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

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