EDS Relief: How Physiotherapy Can Help You Move With More Confidence
Living with Ehlers-Danlos syndrome (EDS) can make everyday movement more complicated than it is for most people. Joints may feel unstable, muscles can become tired from constantly trying to provide support, and activities that seem straightforward to someone else may leave you sore or exhausted.
There is no cure for Ehlers-Danlos syndrome, but appropriate management can make an important difference to how some people cope with their symptoms. Physiotherapy can form part of that management, particularly when joint hypermobility, instability, recurrent strains and musculoskeletal pain are affecting everyday life.
At PhysioAction in Milford, our focus is on understanding the individual in front of us. With EDS and symptomatic hypermobility, that is particularly important because treatment needs to be adapted to your body, your symptoms and what you can comfortably tolerate.
What Is Ehlers-Danlos Syndrome?
Ehlers-Danlos syndromes are a group of inherited connective tissue disorders. Connective tissue provides support throughout the body, including around joints, skin, blood vessels and other structures.
There are different forms of EDS, and symptoms and risks can vary considerably between them. Hypermobile Ehlers-Danlos syndrome (hEDS) is particularly associated with generalised joint hypermobility, joint instability and musculoskeletal problems.
Someone with symptomatic hypermobility may experience joints that move beyond the typical range. While flexibility can sometimes appear advantageous, having more movement available does not necessarily mean the joint has better control or stability.
For some people, the muscles surrounding a hypermobile joint need to work harder to provide support. Over time, this can contribute to muscle fatigue, discomfort and difficulty tolerating certain activities.
Can Physiotherapy Provide EDS Relief?
Physiotherapy cannot change the underlying connective tissue disorder or cure EDS. Instead, treatment can focus on helping you manage some of the musculoskeletal problems associated with the condition.
The objective is generally not to make already-mobile joints even more flexible. For many people, the more useful goal is developing the strength and control required to manage the movement they already have.
Depending on your presentation, physiotherapy may focus on:
Improving muscular support around unstable joints
Developing balance and proprioception
Improving movement control
Gradually increasing physical capacity
Managing recurrent strains or sprains
Identifying movements that repeatedly aggravate symptoms
Finding sustainable ways to remain active
Building confidence in everyday movement
Treatment should be individualised because EDS varies considerably between people.
Stability Before Flexibility
Stretching is often recommended for ordinary muscle tightness, but someone with hypermobile joints may need a different approach.
A joint that already has excessive movement does not necessarily benefit from repeatedly pushing further into its available range. What feels like muscle tightness can sometimes be the body's attempt to create stability around an area that lacks sufficient support.
That does not mean people with EDS should never stretch. It means flexibility work needs to make sense for the individual rather than automatically assuming that greater range of movement is the goal.
Physiotherapy can help identify where mobility is genuinely restricted and where better muscular control may be more useful.
Building Strength Without Overdoing It
Strengthening can be particularly valuable for hypermobile joints because muscles contribute to joint stability. The challenge is finding an appropriate starting point.
Someone experiencing pain or fatigue may not tolerate a conventional gym programme immediately. Doing too much too soon can result in a flare-up that makes maintaining an exercise routine difficult.
A more sustainable approach may begin with manageable exercises performed with good control before progressively increasing resistance, repetitions and functional demands.
The Ehlers-Danlos Society recommends appropriate exercise to improve strength and joint stability, while emphasising that exercises should be adapted to the person's needs.
Progress can sometimes feel slower than you would like, but consistency and appropriate progression are usually more useful than repeatedly pushing hard and then needing extended periods to recover.
Why Proprioception Matters With EDS
Proprioception is your body's awareness of where a joint is positioned without needing to look at it.
When joint position awareness or control is reduced, a person may have difficulty recognising when a joint is moving towards a vulnerable position. This can contribute to awkward movement, instability or repeated aggravation.
Physiotherapy may therefore include controlled movement and balance exercises designed to improve awareness and coordination.
Rather than simply making muscles stronger, rehabilitation can work on how effectively your nervous system and muscles work together to control movement.
This can be especially relevant around commonly troublesome areas such as the shoulders, knees, hips, ankles and spine.
Managing the Boom-and-Bust Cycle
One challenge for people managing persistent musculoskeletal symptoms is the temptation to do everything possible on a good day.
You feel better, so you catch up on exercise, housework, gardening, work or social activities. The following day your symptoms increase significantly, forcing you to dramatically reduce your activity.
