Hypermobility & Physical Therapy

Hypermobility Spectrum Disorders (HSD) include various conditions typically involving joint hypermobility. Joint hypermobility occurs when joints move beyond the normal range of motion. This is sometimes referred to as being "double-jointed" or "loose-jointed." While some individuals with hypermobility may not experience any noticeable issues, others suffer from feelings of joint instability, chronic pain, and fatigue, which can significantly affect their quality of life.

Not every healthcare provider is familiar with treating people with HSD. It is crucial that a clinician considers the whole person when assessing and treating anyone, especially someone with hypermobility. Some clinicians may focus only on the area currently causing pain. Often, patients with HSD have been compensating in an attempt to "stabilize" a loose joint. Addressing only the area of pain can lead to increased pain or issues elsewhere.

What is HSD?

HSD is a broad term that includes many different conditions. Ehlers-Danlos Syndrome, or EDS, is one of the most well-known types of HSD. HSD often involves connective tissue abnormalities, which can cause increased joint laxity. Long-term, patients can experience additional issues due to the increase in joint mobility.

Symptoms vary widely, but commonly include:

• Joint pain and instability

• Frequent joint dislocations or subluxations

• Muscle fatigue and weakness

• Soft tissue injuries

How does PT help someone with HSD?

1. Pain Management

Patients with HSD often find it strange that their muscles feel tight and painful, even though they are told their joints are loose. This may be because the muscles are overworking in an attempt to inefficiently “stabilize” the loose joints. Patients with HSD often respond well to treatments to reduce pain, including:

• Manual Therapy: Gentle hands-on techniques and soft tissue mobilization can help reduce muscle tension and pain.

• Dry Needling: This treatment technique uses thin needles to reduce pain associated with painful trigger points or “knots”. It can also improve muscle activation and relaxation.

2. Strengthening and Stabilization

Stabilization and strengthening exercises are important for improving joint stability and reduce the risk of subluxations and dislocations. Unfortunately, many people with HSD have found exercise to be painful or aggravating to their condition. This may be because the exercise program was too intense or was not developed with specific focus on what a person with hypermobility needs. We design an individualized program that may focus on:

• Targeted Muscle Strengthening: Exercises targeting specific muscles around lax joints can improve joint stability.

• Core Strengthening: A strong core provides better support for the entire body, reducing stress on hypermobile joints.

• Aerobic Exercise: Gentle aerobic exercise can improve overall health and reduce pain.

3. Proprioception and Balance Training

• Proprioception: Proprioception is the ability to know where your body is in space. Improving proprioception helps people with HSD become more aware of joint positioning, which can reduce the risk of injury.

• Balance: Balance exercises can also be beneficial and prevent falls or other injuries.

4. Flexibility and Range of Motion

While individuals with HSD often have increased joint mobility, it's essential to maintain range of motion without overstretching. We educate patients in safe stretching techniques to maintain motion while avoiding injury.

5. Education and Lifestyle Modifications

• Joint Protection Techniques: Strategies to avoid overstressing joints during daily activities.

• Activity Modification: Adapting activities to reduce pain and prevent injury.

• Ergonomic Advice: Education on posture and workspace setup to minimize strain and discomfort.

Each individual with HSD is unique. A one-size-fits-all approach doesn't work. We assess each client’s specific needs, tailoring interventions to address your particular challenges. We work with you to identify your goals and develop a treatment plan to achieve those goals. This personalized approach ensures that therapy is both effective and safe. We are careful in prescribing an exercise program to avoid flaring up symptoms. Through a comprehensive treatment approach, our goal is that you are able to lead a more active, pain-free life.

Have more questions? We’re happy to help. Contact us or schedule a complimentary phone consultation.