What Are The Symptoms Of Hypermobility?

What Are The Symptoms Of Hypermobility?

Hypermobility, hypermobility spectrum disorders (HSD), and Ehlers-Danlos syndrome (EDS), all refer to connective tissue disorders, a condition that occurs later on in life but something you are born with. This blog is about the symptoms of hypermobility. From a musculoskeletal perspective, it is your joint’s excess movement and soft tissue laxity that impact how stable your posture and movement are. It means your pelvis, for example, connected to your lower extremities and spine, becomes easily unstable, leading to pelvic floor dysfunction. While there is a gene associated with EDS, the treatment and presentations of EDS and other forms of hypermobility are the same.

The Pelvic floor is the ‘floor’ of the house, with the pelvis being the ‘house’ so how can the floor be stable when the house is unstable? While every person with hypermobility and its versions has pelvic floor dysfunction, every person with pelvic floor dysfunction does not have joint hypermobility. In this blog, we are going to explore what the common signs and symptoms of hypermobility are so if you happen to be reading our website blogs because you have pelvic floor dysfunction, you get to see if the many other issues you may be experiencing that you are considering as separate problems are different faces of the same problem called hypermobility.

Who Gets Hypermobility Or EDS?

While more common in females than males, it is not gender or age-specific. As children or teenagers, we tend to ‘shine’ in activities such as ballet, gymnastics, cheer, acrobatics, and dance because of our abilities to go to the extreme range of motion but that comes with a price which is injuries and aches and pains in as early as teenage and early 20s to much later stages of life.

I look at hypermobility and movement like driving. Instead of driving at the crosswalk, bendy bodies go into the crosswalk, or past the crosswalk and into the intersection when stopping. That is where the spectrum of hypermobility changes.

What Are The Signs And Symptoms Of Joint Hypermobility?

The following list can be discouraging and that is not the purpose of this blog. It is so you see that so many of your symptoms that you might have considered as separate problems are different chapters of the same problem. While the condition does not go away, managing your health is the focus of this blog and all blogs that I write. What matters is to make sure you seek care from those clinicians who treat the hypermobile population or at least show interest in wanting to learn more to help the bendy friends.

While there are so many people with hypermobility who don’t know they are hypermobile, the ‘generic’ treatments do not apply to you as a bendy person. What works for the other population may be damaging to you. Please make sure to contact my office for a provider near you and also consult the EDS Society for the list of providers.

  • Joint Hypermobility

Joints are generally lax and easy to hyperextend. This is from the laxity in the connective tissues such as ligaments.

  • Pelvic Floor Dysfunction

This is because the pelvis, just like all the other parts, is not stable because the connective tissue is loose, and the support structures and proprioception are not as strong. Also because the soft tissue, including the internal organs, is too ‘loose’, it is easier to have prolapse or excess movement of the internal organs. This means it is easier for the bendy person to have prolapse and incontinence though they are not the only presentations of pelvic floor dysfunction. Please make sure to read my blog on this subject.

  • Joint Pain

There does not need to be an incident related to the pain and it can be something as simple as getting out of pain. This can happen in the ankles and hips, shoulders and wrists, back and knees. Joint pain is the most common complaint of the bendy population,

  • Dislocations And Subluxations

Subluxations are excess movement just before dislocation. It is common to see rib and jaw subluxations, and shoulder and hip subluxations without any apparent reason.

  • Jaw Pain And Tooth Grinding

I see so many cases of jaw pain and this happens because of the excess movement at the jaw joint. The pain happens because the ‘disc’ that has blood vessels and nerve ending between the ‘ball’ and socket’ of the TMJ gets pushed on and does not glide with the bones. It is also common to see the jaw locking in the open position which is then an emergency room visit to numb the area to put the joint back in place.

  • Rib Cage Pain

Oftentimes, because of the excess movement on the joints, the connection between the ribs and the spine in the back or the sternum in the front is easily subluxated causing pain on both or one side with movement, when sleeping or at rest. That is why breathing biologically is so important for the bendy population.