This can create a frustrating cycle of doing too much followed by doing very little.
Pacing aims to find a more sustainable middle ground. Instead of repeatedly testing your absolute limit, activity can be gradually increased based on what your body is consistently able to tolerate.
A physiotherapist can help you establish realistic starting points and progression targets, particularly when previous attempts at exercise have repeatedly resulted in flare-ups.
EDS, Fatigue and Exercise
EDS management is not simply about individual joints.
Fatigue can also affect how much activity someone can tolerate. If your muscles are working hard to stabilise joints throughout the day, seemingly ordinary activities can require considerable effort.
This is another reason an exercise programme needs to be personalised.
More exercise is not automatically better. The aim is to find an appropriate amount that allows you to build capacity without continually provoking significant symptom flares.
That might mean shorter sessions initially, additional recovery between exercises or gradually introducing cardiovascular activity alongside strengthening.
What About Braces, Taping and Supports?
Some people with EDS use braces, taping or other supports to assist particularly troublesome joints.
These can have a place in an overall management strategy, but the right option depends on the individual. The Ehlers-Danlos Society notes that braces, splints and mobility aids can help some people participate in daily activities, while appropriate joint-friendly exercise remains important for maintaining muscle function.
A physiotherapist can help you consider when additional support may be useful and how it fits alongside your strengthening and movement programme.
EDS Requires an Individual Approach
It is important not to treat all EDS presentations as though they are identical.
Different EDS subtypes have different clinical considerations. This is particularly important for vascular Ehlers-Danlos syndrome (vEDS), which is associated with fragile blood vessels and potentially serious complications. The Ehlers-Danlos Society advises people with vEDS to restrict exercise and sport to low intensity and avoid activities such as heavy weightlifting that greatly increase blood pressure.
If you have been diagnosed with a particular EDS subtype, tell your physiotherapist and provide any relevant advice you have received from your specialist or medical team.
Physiotherapy should complement your wider medical care rather than replace it.
What If You Think You Have EDS but Haven't Been Diagnosed?
Being unusually flexible does not automatically mean you have Ehlers-Danlos syndrome.
Joint hypermobility exists on a spectrum, and many people have hypermobile joints without having EDS. If you have unexplained widespread hypermobility alongside persistent symptoms or other features that concern you, discuss them with your GP or appropriate medical specialist.
A physiotherapist can assess your movement, strength and musculoskeletal symptoms, but an EDS diagnosis requires appropriate medical assessment.
What Might Your Physiotherapy Programme Include?
There is no single "EDS exercise programme" that is right for everybody.
After assessing your symptoms, movement and goals, physiotherapy might include controlled strengthening, balance exercises, movement retraining, education about joint positioning and progressive exposure to everyday activities.
Treatment may focus on one particularly troublesome joint initially or take a broader approach when symptoms affect several areas.
The eventual goal might be as simple as being able to walk further without a flare-up, sit comfortably through work, manage stairs more confidently or return to a favourite activity.
For someone else, success may mean improving shoulder stability, becoming stronger through the hips and knees or reducing the frequency with which a troublesome joint becomes irritated.
Your programme should reflect what matters to you.
Physiotherapy for EDS and Hypermobility on the North Shore
If you are living with EDS or symptomatic hypermobility on Auckland's North Shore, having a physiotherapist who listens carefully to how your body responds is important.
PhysioAction's Milford clinic provides personalised physiotherapy and rehabilitation for people managing pain, injury, mobility problems and ongoing musculoskeletal conditions. The clinic is located at 193 Shakespeare Road in Milford, making it convenient for people throughout Milford, Takapuna and the wider North Shore.
Rather than pushing you through a generic exercise programme, the aim is to identify an appropriate starting point and progressively develop the strength, control and physical capacity needed for the things you want to do.
Contact PhysioAction
Living with EDS can require a different approach to movement and rehabilitation. If joint instability, recurring pain, muscle fatigue or difficulty exercising is affecting your everyday life, physiotherapy may be one useful part of your overall management plan.
Contact PhysioAction to arrange an assessment and discuss how an individualised physiotherapy programme could support your movement, strength and joint stability.
Our North Shore clinic is located at 193 Shakespeare Road, Milford, Auckland.
Phone: 0800 749 746
Email: reception@physioaction.co.nz
Contact PhysioAction to arrange an appointment with the Milford physiotherapy team.