Is Joint Hypermobility The Same As EDS?

Is Joint Hypermobility The Same As EDS?

Joint hypermobility is a result of a connective tissue disorder impacting the joints specifically. Ehlers-Danlos Syndrome (EDS) is a connective tissue disorder impacting all connective tissues including the joints. Do you see the connection?

Joint hypermobility is one of the presentations of Ehlers-Danlos Syndrome which is one version of a connective tissue disorder. Joint hypermobility, therefore, is not exclusive to EDS. There are conditions such as Hypermobility Spectrum Disorder or HSD, Marfans, Scleroderma, and Sjogrens, that clearly are not EDS but still exhibit joint hypermobility.

What is important to note is that the hypermobility treatment for all of these conditions, which may have variations in other associated symptoms, is the same.

Is Joint Hypermobility The Same As Flexibility?

No. A person is flexible when their muscles, tendons and ligaments can stretch, can shorten, and can resume their neutral length when indicated. With joint hypermobility, the ligaments are too lax and don’t contract the same way. That is in fact, one of the reasons why the Bendy community’s proprioception, the knowledge of where you are in space at any given time, is not their strongest forte.

How Do I Know If I Have A Subluxated Joint?

When it comes to explaining mobility and stability to my hypermobile patients, I explain their joint hypermobility like driving a car and stopping at the crosswalk, vs going a little bit into the crosswalk, vs going more into the crosswalk, vs going past the crosswalk, vs going all the way into the middle of the intersection.

Hypermobility degrees vary from one hypermobile person to another. When you are ‘in the middle of crosswalk’ is when you have gone past subluxation and into the dislocation zone. Being on the end side of the crosswalk is where subluxation resides! This is when you are hypermobile and can tell if you are subluxated or not.

The picture below shows hypermobility of the left hip, knee, and ankle, pushing the limits toward subluxation but not there yet. She is in the middle of the crosswalk, so to speak! 🙂

woman on a bench doing a yoga pose with overextended knee

What Is The Treatment For Joint Hypermobility?

The treatment for joint hypermobility has to be done with the help of rehab. clinician who is familiar with EDS, HSD, and other connective tissue disorders that involve the joints. The Bendy and Normie treatments are NOT the same and will hurt the hypermobile individual.

I always tell my hypermobile patients who are the majority of my practice that when it comes to moving our house, we package our belongings differently. Sometimes we just through the items in a box, and tape it  and with some of our treasured belongings, we bubble wrap them carefully, mark the box and then tape it. We don’t abandon the valuable belongings because we don’t want to break them, nor do we skip the bubble wrapping, right? We are not any different and this goes for everyone and not just the hypermobile.

The focus of the treatment has to be the recognition of what is not safe, learning how our joints like to move and since the connective tissue, which means everything but your bones essentially, is lax, we need to bring in more of the right muscles working together to provide a safer move. THIS is where the rehab world fails also.

Once you understand the mechanics of movement, it is through repetition without compromising the principles of movement that you build strength. This goes for everyone btw.

Who Treats Joint Hypermobility?

All rehab clinicians who treat hypermobility are a good fit. Rehab clinicians are not just physical therapists but chiropractors and occupational therapists who do exercise with patients are great fits. The key is they must know how to treat hypermobility.

I am for instance a chiropractor by license and adjust patients on occasion though my hypermobile patients are not adjusted in certain areas (such as neck) unless I have clarity of certain presentations. The adjustments are NEVER the same as those of the Normies no matter what. With that said, my practice is fully focused on functional movement and postural stability. This is the reason why I see so many patients with joint hypermobility.

I do brain and body exercises that are NOT the same as a gym workout or generic exercises. I know that my hypermobile bodies behave differently and have specific needs. I do Developmental Exercises that are gentle and easy to do on the joints but challenging for my hypermobile patients. What I do in my practice as a chiropractor is not the same as a high majority of my colleagues.

How Do I Find The Right Clinician For My Hypermobility Treatment?

Consult the EDS Society provider list, call and interview the office. Do a web search, read the reviews, and contact the office. See if you can have a short time with the clinician; trust your gut feeling and make sure the provider understands the joint hypermobility presentations. Ask the related closed groups that you belong to and still go through the process to vet the provider.

If you have Ehlers-Danlos Syndrome, Hypermobility Spectrum Disorder, Mast Cell Activation Syndrome, or other connective tissue disorders causing joint hypermobility, contact me for a Solution Session or Telehealth Coaching.