  • Headaches

The connection between the skull and the neck is commonly weak and unstable in the hypermobile population. This is referred to as CSI or CranioSacral Instability. This can cause headaches in the form of tension and when coupled with blood vessel complications, can also show up as migraine headaches.

  • Foot And Ankle Pain

Once again, all joints in hypermobility and EDS are involved and when it involves the foot and ankle, given that they have to balance the structure above (the body), it is so common to have sprained foot and ankle or pains in those areas. At my clinic, we focus heavily on the feet and ankle stability and the device I like almost all of my patients have is ToePro.

  • “Clumsiness” And Poor Proprioception

Most bendy persons call themselves clumsy while as children or teenagers, they have a history of performing tasks that others simply could not do. The clumsiness happens because the joints are not stable and the poor proprioception, while still being studied, in my opinion, comes from not being stable enough in any given position, long and often enough to establish what it takes to end with a stronger proprioception.

  • Soft Or Stretchy Skin

Because hypermobility is a connective tissue condition, it is easy to have more elastic skin.

  • Muscle Weakness

Weakness in the muscles happens because all soft tissue is more lax and joints don’t have the full collection of nature’s best tools needed for stability. This means that muscles are pulled into the picture out of sync. sometimes much longer than they are designed to be and for tasks that are not the specific muscles’ tasks. Weak muscles happen as a result of being overworked and tired or not being used enough so they are not conditioned. In the world of pelvic floor dysfunction, this can mean too tight or too ‘weak’ of the pelvic floor.

  • Fatigue

The level of ‘chaotic’ order of use of the body only means tiredness and fatigue. Lack of sleep does not help the matter either. Also, there seem to be low levels of testosterone in women that should be measured since the low levels cause a lack of energy, fatigue and not building muscles.

  • Allergies

Mast Cell Activation is a common finding among the hypermobile and as a part of its activation, histamine is released. Histamine leads to allergies so a ‘bug’ bite can easily turn into a blister that lasts a long time before it heals.

  • Increased Healing Time

This again happens as a result of mast cell activation and soft tissue involvement.

  • Bruising

Blood vessels are soft tissue and with the involvement of the blood vessels and their rupture, it is easy to get a bruise.

  • Digestive Issues

Gastrointestinal problems are common as a result of dysautonomia which is a common finding of the bendy population. Dysautonomia is when the sympathetic and parasympathetic nervous systems do not control each other so if for instance, the stomach acid is produced for digestion, it is not downregulated by the parasympathetic nervous system when enough of it is produced to digest the food. Dysautonomia impacts all functions of the body and requires the autonomic nervous system to control the functions.

  • Constipation

A great example of dysautonomia is constipation which is a multidimensional issue. So while movement of the food along the intestine is an autonomic nervous system function, it is also controlled by the function of a muscle called puborectalis. When that muscle is tight, it does not relax enough for the fecal material to go down the colon to exit. The tightness can easily happen as a result of pelvis instability. Most often people think of constipation as a nutrition-related issue and while nutrition plays a role, it is not the only factor to consider.

  • Orthostatic Intolerance Or POTS

Postural orthostatic tachycardia syndrome, or POTS, is an increase in heart rate when standing up from a lying position which can cause dizziness and nausea. This is a result of dysautonomia discussed before. POTS is another common presentation among the hypermobile population.

  • Flat Feet Or Pronated Arch

The arches of the feet may be flattened or collapsed because of joint instability.

  • Anxiety

Another presentation of dysautonomia is anxiety which unfortunately gets treated with psychiatric medications while it is the lack of control of the parasympathetic vs sympathetic nervous system.

  • Heat And Cold Intolerance

Here comes another way dysautonomia can show up: controlling the constriction vs dilation of the blood vessels is the function of the autonomic nervous system which is impacted by hypermobility.

  • Swelling In Hands And / Or Feet

When blood vessels dilate but don’t constrict accordingly, the hands and feet can get swollen.

