor spaces may be uncomfortable for people who are temperature-sensitive. Layering clothing, identifying individual triggers, and working with a healthcare provider to manage symptoms may help.
3. Chronic Fatigue, Pain, and Migraines
Fatigue is one of the most common challenges reported by people with symptomatic hypermobility. When muscles are constantly working to help stabilize joints, everyday tasks may feel more physically demanding. Sleep disturbances, chronic pain, and other overlapping conditions can add to that fatigue. Migraines and widespread pain conditions are also reported in people with hEDS and HSD. [1]
What about cooler weather?
Some people report more pain or stiffness during cold weather, although research hasn't established that colder temperatures consistently worsen joint pain for everyone.
Shorter days, changes in sleep, reduced activity, and shifts in daily routines may also contribute to how you're feeling.
Keeping a consistent movement routine, getting adequate rest, and recognizing when your body needs recovery can be especially valuable.
4. Digestive and Gastrointestinal Conditions
Digestive symptoms are another common part of the hypermobility picture. People with hEDS or HSD may experience reflux, irritable bowel syndrome (IBS), bloating, constipation, diarrhea, or other gastrointestinal symptoms. [1, 2]
Although these issues may not change directly with the weather, seasonal shifts in eating habits, hydration, stress, and physical activity can influence digestion. Maintaining regular meals, staying hydrated, and discussing persistent symptoms with your healthcare team can help you develop a sustainable approach. Hypermobility and Cooler Weather: Understanding Your Body and Staying Active This Season
Five Ways to Prepare Your Hypermobile Body for Cooler Weather
You don't need to overhaul your entire routine as temperatures change. Small, intentional habits can make a meaningful difference.
1. Keep Moving, Even When It's Cold
It's tempting to stay curled up indoors when temperatures drop, especially if you're experiencing pain or fatigue. But prolonged inactivity can make it harder to maintain the muscular strength and endurance that support your joints.
Consider:
Short indoor walking breaks
Gentle mobility exercises
A manageable strength-training routine
Stationary cycling or other low-impact exercise
Shorter, more frequent bouts of activity when needed
The goal isn't to push through symptoms. It's to find a level of movement your body can consistently tolerate. [3]
2. Prioritize Strength Over Stretching
If you're hypermobile, you may already have more joint mobility than you need. Rather than repeatedly stretching into your end ranges, consider emphasizing exercises that improve muscular support and movement control.
Some examples include:
Squats or sit-to-stands
Bridges
Rows
Controlled step-ups
Balance exercises
Core and hip strengthening
Start with a manageable range of motion and increase resistance gradually. Strength training can help your muscles better support your joints and improve confidence with everyday activities. [3]
3. Stay Hydrated Throughout the Day
It's easy to forget to drink water when it's chilly outside. For people who also experience POTS or orthostatic intolerance, keeping up with fluid intake can be particularly important.
Keep a water bottle nearby, establish regular hydration habits, and follow your medical team's guidance about sodium or electrolyte intake. Remember that more salt isn't appropriate for everyone, particularly people with certain cardiovascular, kidney, or blood pressure conditions. [4]
4. Warm Up Before Heading Outside
Cold mornings can make it harder to feel ready for movement, particularly if your body already feels stiff or uncomfortable. Before heading out for a hike, walking the dog, or playing a round of disc golf, give yourself a few minutes to warm up.
Try gentle marching, controlled squats, arm circles, or light resistance exercises. The goal is to increase circulation and prepare your muscles for activity, not to force your joints into their maximum range.
5. Learn to Pace Yourself
One of the most valuable skills for people with hypermobility is learning to balance activity and recovery. You may feel great one day and be tempted to accomplish everything on your to-do list, only to experience increased symptoms afterward. Try breaking larger tasks into smaller sessions, planning recovery time, and monitoring how your body responds over the next day or two.
For people who experience post-exertional malaise (PEM)—a delayed worsening of symptoms after physical or mental exertion, traditional exercise progression may not be appropriate. Activity needs to remain within individual energy limits rather than pushing through crashes.
Consistency matters more than intensity, and recovery is part of progress.
How Physical Therapy Can Help
At Outshine Physical Therapy & Fitness, we believe being hypermobile doesn't mean you need to stop doing the activities you love.
It means your body may benefit from a more individualized approach to movement.
Physical therapy can help you:
Build strength and stability. Strengthening the muscles surrounding your joints can improve support, reduce unnecessary strain, and make everyday movement feel more secure.
Improve proprioception and body awareness. Proprioception is your body's ability to recognize where your joints are in space. Some people with hypermobility have difficulty sensing joint position, particularly near the ends of their range of motion. Targeted exercises can improve awareness and control.
Develop better movement strategies. Whether you're hiking, lifting weights, playing pickleball, or simply navigating your day, we can help you find movements that feel stable and sustainable.
Adapt exercise to overlapping symptoms. If you experience fatigue, orthostatic intolerance, or other symptoms, your exercise program should account for those challenges. That might mean beginning with supported or seated exercises, adjusting rest periods, or progressing more gradually.
Build confidence in your body. Perhaps most importantly, physical therapy can help you understand which activities are appropriate, how to manage flare-ups, and how to gradually build capacity without constantly worrying about injury.
These principles are consistent with recommendations emphasizing individualized strengthening, movement control, and gradual progression for people with hypermobility. [3, 4] There is no one-size-fits-all exercise program for hypermobility. What works beautifully for one person may need significant adjustments for another.
That's why individualized care matters.
You Don't Have to Put Your Life on Hold This Winter Hypermobility and Cooler Weather: Understanding Your Body and Staying Active This Season
Living with hypermobility can feel complicated, especially when joint symptoms overlap with fatigue, dizziness, digestive concerns, or other conditions. But cooler weather doesn't have to mean giving up the activities that make you feel strong, healthy, and connected to your community.
By understanding your symptoms, preparing for seasonal changes, and building a movement routine that works with your body, you can continue making meaningful progress.
At Outshine Physical Therapy & Fitness, we help people with hypermobility build strength, improve stability, and return to the activities they love through every season.
If you're struggling with joint pain, instability, or uncertainty about how to exercise safely, we'd love to help.
Ready to feel stronger and more confident in your body?
Schedule a one-on-one physical therapy evaluation with Outshine Physical Therapy & Fitness in the Asheville and Weaverville area.
References
Hakim, A. (Updated 2024). Hypermobile Ehlers-Danlos Syndrome. GeneReviews®, University of Washington, Seattle.https://www.ncbi.nlm.nih.gov/books/NBK1279/
Aziz, Q., Harris, L. A., Goodman, B. P., Simrén, M., & Shin, A. (2025). AGA Clinical Practice Update on GI Manifestations and Autonomic or Immune Dysfunction in Hypermobile Ehlers-Danlos Syndrome: Expert Review. Clinical Gastroenterology and Hepatology, 23(8), 1291–1302.https://doi.org/10.1016/j.cgh.2025.02.015
The Ehlers-Danlos Society. (n.d.). Physical Therapy.https://www.ehlers-danlos.com/physical-therapy/
Fu, Q., & Levine, B. D. (2018). Exercise and non-pharmacological treatment of POTS. Autonomic Neuroscience, 215, 20–27.https://pubmed.ncbi.nlm.nih.gov/30001836/
This article is for educational purposes and is not a substitute for individualized medical advice. Persistent dizziness, recurrent fainting, allergic-type reactions, and significant gastrointestinal symptoms warrant appropriate medical evaluation.
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