Types of Splinting and Bracing for Hypermobility Syndromes. - Jo Southall, Independent OT (2025)

There are many different types of splints for different uses. When deciding what will suit you there are lots ofpoints to consider. So here goes, my run down on different methods of supporting your joints.

Neoprene or Elastic Supports

These are often fairly basic lightly shaped stretchy sleeves you simply pull on, commonly available for supporting extremities like your wrists, elbows, knees and ankles. They offer light support and some proprioceptive feedback so they can help minimise the clumsy kind of injuries that bendypeople get so often! Stretchy supports like these also allow for swelling after acute injuries ¹ .

Pro’s

• A simple wrist or ankle support will often set you back less than £10 I’ve even seen them in pound shops!
• You can usually wear pull on supports like this under clothing or shoes without it being obvious at all.
• Each support will have its own washing instructions but generally you can just pop it in the washing machine on a delicate setting like you would for clothing and you’re good to go!
• They are widely available in sports shops and high street chemists so no need to order online or wait months to see an orthotist.

Con’s

• Supports like this usually come in 4 colours, black, bright blue, not-quite-white and something that’s supposed to be ‘beige’. Not exactly sleek and stylish.
• During the hotter months of the year lining your joints with neoprene can be really sweaty and this can easily lead to skin irritation².
• Cheap pull on splints like this usually come in limited sizing af if you fall out side the ‘normal’ ranges you might struggle to find something that fits.
• Pulling on supports like this can be really hard especially if you have problems with your wrists or fingers.
• Because of the limiting shaping I find the fabric bunches up, especially behind my knees.

Off the rack (OTR) Compression

Compression clothing is usually made with tight, stretchy materials but is often much thinner than neoprene stuff. Compression is becoming increasingly popular with bendyfolks, especially sporty ones. Compression stuff provides good proprioceptive feedback which can improve balance and spatial awareness. The compression stuff with reinforcements can help improve posture too. For people with PoTS (Postural Tachycardia) compression clothing can help manage blood pooling and prevent syncope too.

Pro’s

• Improved posture and proprioception, ability to manage blood pooling and reduction in syncope.
• The sports compression can have a sporty look and feel, I like this as, I sometimes prefer to feel like an injured athlete than simply a walking disaster!
• The compression is lighter than neoprene supports so it can be much more comfortable.
• Good range of colours available as ‘sports compression’

Con’s

• Often the high quality compression clothing like ‘Skins’, ‘bio-skin’ and ‘Inteli-skin’ can be pretty expensive.
• The lighter compression might not be supportive enough for particularly wonky joints.
• Although my joints are pretty unstable I do have good muscle tone, this causes one bug problem. I can still hyperextend through a lot of different kinds of splints. With compression clothing there isn’t much to actually prevent you from hyperextending, its more about encouraging your joints into the correct movements.
• Full body compression can be very hot, so if you’re heat intolerant then be careful.
• Getting in and out of compression can be a bit of a mission, make sure you have time for a rest afterwards before you need to go out!

Custom Compression

For those who have tried OTR compression and found it good-but-not-great there is another option. Custom fit compressions stuff. Lycra Suits are becoming increasingly popular with children especially kids with dyspraxia and cerebral palsy as well as hypermobility syndromes like EDS. Orthotists seem less keen to prescribe it to adults but if you state your case many will relent and sort you out with some. You can have a full body suit or just sections like shorts or socks or gloves. This works in much the same way OTR compression does but there are a couple of major differences. Having zips and velcro added means that getting into your compression stuff is much easier, and having it custom-made means that it fits a lot better. With OTR compression tops I found that the smaller sizes supported my shoulders but squashed my boobs badly andthe bigger size fit my boobs but was too loose around my shoulders. With custom-made this isn’t a problem.

Pro’s

• Made especially for you so the fit should be perfect.
• You can choose your own patterns and colours although some of the best fabrics aren’t available for adults unless you specifically ask.
• Easy to get on and off than OTR compression due to zips
• Highly customisable so if you need more support later down the line the suit can be sent back and added to.

Con’s

• Very difficult to get without the help of an Orthotist. It is possible to contact the companies directly but they work almost exclusively with hospitals.
• If you gain or lose weight you might well need a whole new suit made.
• Because of the highly specialised nature of the garments it can take weeks to get a suit made, if you need repairs it can take weeks too.

Fabric splints with metal stays (activity splints)

This is the sort of splint you will usually get from hospital departments, often wrist and thumb splints they are beige monstrosities made of fabric that have removable metal bits in. Outside the NHS they are available in a few different colours and styles, some have removable stays others have them sewn in. These supports work fairly similarly to the pull on elastic ones, the fabric fives light support but in this case the metal stays can prevent movement in certain directions. These splints are good for short-term use, for example, you could basically immobilize your wrist while lifting something heavy then take off the splint for lighter jobs ⁴ . Splints like this can be very restrictive so wearing them for too long leads to stiffness and loss of muscle tone quite quickly.

Pro’s

• The splint does a lot of the work so you can take a lot of the strain off your joints during intense activity.
• The metal stays can be bent to fit your body so the fit can be very specific.
• Great for immobilizing joints during very unstable phases, like after a dislocation.

Con’s

• Immobilizing joints for long periods of time can cause loss of muscle tone very quickly, immobilizing can also lead to stiffness ⁵ .
• The restrictive nature of the splints can make some activities very difficult, if you can’t use your hands joints normally then you can end up developing odd habits and doing things awkwardly.
• The metal support stays can dig in.
• The fabric and velcro can be uncomfortable and cause skin irritation.
• NHS braces like this almost always come in beige.

