How does hypermobility impact the singing voice? To find out, we spoke to voice coach and blogger Sarah Algoet.

With about one in ten people having hypermobile joints, singing teachers are likely to come across hypermobility in the singing studio at some point.

So what does this mean in the context of voice use and how can teachers best support singers with hypermobile conditions?

To find out we spoke to vocal coach Sarah Algoet, who is hypermobile.

What is it?

First, let’s start with the statistic that one in ten people have hypermobile joints. This essentially means that their joints have an unusually large range of movement.

Many people who fall into this category will not experience any problems. 

“Hypermobility presents differently in everybody,” Sarah says. “It’s possible that you’re asymptomatic or that you’re only experiencing the positive symptoms.”

However, hypermobile joints can be an indicator of Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HDS), both of which are associated with a range of symptoms including pain, fatigue, instability and a bigger risk of injury.

What causes hypermobility?

People with hypermobility have weak collagen. As a result, the connective tissue, which provides support to the bones, blood system and muscular-skeletal system, is weakened and too stretchy.

Symptoms

These can vary from person to person but may include:

• Pain and stiffness in the muscles and joints.
• Poor balance/co-ordination.
• Higher propensity to injury.
• Tiredness.
• Thin/stretchy skin.
  
  

Other considerations

Hypermobility is more common in women. People who are neurodivergent also have a higher prevalence of hypermobility.

A significant number of people with hypermobility also have Postural Orthostatic Tachycardia Syndrome (POTS).

POTS is a condition where your heart rate spikes abnormally. People may experience dizziness or fatigue when they stand up or faint.

Hypermobility and the voice

What kind of issues might hypermobility throw up in the singing studio?

“Hypermobility can be an asset if you’re a gymnast, guitarist, pianist, yogi or ballet dancer because of the bigger range of motion,” Sarah says.

“And, as hypermobility is about our joints, and our larynx is a big collection of joints, it can sometimes be an asset for singers too.”

Singers who are hypermobile may:

• Have a flexible voice making riffs and runs easy to master.
• The ability to easily change vocal quality or register.
• An extended vocal range.
• Access to whistle register. “I’m not saying that they naturally can control it very easily, however, the access tends to be pretty easy.”
• Easy access to a breathy, intimate vocal quality. (Whisper-pop singer Billie Eilish is hypermobile.)

However, singers may also experience other, more challenging, issues such as:

• Voice problems. Overuse can occur more quickly, and lead to vocal fatigue, hoarseness, loss of stamina and voice-related pain.
• A tendency to push when singing.
• Vocal instability, such as the sudden loss of function and progress. This can lead a singer to view their voice as unreliable and inconsistent – and trigger heightened performance anxiety.
• Skeletal issues like jaw and tongue tension.

Diagnosing hypermobility

It’s not within the remit of a singing teacher to diagnose hypermobility.

However, the Beighton Score, a nine-point scale used to assess joint hypermobility, can be a useful indicator. (If you score five or higher, then you are considered hypermobile.)

“If we think it could be an issue, we can do the test [with the student] and say, ‘I suspect that you have hypermobility; it might be interesting to discuss this with your doctor’,” Sarah says.

“We might do this especially if the student is presenting with other symptoms that could be linked, such as POTS.”

On the other hand, if a student’s hypermobility is not very high on the spectrum and it’s not causing them any issues, they may decide not to bother with a formal diagnosis.

Supporting hypermobile singers

What constitutes good practice for hypermobile singers is good for all singers. It’s just worth being aware that hypermobile singers can experience injury or fatigue more quickly than others.

Here are some things singing teachers can do.

• Provide training in microphone technique and in-ear monitoring (to combat the propensity to push).
• Remind singers to be mindful when going to the limits of their range and singing with high volume.
• Encourage good vocal hygiene with extra focus on SOVTs.
• Reinforce the importance of hydration. “I do not think that a nebulizer is a luxury for a singer, especially a hypermobile singer,” Sarah says.
• Provide tools to manage anxiety.
• If a singer also has POTs, allow them to sit when they need to.
• Provide proprioceptive stimulation because proprioception is often a challenge for hypermobile people

Learn more

Listen to the Singing Teachers Talk podcast, where Sarah discusses her own experience with hypermobility and shares her favourite resources on the topic.