Dr. Shakib

Hypermobility and Pelvic Wellness

Hypermobility and Pelvic Wellness

Pelvic health requires a balance in the pelvis, the house that the pelvic floor is the ‘floor’ of and hypermobility is more about instability vs flexibility. Hypermobility and pelvic health, therefore, are intimately related and important subjects to explore in this blog.  In this blog post, we’ll explore the relationship between hypermobility and pelvic wellness and provide tips for managing both conditions.

Hypermobility vs Instability

Hypermobility is a condition that affects the connective tissues in the body, causing them to be more flexible than normal. This can result in joints that move beyond their normal range of motion, leading to pain, inflammation, and instability. Hypermobility can be genetic or acquired, and is more common in women than men.

Hypermobility when at a younger age in elementary through even early 20s seems to be the advantage when doing gymnastics, cheer, acrobatics, and dance. This is always exciting and encouraging to participate in the activities that make you ‘shine’; however, the overuse of already unstable body parts over time will catch up later on mostly in the 30s and beyond.

One of the areas that can be most affected by hypermobility is the pelvic region. The pelvic floor is made up of muscles, ligaments, and tissues that support the bladder, uterus, and other organs. Of course, there is more to the dysfunction in the pelvis than just the internal organs. You can read all about what pelvic floor dysfunction can look like in my blog.

The Subtle Symptoms of Pelvic Floor Dysfunction?

Pelvic floor dysfunction can cause a range of symptoms, including incontinence, pain during sex, and chronic pelvic pain. Individuals with hypermobility may be more susceptible to developing pelvic floor dysfunction because the connective tissues in their body are less able to provide the necessary support. Here are the subtle signs of pelvic floor dysfunction that are most often missed and considered their own separate issues! You can learn more about this in my blog: ‘ Pelvic Floor Dysfunction Symptoms’.

  • “Lower back pain
  • Pain in the back joints of the pelvis (SI Joints)
  • Pain in the front pubic area
  • Arched lower back
  • Slouched lower back
  • Slouched mid-back or hunchback
  • Military posture with the chest pushed out
  • A V-stance where the torso is positioned behind the hip joints on the side view
  • Chronic forward neck
  • Inability to bend down below the knees
  • Habitually standing on one leg with the other leg bent
  • Chronic one-sided pain in the lower extremity
  • Hip pain on one or both sides”

Tips To Manage Hypermobility & Pelvic Wellness

  1. Exercise regularly but your exercises need to be low-impact and specific. I find Dynamic Neuromuscular Stabilization (DNS),  baby exercises, to be the most effective type of exercise. So much so that it has become the source of attraction among hypermobile and EDS individuals in my region.
  2. Practice good posture: Good posture helps reduce the strain on your joints and pelvic floor muscles which is easier said than done. I use Postural Neurology to work on the brain because if the brain gives the command to move and hold your posture a certain way, your body will follow. This is why gadgets and tools claiming to help you with your posture do NOT work! UNLESS they work on changing the map of movement (Homunculus) and posture in your brain the effects won’t last.
  3. Use proper lifting techniques: When lifting heavy objects, make sure to use proper technique to avoid putting unnecessary strain on your joints and pelvic floor. I strongly suggest you follow me on IG and subscribe to my YouTube channel for the specifics of movement.
  4. Maintain a healthy weight: Being overweight can put additional strain on the joints and pelvic floor muscles. This increases the risk of both hypermobility and pelvic floor dysfunction. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce this risk.
  5. Consider pelvic floor therapy: Not all physical therapists and chiropractors are trained in pelvic floor dysfunction and not every pelvic floor therapy treatment involves internal manual treatment. In my practice, I first start stabilizing the pelvis, the house that the pelvic floor is the floor of, BEFORE anything else. No sense in working on anything else when the whole house is shaky and unstable.
  6. Be mindful of your activities: if playing sports, take it easy during ovulation and/or menstruation when the level of relaxed soft tissue goes even higher.
  7. Hypermobile toes and ankles

    Hypermobility and Pelvic Floor Dysfunction

    Wear DuoJoint, a brace I have designed for hypermobile ankles to be worn at night to address the over-extension of the ankles and feet at night. This is important because your feet are the points of contact with the ground and without stable feet and ankles, everything above is unstable. DuoJoint at the time of writing this blog is not available but search for it online to see where you can purchase it now.

  8. Manage stress: Stress can contribute to both hypermobility and pelvic floor dysfunction. Finding ways to manage stress, such as meditation, yoga, or therapy, can help improve overall well-being and reduce the risk of these conditions.

Dr. Shakib

 

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