Hypermobility, hypermobile joint syndrome, EDS, HSD, MCAS, and hEDS are terms that are used interchangeably, all being connective tissue disorders. While the connective tissue is targeted with these conditions, other symptoms and signs are commonly seen such as:

  • POTS
  • Cranio-cervical instability (CSI)
  • Headaches
  • Chiari malformation
  • Digestive issues
  • Increased heartbeat
  • Anxiety
  • Pelvic instability
  • Wrist and ankle pain
  • Hip, elbow, and knee pain
  • Unexplained swelling of feet and hands
  • Clumsiness
  • Some sort of daily pain and/or bendy-ness in joints

In my practice, I see many patients with pelvic floor dysfunction and hyper-mobility who have no idea they have it hypermobility. They have suffered and been gaslit throughout their life by other doctors, health care providers, and family members. This blog looks into the correlation between the pelvic floor, hypermobility, and pelvic pain.

How Are Connective Tissue and The Pelvis Related?

The pelvis is the base of your spine and torso, and its stability directly impacts how you maintain your balance and movement. It is the ‘house’ that the pelvic floor is the ‘floor’ of and holds important organs such as the uterus, ovaries, prostate, intestine, and bladder. The 3 pieces of the pelvis are connected to each other, the spine, and hips with ligaments and tendons. Any laxity of those connective tissues leads to instability of these structures to say the least.

Unstable joints, when used, become painful to the point that sometimes breathing can cause pain. Breathing, by the way, impacts the pelvis (positively when done right and negatively when done wrong). The connective tissue connecting different parts of the pelvis to the tailbone can be involved in causing pelvic pain with walking, sitting, standing, and at rest.

With the laxity of the connective tissue, other soft tissue takes on the roles that are beyond their ‘workload’. This then can lead to tension in muscles that the hypermobile person experiences while they appear ‘normal’ to an untrained clinician. It is of utmost importance for the bendy population to seek care and advice only from clinicians who have treated hypermobility vs learning about it from a text book.

Does Posture Play A Role In Pelvic Pain & HyperMobility?

With hypermobility and its associated pelvic floor dysfunction, instability shows as flexibility. Joints sublux often which means they go beyond where they need to stop. That is like stopping in the middle of an intersection vs at the crosswalk. When it comes to pelvis instability, this means pain in the lower back, hip pain, labral tear, compressed soft tissue, clicking when moving, and forward or backward pelvic tilt.

Hyperextension of the knees, a common finding with hypermobility, pushes the top of the thigh bone toward the front of the hip socket causing pain in the hip joints. The integrity of movement and joint functionality of the hips directly impact the pelvis, what it holds inside, and what supports its stability. You cannot have a strong pelvic floor if the ‘house’ is unstable.

What Is The Holistic Treatment For Pelvic Floor Dysfunction And Pelvic Pain?

Hypermobility is a condition that you are born with and managing different ‘chapters’ of that ‘book’ is something that you should invest your time in. When it comes to postural instability impacting the pelvis, pelvic pain, and pelvic floor dysfunction, here are my recommendations to my patients:

  • Breathing

Learning proper biological breathing techniques is underestimated and undervalued and yet, it should be the focus of every musculoskeletal condition. This breathing is what we all did as babies and is not a version of breathing but is the core breathing that we know from studying babies. Place your hands on the side of your rib cage and as you breathe through your nose, push your sides outward. Not as easy as it sounds but certainly something you will be able to do easily with practice.


  • Postural Neurology

This is how we can see what the blueprint of your movement looks like and then present you with exercises that strengthen what seems to be weak from the assessment. To learn more about postural neurology, visit my website on functional mobility.

  • Functional Mobility Exercises

That means rehabilitating what is weak and tight with movement exercises. The question is which ones? To isolate an area to work it out is a mistake IMO. Your body works as one unit and working out an area in isolation is not going to solve the problem. With that said, I am a huge fan of developmental exercises such as Dynamic Neuromuscular Stabilization. If a helpless infant can become a running toddler without going to a gym and if we all have gone through that process, then common sense tells me that those are the right exercises to do and my brain and body are already familiar with them. Why reinvent the wheel?

  • Lifestyle Changes

Your lifestyle directly impacts your body and the wrong choices in a hypermobile person can make a much more negative impact. This goes from nutrition to workspace, to sleeping styles, and exercises. I strongly suggest you visit my blog on lifestyle.

  • Supportive Garments

In some cases, individuals with hypermobility may benefit from wearing support garments like high-top shoes and garter belts that go higher up to the belly button. Also things like rolling a towel or small blanket at the bottom of their feet on the bed to limit ankle extension.

Hypermobility is not a life sentence and learning how to manage it brings great comfort to your day. You can visit the EDS website for the list of providers familiar with the bendy population. If you have pelvic floor dysfunction and are hypermobile, I strongly encourage you to contact me.

Dr. Shakib