  • Daily Aches And Pains

With all that I listed, you can see how so many functions of the body are compromised and how the unstable joints can be taxing to the supportive structures causing aches and pain. The question to the bendy population is not if they have no pain but how intense their pain is each day.

There seems to be a high incidence of scoliosis and neurodivergence such as ADHD, and autism but I don’t necessarily see that across the board.

What To Do Next If You Are Hypermobile?

If you are hypermobile regardless of if you have pelvic floor dysfunction or not, please make sure you seek care from clinicians who have experience working with the hypermobile population. We are connected to other providers and chances are we may know someone in your area that treats hypermobility. Once again, you can use the directory on the EDS Society for a provider near you. Look on social media and ask around; whatever you do, make sure you educate yourself about your condition and be an advocate for yourself.

Please contact me regardless as I may be able to point you in the right direction; of course, for those close to me, do not hesitate to contact my office for an appointment and those from other states or far away, contact me for a coaching session. 

Dr. Shakib

Hypermobility And Pelvic Pain

Hypermobility And Pelvic Pain

You may have heard of Ehlers Danlos Syndrome or EDS, Hypermobility Spectrum Disorder or HSD or hypermobility but not associated it with pelvic pain because you know that it is a connective tissue disorder that also has joint instability and pain. While most hypermobile individuals are aware of the general joint pain and overall postural instability, most people miss the connection between pelvic pain and postural instability. In this blog post, we’ll break down the basics, exploring what hypermobility is, what factors can contribute to pelvic pain, and why the connection between hypermobility and pelvic pain is often overlooked.

What Is Hypermobility?

Hypermobility is a connective tissue disorder that affects all connective tissue in your body and can show up with many faces. In this blog, we are looking at how it can impact the joints and postural stability, and how they contribute to pelvic pain. Imagine driving a car and reaching an intersection; with hypermobility, instead of stopping at a crosswalk, you drive onto the crosswalk, and depending on the spectrum of hypermobility, you may end up in the intersection! This is what extreme range of motion, subluxation of the joint, and dislocation are like.

I recommend you refer to my Hypermobility Collection blogs to understand more about hypermobility.

What Causes Pelvic Pain?

Pelvic pain is a common complaint, affecting both men and women. While infection and issues related to reproductive issues can cause pelvic pain, it is the muscle spasm, lack of synchronicity of the soft tissue, and the misfiring (or relaxation) of the muscles in movement. The last factor, muscle involvement, is the main issue with the bendy population and their postural stability challenge.

Why Pelvic Stability?

The pelvis serves as the foundation for the spine and plays an important role in supporting the body’s weight, movement, and balance. Yet, its significance is frequently overlooked when assessing and addressing pelvic pain. Pelvic stability is the key to a healthy and pain-free pelvis. When the pelvis lacks stability, various issues can arise, including pain and discomfort.

How Is Hypermobility Linked To Pelvic Pain?

Joint stability is a challenge among the bendy population because of the connective tissue involvement.  The pelvic region, being a complex network of bones, muscles, and connective tissues, is particularly vulnerable to instability in hypermobile individuals. This happens as a result of:

  • Joint Hyperextension / Hyperflexion

Hypermobile individuals tend to go beyond the normal range of motion and this impacts the stability of the joint. The soft tissues that are to support stability become the sole provider of support and when the natural design and progression of soft tissue involvement changes, injuries and pain are expected. This unnatural movement puts strain on the surrounding muscles and ligaments, contributing to pelvic pain over time.

  • Muscle Imbalance:

Hypermobility can result in muscle imbalances as certain muscles work overtime to compensate for the lack of joint stability. In the pelvic area, this imbalance can lead to tightness, spasms, and ultimately pain.

  • Connective Tissue Strain:

Serving as a scaffold, connective tissue plays a crucial role in maintaining the shape and integrity of organs while allowing communication between different tissues to provide proper functioning of the body’s complex architecture. The connective tissues that hold the pelvic bones together can get strained due to hypermobility leading to inflammation and pain.