Hyperextension Blocking Splints

Splints like this are my personal favourite. These are splints that are designed to allow ‘normal’ movement but block hyperextension, examples of these are hinged (cage) knee braces and oval-8 finger splints. This type of splint doesn’t provide support or compression they just stop your joints from going places they aren’t supposed to.

Pro’s

• Provides a relatively normal range of movement ⁶ .
• This kind of splint doesn’t squish or compress so if you have issues with swelling your braces will probably still fit!
• Low surface area, hinged knee braces are very supportive while being pretty low profile, they have the hinges and straps and nothing else.
• I actually think they look pretty sleek compared to neoprene.

Con’s

• EXPENSIVE – I got my knee braces through the NHS but if I’d bought them myself I would have had to spend upwards of £200 each.
• They are highly restrictive in ‘danger’ directions, they block you from twisting your knees etc so they can take some getting used to if your ‘normal’ movement patterns are very bendie.
• They are pretty bulky and are hard to hide under clothing. I tend to just go with it and try to look cool anyway. 😉

Custom Plastic Splints

These come in a few different types like thermoplastic hand therapy splints or AFO’s (ankle braces) usually custom-made by medical professionals and moulded to fit your body. The plastic they are made of is heated until it turns soft and then draped over/around your body or a mould of the limb needing splinting. ⁷

Pro’s

• Very very specific fit so they shouldn’t pinch or gape at all, well made custom splints are usually really comfortable.
• You can usually chose the colour and sometimes even the patterns.
• Having the splint made just for you means the amount of movement allowed is just what you need, in my ankle braces I can point and flex my foot but I can’t roll my ankles even when stood on one leg!

Con’s

• The plastic can be pretty sweaty and people with very delicate skin can end up with contact dermatitis quite quickly.
• Hinged AFO’s (Ankle/ Foot orthosis) like mine are very difficult to fit into shoes!!
• Some thermoplastics have a pretty low melting point, I have spoken to people who’ve melted their splints while washing up in hot water or using a hairdryer!
• They need to be made by an expert so you’ll have to wait for an appointment, you can’t just buy them off the internet.

Kinesiology Tape

Kinesiology Tape is becoming increasingly popular, I first saw it on professional athletes on TV but it was a few years before I actually tried it on myself. Once I did I got hooked. I use tape a LOT.. I buy in bulk and generally have about 4 or 5 different colours around the house at any one time. Kinesiology tape provides dynamic support which can also help improve proprioception ⁸ . Physiotherapists can tape so if you think it might help you then ask your Physio or check out YouTube for tutorials. A lot of taping is trial and error so don’t give up if it doesn’t seem to work well to start with.

A few quick tips…

• When applying tape, make sure the area you’re taping is exfoliated, clean, dry and hair free. If you’ve done all of this and tape isn’t sticking you can try a tape adhesive spray. I use Mueller’s Tape Adhesive and it works for me.
• If you’re taping so you can exercise try to tape about an hour before you start getting hot and sweaty, this gives the tape adhesive time to stick to you properly.
• If you’re cutting your own tape from a roll then trim the corners off each section. Rounding off the edges makes it less likely that the corners will roll up and peel off.
• The first half an inch of tape should be applied without stretching. Just stick it down and make sure its well stuck before you start adding tension. The same goes for the final half-inch, don’t stretch it just stick it down. This helps the tape stay stuck down.
• If your tape is starting to peel at the edges don’t feel like you have to take it all off and start again just trim the peeling edges with small scissors or tape it down with micropore.

Hope some of that helps!

Pro’s

• Tape can be hidden almost completely under clothing (depending on where you’ve taped).
• You can choose your colours.
• No need to keep fiddling with velcro or taking off splints so you can get changed or go to bed, just tape and leave it. (Tape can last me as long as a week or so)
• Sporty look and feel as supposed to looking and feeling medical.
• You can tape areas its hard to splint, like your back and shoulders.
• You can tape under other splints for extra support.

Con’s

• Some people, particularly those with Classical or Vascular EDS are just simply tape resistant. A good friend of mine can only keep tape on for about half an hour before it peels off, it doesn’t matter what extra measures are in place or how good the tape is!
• Skin irritation. A lot of people with hypermobility syndromes have quite delicate skin, some people find that peeling off the tape tends to peel off their skin too. A lot of the ‘professional sports tapes’ (that cost a lot more) tend to have stronger adhesives, this is good because they stay on longer, but for bendyfolks this can just mean they peel off more skin! My personal favourites are Levo Tape and Rea Tape. Rock Tape, 3NS TEX, Kinesio and KT also come highly recommended by bendyfriends.
• Its single use, you’ll need to re-tape a joint each time so it takes longer than splinting and is also more wasteful.

There are specific types of braces that don’t really fall into any of these categories, splinting is a constantly evolving industry and more and more advanced splints are released every year. Sports splinting is becoming increasingly high-tech and low profile. There are also advanced custom-made braces that are in categories all of their own but if you’re in need of these you’ll probably have an orthotist who knows a lot more about it all than me! Hopefully this post will give you some guidance as to what splints will suit your needs.

As always I’d love to hear your experiences and if you have anything to add I’d be pleased to hear it.

I do hope this has been useful, please let me know what you think.

JBOT

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