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The sensory environment

Understanding the sensory differences which can occur with hypermobility and the impact at school


We have eight senses: taste, smell, touch, sight and sound plus the sense which tells us where our limbs are (proprioception); one which helps us to maintain balance and know where we are in relation to the space around us (vestibular sense) and one which is the inner sense of knowing if you are hungry or not, hot or cold, thirsty, need the toilet or are tired (interoception). It is the system that helps sense what is happening in the body.  If there are problems with proprioception, vestibular sense or interoception, the likelihood of trips and falls increases, especially in crowded places.

People with JHS or EDS often have poor proprioception, making them appear clumsy and uncoordinated. This can also increase the likelihood of injuries such as joint sprains. Some recent research suggests that people who are hypermobile may also have altered interoception. This sense also affects the interpretation of emotions or emotional regulation. For example, a pupil might have a racing heart, tense muscles and shallow breathing but might not realise they are feeling the emotion of fear. This can also apply to awareness of hunger, thirst or needing to use the toilet. Pupils with JHS or EDS may be in constant pain and not recognise a new pain until it suddenly overwhelms them. Or they are simply unaware that their ankle has perhaps dislocated as they are used to pain which would be overwhelming for other pupils.

There is evidence that anxiety is more common in people who are hypermobile and possibly in those who have JHS or EDS but the link is not understood. Anxiety can be mental or emotional in origin. However, it can also be a type of physical anxiety from the dysfunction of the body’s involuntary nervous system which in turn leads to further anxiety.  The labelling of emotional states  may need to be different for pupils with JHS or EDS as anxiety may just be a part of their condition.