How would you differentiate a hypermobile spinal segment from a hypomobile one clinically?

• A. Hypermobile segments show reduced motion.
• B. Hypermobile segments show no motion at all.
• C. Hypomobile segments show excessive motion.
• D. Hypermobile segments show excessive or unstable motion and may feel lax or give-way during testing.

Answer: (D)

The main idea is how much a spinal segment moves and what the end-feel feels like during a clinical exam. A hypermobile segment moves more than normal and can feel unstable because the supporting structures are allowing extra excursion. On palpation or during passive motion testing, you may notice the segment gliding farther than expected and even give-way or a lax sensation as you attempt to restrain it. Patients often describe a sense of instability or the segment “going out” with loading, and pain can be reproduced with motion because the excess movement stresses the joints and surrounding tissues.

In contrast, a hypomobile segment is stiff and restricts motion. You’ll see reduced range, a firmer end-feel, and diminished joint play, sometimes with muscle guarding that further limits motion. The key distinction is: hypermobile = excessive motion with potential laxity; hypomobile = limited motion with stiffness.

So the description of excessive or unstable motion and a lax or give-way feeling during testing best fits a hypermobile segment.