Beighton Score Calculator

What Is the Beighton Score?

The Beighton Score is a widely used clinical screening tool that assesses generalized joint hypermobility (GJH). Developed by Peter Beighton and colleagues in 1973, it is a simple, standardized 9-point scoring system that evaluates flexibility at specific joints in the body.

Joint hypermobility refers to joints that move beyond the normal range of motion. While often benign, significant hypermobility can be associated with connective tissue disorders such as Ehlers-Danlos syndrome (EDS), chronic pain, and increased injury risk.

The Beighton Score evaluates 5 types of maneuvers, 4 of which are performed bilaterally (left and right), giving a maximum score of 9:

• 5th finger dorsiflexion (2 points — left and right)
• Thumb apposition to forearm (2 points — left and right)
• Elbow hyperextension (2 points — left and right)
• Knee hyperextension (2 points — left and right)
• Forward trunk flexion with palms on floor (1 point)

The 9 Beighton Tests Explained

How to Perform Each Test

Interpreting Your Score

Hypermobility vs. Ehlers-Danlos Syndrome

It is important to distinguish between benign joint hypermobility and hypermobile Ehlers-Danlos syndrome (hEDS):

The 2017 diagnostic criteria for hEDS require: (1) GJH (Beighton ≥ 5), (2) two or more features from a list including skin and tissue fragility signs, musculoskeletal complications, and family history, and (3) exclusion of other heritable connective tissue disorders.

Age, Sex & Ethnic Factors

Joint hypermobility is influenced by several demographic factors:

• Age: Flexibility naturally decreases with age. Children and adolescents often score higher than adults. The 2017 criteria use a higher cutoff (≥ 6) for prepubertal children and adolescents.
• Sex: Females generally have greater joint laxity than males, with studies showing significantly higher Beighton scores in women across all age groups.
• Ethnicity: Individuals of African, Asian, and Middle Eastern descent tend to have higher baseline flexibility compared to those of European descent.
• Physical training: Athletes in certain sports (gymnastics, dance, swimming) may develop increased flexibility that inflates their Beighton score without indicating pathological hypermobility.

Clinical Use & Brighton Criteria

The Beighton Score is part of larger diagnostic frameworks:

Brighton Criteria (1998)

The Brighton criteria for benign joint hypermobility syndrome (BJHS) use the Beighton Score as a major criterion alongside other features:

• Major criteria: Beighton score ≥ 4 (current or historical), arthralgia > 3 months in ≥ 4 joints
• Minor criteria: Beighton 1–3, arthralgia in 1–3 joints, history of dislocation, soft tissue lesions ≥ 3, marfanoid habitus, skin abnormalities, eye signs, varicose veins

2017 International EDS Classification

The most current classification requires the Beighton Score as Criterion 1 for hEDS diagnosis, with age-adjusted cutoffs:

Managing Hypermobility

If you score high on the Beighton Score and experience related symptoms, the following strategies may help:

• Strengthening exercises: Focus on muscles around hypermobile joints (especially core, quadriceps, and shoulder stabilizers) to provide dynamic joint stability.
• Proprioception training: Balance and coordination exercises help the nervous system better control joint positioning.
• Avoid hyperextension: Consciously keep joints in a slightly flexed position rather than locking them into hyperextension during daily activities.
• Pacing activities: Balance activity and rest to manage fatigue and prevent overuse injuries.
• Pain management: Physical therapy, gentle aquatic exercises, and appropriate medication can help manage chronic pain.
• Joint protection: Use splints, braces, or taping when needed during activities that stress vulnerable joints.
• Specialist referral: If your score is high and you have chronic symptoms, consult a rheumatologist or geneticist for comprehensive evaluation.

Frequently Asked Questions

Can my Beighton Score change over time?

Yes. Joint flexibility naturally decreases with age, so your score may be lower as you get older. Previous injuries, surgeries, or progressive joint degeneration can also reduce your score. Conversely, consistent flexibility training may increase it.

Is a high Beighton Score always a problem?

No. Many people with high Beighton scores are completely asymptomatic and live without any joint-related issues. Benign joint hypermobility is considered a normal variant. Problems arise when hypermobility is accompanied by pain, instability, dislocations, or other systemic symptoms.

What if I can perform a test on one side but not the other?

You simply score 1 point for the side that is positive and 0 for the other. Asymmetric results are common and normal. Previous injuries to one side may reduce flexibility on that side only.

Should children be tested differently?

The same 9 maneuvers are used for children, but the diagnostic cutoff is higher (≥ 6 for prepubertal children) because children are naturally more flexible. Children who lose significant flexibility by adolescence may still have a historical positive score that is clinically relevant.

Can the Beighton Score diagnose Ehlers-Danlos syndrome?

The Beighton Score alone cannot diagnose EDS. It is one component of a larger diagnostic workup. For hEDS, additional criteria involving skin, tissue, musculoskeletal, and genetic factors must also be met. For other EDS subtypes, genetic testing is required.