Feet & Ankles
Foot and Ankle Instability and Gait Changes in Hypermobility
We're not podiatrists or physical therapists. This page is a summary of published research on hypermobility and gait, meant to give you specific studies to raise with a specialist, not a substitute for seeing one. Rolled ankles, arches that seem to give way, and shoes that never quite fit right are common complaints among people with hEDS/HSD, and there's now research measuring what's actually happening mechanically when hypermobile feet walk.
This is one of the better-evidenced clusters on this site: the studies here are specific and the findings are fairly consistent.
How Hypermobility Changes Gait and Walking Pattern
A 2022 case-control study compared 23 people with hEDS/HSD to 23 controls and measured multisegment kinematics: how individual joints in the ankle and foot move in relation to each other during walking, rather than treating the foot as one rigid unit. It found altered movement patterns in the hEDS/HSD group. That's a mechanical finding. Something measurably different is happening in how the ankle and foot segments move together during gait.
Balance Training for Hypermobile Ankle Instability
A 2023 prospective cohort study followed 40 people with chronic ankle instability (20 with generalized joint hypermobility and 20 without) through three months of supervised balance training. Both groups benefited. The study's own conclusion is worth stating plainly: hypermobility is not a contraindication to conservative balance training. That matters because it's easy to assume hypermobile joints are too unstable for standard rehab approaches to help. This study specifically tested that assumption and found it didn't hold up.
Footwear for Hypermobile Feet: Guidance vs. Evidence
Stability or motion-control footwear, including brands like On Cloud, Brooks Adrenaline, and Hoka, is recommended by the Ehlers-Danlos Society and by at least one hypermobility specialty clinic (Tulane). That's clinical guidance from people who treat hEDS/HSD patients regularly, not a randomized trial testing these specific shoes against alternatives. That doesn't make it worthless, but it's a different tier of evidence than the gait and balance-training studies above, and worth naming as such.
Do Orthotics and Ankle Braces Help Hypermobility?
Custom or semi-custom orthotics and ankle braces are generally discussed in this research as something obtained through a podiatry referral and fitted to the individual foot, rather than picked off a shelf. Given how variable hypermobile feet can be from one person to the next, that individualized fitting is part of what the approach is built around.
What to do with this
If ankle rolling or foot pain is a recurring issue, a podiatry or physical therapy referral for a gait assessment is a reasonable starting point. The 2022 study above shows there's something specific and measurable to look for, beyond "weak ankles." It's also reasonable to ask directly whether supervised balance training is appropriate for you; the 2023 study suggests it can help even with confirmed joint hypermobility.
On footwear, it's fine to mention the specific brands named by the Ehlers-Danlos Society and specialty clinics as a starting point for a conversation. But a fitting from a podiatrist or orthotist, informed by how your own gait actually moves, will tell you more than any shoe recommendation can on its own.
Sources referenced on this page
- 01Case-control study, 2022 — n=46 (23 hEDS/HSD vs. 23 controls)
- 02Prospective cohort study, 2023 — n=40 (20 with generalized joint hypermobility vs. 20 without), all with chronic ankle instability
- 03Ehlers-Danlos Society and Tulane hypermobility specialty clinic footwear guidance (link not yet sourced)