  • Impact On Pelvic Floor Muscles:

You cannot have an unstable pelvis without impacting not only the pelvis but the spine and hips which are connected to the pelvis. You also cannot have issues with the pelvis stability without impacting the muscles outside and inside the pelvis; this includes the pelvic floor which is the floor to the ‘space’ that holds your internal organs such as the intestine, bladder, uterus and ovaries, or prostate. When the whole area is unstable and not strong enough to perform its job, inflammation and pain occur.

The biggest mistake in my opinion is to give medication for pain without addressing the cause, or only work on the muscles of the floor internally, thinking the issue is solved.

Why Is Pelvic Stability Important For Pelvic Pain And Hypermobility?

You can’t fix the ‘floor’ when the ‘house’ is unstable, right? Then how is it that when it comes to the health of the pelvis, hypermobility or not, we don’t attend to the right things first? If you are in pain, sure, take medicine to make your day easier but what are you doing about the cause of your pain? Broaden your focus lens to address the root of the problem which can be more than one factor. The one thing that has to be present is the stability of the structure which has the issue. That is irrelevant to what else is going on and should not be put off because you may have other issues related to the area!

If you have pelvic floor dysfunction, if you are hypermobile, if you have had many doctor visits and are still feeling lost and without understanding what is going on, contact me, I can help. We now have a telehealth coaching option for those far away and overseas.

Dr. Shakib

Pelvic Floor Dysfunction In The HyperMobile Population

Pelvic Floor Dysfunction In The HyperMobile Population

Pelvic floor dysfunction is much more common than most realize. While not everyone with pelvic floor dysfunction has hypermobility, every hypermobile person has pelvic floor dysfunction. As bold as this statement may seem, in this blog, we will explore the following:

  • What pelvic floor dysfunction is
  • Why do all hypermobile individuals have pelvic floor dysfunction
  • How to address postural instability which is the common denominator between pelvic floor dysfunction
  • Hypermobility, who to seek treatment by, and where to start

What Is Pelvic Floor Dysfunction?

Pelvic floor dysfunction refers to a collection of symptoms ranging from incontinence and pelvic pain to chronic pain in the tailbone, sacroiliac joint, and lower back to poor posture. While the ‘stories’ as to why it is present in an individual may vary from a person to a person, the common theme is the presence of postural instability. You can read about the subtle and not-so-subtle signs and symptoms of pelvic floor dysfunction in a blog I have written.

While women who have gone through childbirth and individuals of advanced age are commonly associated with pelvic floor issues, it is essential to recognize that pelvic floor dysfunction can affect anyone, regardless of age or gender. Another fact to consider is that because hypermobile individuals lack stability in the transitional sections of their body with the connection of the lower back spine to the pelvis being one of those transitional areas, all bendy bodies have pelvic instability and therefore pelvic floor dysfunction.

How Are Posture, Pelvic Instability And HyperMobility Related?

If pelvic floor dysfunction was the name of a book, it would have many chapters with pelvic instability being one of them. The pelvis is the base and foundation of the torso with the legs connected to them. This base not only has to manage the ‘structures’ above but has to somehow do so while the legs do the ‘walking’ and with any limitations or dysfunctional movements in the lower extremities, this job of stabilization becomes even harder. With this lack of stability of the pelvis, the ‘house’ that the pelvic floor is the ‘floor’ of, it is hard to avoid pelvic floor dysfunction.

Hypermobility often affects multiple joints, including those in the pelvic region, making it difficult for individuals to maintain a stable and aligned posture.

What Is HyperMobility?

Hypermobility is a condition where joints move beyond the normal range of motion. It is a connective tissue disorder typically due to increased mast cells, the type of white blood cells that lead to histamine production. While those individuals with hypermobility have other non-musculoskeletal (muscles, joints, ligaments, and bones) symptoms, we will focus on the postural and movement presentations that typically exist with hypermobility.

There is a difference between flexibility and instability and hypermobility is instability that may appear as being flexible. Most hypermobile individuals at some point in their life, primarily younger years, shine in the field of gymnastics, acrobatics, ballet and dance, cheer, or sports excess movements put them at a higher level of notice.

