Ehlers-Danlos Syndrome, Hyper-Mobility, and Posture

Ehlers-Danlos Syndrome, Hyper-Mobility, and Posture

Ehlers-Danlos Syndrome (EDS) and other hyper-mobility conditions are much more common than people realize. It seemed like a great thing to have as kids, being called double-jointed and doing great in sports requiring flexibility. But the reality is flexibility and instability are not the same. EDS and other hyper-mobility conditions end up in many musculoskeletal and posture issues later on. Most often, the symptoms are not considered different ‘chapters’ of the same ‘book’. In this blog, I cover the musculoskeletal aspect of EDS and the top 3 exercises I do with hyper-mobile patients.

While not curable, there are many stability exercises you can do to bring more structure to your movement and posture! The lack of which can lead to many issues including pelvic floor dysfunction!

What is Ehlers-Danlos Syndrome?

According to the Mayo Clinic, “ Ehlers-Danlos syndrome is a group of inherited disorders that affect your connective tissues — primarily your skin, joints, and blood vessel walls… People who have Ehlers-Danlos syndrome usually have overly flexible joints and stretchy, fragile skin.”. Again, for this blog, we will focus on the effects EDS has on connective tissue such as tendons and ligaments. We will also discuss how this impacts posture and movement.  

Now, connective tissue such as tendons and ligaments are responsible for holding your many joints together. Tendons connect muscles to the bones and cross over joints making movement possible. Ligaments connect bone to bone playing a vital role in joint stability. 

These connective tissues, in someone who has EDS or other hyper-mobility conditions, have more laxity compared to someone without it. This means less stability in the joints including the joints throughout the spinal column making up the:

  • Lower back
  • Mid-back
  • Neck
  • And pelvis

Now let’s discuss how this impacts posture and can contribute to pain. 

Does Ehlers-Danlos Syndrome Cause Bad Posture?

Hyper-mobility of the joints that come with Ehlers-Danlos Syndrome contribute to poor posture and dysfunctional movement. But that does not have to be the case! Although hyper-mobility cannot be cured, there are things you can be doing to bring stability to the hyper-mobile joints which we go over in the next section.  

Looking at the picture below you can see the complexity of the ligaments surrounding just the torso, pelvic region, shoulders, and arms. For people with EDS, these ligaments allow for more movement within a joint compared to that of a non-hypermobile person. What is considered a normal range of motion in the elbow joint for example, a person with EDS would be able to go into what is called hyper-extension (or extension beyond the norm). This applies to every joint, not just the elbow.

ligaments highlighted on skeleton

Although hyper-mobility is a quality that is unfortunately desirable in specific sports like gymnastics, dance, or ballet, what is ignored is the dysfunction that comes with it. The video below best explains dysfunctional movement vs functional movement. It’s like driving home sober vs drunk. You may still reach your destination, but the quality of the drive, and how you got from point A to point B, are not the same.

Unfortunately, banging up he car is not going to be a surprise when intoxicated. The ‘car’ is the body of the hyper-mobile/EDS person that is constantly impacted as a result of instability in posture and movement.

Functional Movement and EDS

Depending on the degree of hyper-mobility in our patients, we find a collapsed posture displaying little structural integrity. Through functional movement assessments, the same lack of stability is seen in movement. For someone with EDS, in the example above, it’s like driving drunk 24/7. You have to be more alert and aware of your movements to avoid injury and stop doing things that “feed” your dysfunction.

Fortunately, with Developmental kinesiology type exercises, such as DNS, over time, it is easy to impact the blueprint of movement in the brain, making the movements and posture more functional vs dysfunctional.

When it comes to posture and functional movement, full body stabilization is the key. Find out how to achieve this in the section below! Bear in mind that the exercises shown are just a sample of what we do at our clinic to achieve the results our patients are looking for.

Best Postural Stability Exercises for Ehlers-Danlos Syndrome

With every EDS patient, the priority is stability and what we find works the best is Dynamic Neuromuscular Stabilization (DNS) exercises which involve:

  • Breathing
  • Core Stability ( including the whole spine, neck, and pelvis!)
  • Whole Body Functional Movement 

In my blog, How to Improve Posture with DNS, I mention that, “Dynamic Neuromuscular Stabilization or DNS is a new rehabilitation approach (but nothing new!), from The Prague School of Rehabilitation and Manual Medicine, that utilizes the developmental movement pattern that every person around the world follows to develop proper movement and body function from around 3 months of age throughout the first years of life.”. 

Why reinvent the wheel when we already know what works and makes sense? This is how we all, as babies, develop functional movement patterns and proper stabilization to go from being a helpless newborn to rolling over, crawling, walking, then running. So we re-walk this path to restore proper function always.

The 3 steps below are the basics of what it takes to be stable and move functionally. This is where we start with all EDS patients. 

Breathing 

The most important thing is the very first thing we all did when we were born which is to breathe. Believe it or not, almost every patient we see is doing it incorrectly! Watch the video below to understand how to breathe properly (engaging the barrel) and why it’s important for every musculoskeletal condition, especially EDS. 

Core Stabilization and EDS

Once the breathing is corrected, you have what it takes to start building the core stabilizing muscles. If you are thinking of abdominal crunches, you are mistaken. In the video below, I share what we all did as 3 to 4-month-old babies. That is developing the oblique muscles necessary for core stabilization, connecting the mid-back to the lower back, and for the whole spine to ‘dance’ in unison! 

No babies ever lift weights, see a PT or a chiropractor, or take supplements to boost their muscles and movements. We are all programmed to follow the same path of movement! So why not use that to strengthen what is needed and move gracefully as we are meant to move? Common sense, right?

Full Body Functional Movement 

Once the basics of breathing and core stabilization are established, you can try something we all did at around 9 months of age! It’s important not to mechanically reproduce a movement or exercise but to do so functionally.

If movement is like a concert, the body parts are the musicians! The spotlight is focused on one musician while the others play in the background. In movement, this means every part of your body does its job while the spotlight is on the mover. In the video below, the spotlight is on the legs and glutes while the torso stabilizes and the arms ‘dance’ with the legs! 

I Have Hyper-Mobility. Where Do I Start?

If you have Ehlers-Danlos Syndrome or other hypermobile conditions and are not sure where to start when it comes to correcting your movement, posture, and getting out of pain, contact us. Just because hyper-mobility cannot be reversed does not mean you do nothing! Strengthening joints and overall stability is vital in preventing injuries such as dislocations/subluxations which are common to those who are hypermobile.

It is common to have pelvic floor dysfunction associated with hyper-mobility, but this is typically overlooked. My blogs on pelvic floor dysfunction explore the many presentations of pelvic floor dysfunction. Use the link to find out how addressing postural stability, many of the symptoms and signs of pelvic floor dysfunction go away.

If you think you have a hyper-mobility condition, or have EDS with mobility, spine, or musculoskeletal issues, and need help, contact us.

Dr. Shakib