HyperMobility, Pelvic Floor, and Pelvic Pain

HyperMobility, Pelvic Floor, and Pelvic Pain

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

Can Hyper-Mobility Be Cured?

Can Hyper-Mobility Be Cured?

Hyper-mobility is diagnosed more now than ever before. The most common type of hyper-mobility diagnosed these days, Ehlers-Danlos Syndrome (EDS), comes with a collection of issues that have historically been looked at as separate issues. This blog explores hyper-mobility, can hyper-mobility be cured, what the proper treatment is, and how to live with hyper-mobility.

What is Hyper-Mobility ?

Hyper-mobility is a condition in which a person’s joints are too loose, or double jointed as it is commonly known. It can affect any joint in the body, but is more common in the:

  • Fingers
  • Wrists
  • Elbows 
  • Hips 
  • Knees
  • Ankles
  • Feet
  • Shoulders

People with hypermobility often feel pain, stiffness, and decreased stability. This can lead to difficulty with everyday activities like walking, running, and lifting. In my office, I find that our hyper-mobile patients display a collapsed-unstable posture and dysfunctional movement patterns.

Can Hyper-Mobility Cause Pain & Affect Movement?

I mention in my last blog, “When it comes to hypermobility, what is often ignored is the impact on movement, posture, and joint health. Because the ligaments and structure of a hypermobile joint allow for excess movement, the following must be considered:

  • Increased risk for joint dislocation
  • Postural instability 
  • Dysfunctional movement 
  • Increased risk of musculoskeletal injury 
  • Pelvic Floor Dysfunction 
  • Pathological breathing patterns 
  • Lack of coordination and balance 

Typically a hypermobile person visits different doctors for different issues and in our practice, we connect the dots! At that point, it becomes obvious that their hyper-mobility either adds to their problem or is the root cause of their issue(s).

The most logical and effective way to create stability in otherwise unstable joints of the hyper-mobile individual is through  Dynamic Neuromuscular Stabilization and Postural Neurology. That is duplicating the methods with which the” helpless infant is able to become the strong, running toddler.”

Can Hyper-Mobility Be Cured? 

There is no cure for hypermobility, however, there are treatments that can help alleviate the symptoms associated with the condition. The goal of most hyper-mobility treatments is to help strengthen weakened muscles, improve flexibility and range of motion, and reduce pain. This may also include things to improve balance, coordination, and overall function. Another important factor often skipped is lifestyle changes to help in managing hypermobility.  

While there are braces and supports in an attempt to stabilize the joints of hypermobile individuals, some are in fact helpful while others are not.

What Does Hyper-Mobility Treatment Look Like?

Whether you see a chiropractor or physical therapist remember that no 2 providers are equal when it comes to the treatment provided. When seeking treatment I suggest looking for a provider that is trained in Dynamic Neuromuscular Stabilization and Postural Neurology although I have yet to come across another office that provides both like we do.  

When it comes to the joints and movement in hypermobile individuals, the comprehensive treatment should include:

  • Biological Breathing

This is not belly breathing or deep breathing, but breathing the we all have done as babies and what all babies across the globe do. This allows the optimized breathing apparatus to become a tool assisting in the foundation for stability in posture. Watch this video to learn how.

  • Core and Full-Body Stabilization

This is accomplished using Dynamic Neuromuscular Stabilization; in short, DNS is based on the fact that all babies across the world go through the same stages of movement development without any training or coaching. This means that the best and most suitable way to rehab an unstable joint is the way we were programmed to go from a helpless infant to a running toddler.

  • Postural Neurology

There is a map of all your body parts in the brain that dictate the progression of movement, a blueprint of a kind. This map changes, negatively or positively, based on many factors including lifestyle choices, habits, and trauma to name a few. For example, in the case of hyper-mobility, this map can be changed positively if exposed to positive stimulation by rehabilitating based on the common sense of DNS.

Postural Neurology is finding out what the status of the faculties designed to impact our balance and coordination is and through proper activation of the weak parts, reinstating the foundation to stability and coordination of function which are compromised in hypermobile individuals.

  • Lifestyle Modifications

When it comes to hyper-mobility there are a few important things to watch out for. First, wearing braces at night to guard the accidental over-stretching of the joints such as wrists and ankles is helpful. Another thing is Sleeping on the stomach should be avoided at all times. If working behind a desk use an exercise ball as a chair to stimulate the brain. As for ergonomic modifications, it is important to pay close attention to the chair and keyboard size.

Dr. Shakib