This only becomes problematic because the structures that support the joint end up going beyond their roles to stabilize the joint and since the ‘job’ of these structures is to support the move and not necessarily become the main ‘stabilizers’, they get injured and damaged.

When it comes to the pelvis, it is a foundation for the spine and the entire musculoskeletal system. In hypermobile individuals, maintaining a stable pelvis becomes a significant challenge. As we move, stand, or sit, the pelvis may shift and tilt unpredictably; this instability can contribute to chronic pelvic pain, urinary and bowel issues, and a range of other symptoms associated with pelvic floor dysfunction that providers and people, in general, don’t necessarily associate with pelvic floor dysfunction.

How Are HyperMobility And Pelvic Floor Dysfunction Connected?

The instability in hypermobile individuals places strain on the pelvis, pelvic floor, pelvis wall, and whatever is connected to the pelvis. Simultaneously, the dysfunctional pelvis exacerbates pelvic instability, creating a feedback loop of discomfort and dysfunction on the hypermobile joints.

Poor posture, a common feature in hypermobility, feeds this cycle too. Slouched or misaligned postures can increase pressure on the pelvis and contribute to pelvic instability. As hypermobile individuals may struggle to maintain a consistently stable posture, the risk of pelvic floor dysfunction increases.

How Is Pelvic Floor Dysfunction Addressed In The Bendy Bodies?

Recognizing the connection between hypermobility, posture, and pelvic floor dysfunction is the first step toward effective management and prevention. A holistic approach that combines whole body exercises vs specific regional exercises, lifestyle modifications, and understanding the positions, movements, and activities that put the body in a more vulnerable state is crucial in the treatment of pelvic floor dysfunction in all populations, hypermobile or not.

I wrote a blog on a comprehensive treatment list for pelvic floor dysfunction and when it comes to the hypermobile, EDS, hEDS, HSD, and MCAS population, I STRONGLY suggest seeking clinicians that TREAT the same population. Being able to treat and knowing what these acronyms stand for are not the same.

In my practice, treating a high number of the hypermobile population I can assure you that the response, awareness, strengths, and weaknesses of the bendy bodies are unique and different from the non-bendy people and many subtle and non-subtle factors can easily be missed if the clinician is unaware.

As explained in my blog, the treatment length varies depending on the following factors:

  • “The extent of the instability of the pelvis
  • How dysfunctional your movement is [and bendy bodies have a higher than average number of dysfunctional patterns of movement]
  • How balanced you are with movement
  • What portions of your brain with regards to balance and coordination are weak
  • Are the muscles in your lower back, hips, and pelvis moving in coordination or skipping function
  • How strong is your cortical connection (the connection of the brain to the body part when it comes to following a command) is
  • How motivated you are in performing the exercises you are given
  • How compatible your work environment is
  • How weak the muscles of your lower back, hips, and pelvis (internal and external) are
  • If you have any comorbidity such as EDS, other hypermobility, nerve, or tissue association with your pelvic floor dysfunction
  • If you have had any surgeries or scar tissue”

Who Do I See If I am HyperMobile And Have Pelvic Floor Dysfunction?

Seek care only from clinicians who are familiar with the hypermobile population; consult the EDS society website for the clinicians near you, ask other bendy friends, your existing providers, and social media!

Make sure you have a short session with the provider you are considering to see how their method of treatment is different and how much of their practice is the hypermobile population. Finding a clinician that does functional movement and stability, pelvic floor dysfunction and treats hypermobility is not common but not unheard of.

My practice has a high majority of hypermobile patients because of the style of movement practices that I guide them through and because of my overall mission of teaching them how to be so they can live their lives the way they wish to live. A combination of functional movement, pelvic floor dysfunction, and hypermobility care and awareness has allowed me to help many, and am here to help you either myself or with a referral elsewhere if I know someone in your area. Do not hesitate to contact me.

Dr. Shakib