Navigating Hypermobility: Embracing the Responsibility That Comes With It

Hypermobility Spectrum Disorder (HSD) is now considered the most common systemic inherited connective tissue disorder in humans, meaning it often runs in families.

Despite its commonality... HSD remains widely misunderstood. This lack of awareness often translates to significant challenges for patients, and we see this right here in Holly Springs and the Triangle region. Patients frequently report feeling misunderstood and misdiagnosed, with their complex, multi-systemic symptoms being dismissed or not taken seriously by healthcare professionals. As a Physical Therapist, I am committed to providing the care this community needs to address these often-misunderstood connective tissue disorders.

HSD is the diagnosis given to individuals who are hypermobile, have health problems related to that hypermobility, but do not quite meet the criteria for hypermobile Ehlers-Danlos Syndrome (hEDS). https://pubmed.ncbi.nlm.nih.gov/28306229/

Initially, HSD was often thought to be a milder form of hEDS, but we now know this isn't true. From a treatment perspective, HSD and hEDS are identical. There is no real benefit to distinguishing between them as both require a comprehensive, holistic management plan.

The Whole-Body Impact of HSD

HSD is not just about flexible joints; it is a systemic disorder that affects the entire body. While the Beighton Score is the official measure of hypermobility, any joint may have excessive motion or instability, leading to a wide range of issues:

🦴 Bones and Joints

• Instability: Frequent sprains, subluxations (partial dislocations), and full dislocations.

• Chronic Issues: Chronic joint pain, early-onset osteoarthritis, and issues like scoliosis.

• Bone Health: Decreased bone density.

🧠 Neurological and Motor Control

• Motor Issues: History of being clumsy or uncoordinated, motor delay in children.

• Proprioception Deficits: Decreased body awareness and motor control deficits, leading to clumsiness, frequent falls, tripping, or bumping into things.

• Nerve Pain: Fibromyalgia/central sensitization, hyperalgesia (oversensitive nerves), numbness/tingling, and nerve compression disorders.

• Head/Brain: Headaches, migraines, dizziness, and ringing in the ears.

⚕️ Other Systemic Issues

The impacts of HSD frequently extend to other body systems, often requiring specialist care for issues like GI dysfunction, MCAD (Mast Cell Activation Disorder), incontinence, and fatigue often related to conditions like POTS (Postural Orthostatic Tachycardia Syndrome).

Empowering Yourself: Management and Treatment

As HSD is a chronic condition with no known cure, management focuses on patient education and empowerment to mitigate symptoms and prevent long-term joint damage. These physical limitations often result in significant restrictions on daily activities and employment.

Core Principles: Education, Protection, and Self-Management

Effective management of HSD is built on empowerment and minimizing reliance on constant medical intervention. The core principles are integrated to improve function, stability, and independence:

1. Education and Body Protection 🛡️

• Body Mechanics & Ergonomics: Patients are taught to use their bodies "wisely", maintaining good posture, avoiding joint overstretching, and consciously preventing muscle strain.

• Joint Stability: A primary goal is to improve the endurance and strength of core postural and joint-stabilizing muscles.

• Postural Re-education:  Therapy focuses on correcting abnormal posture and gait to optimize biomechanics. In our Holly Springs clinic, we guide patients through customized therapeutic exercise to achieve these functional goals.

• Aids and Supports: Using external supports like orthotics, braces, or splints is utilized when necessary for joint protection during activity.

2. Physical Conditioning and Function

• Stamina & Fitness: Interventions are designed to improve stamina and general fitness, ultimately facilitating a return to normal activities and promoting an active lifestyle.

• Proprioception: Improving balance and coordination is critical to enhance spatial awareness and joint control.

3. Acute Symptom and Pain Management

• Treating the Treatable: Management involves addressing acute issues like new soft tissue lesions or injuries.

• Pain Relief: Strategies include soft tissue work and gentle mobilizations. For acute relief, our Physical Therapy practice utilizes targeted methods such as treating myofascial trigger points, employing specialized techniques (e.g., Graston Technique).

  
  

These combined efforts ensure the individual achieves improved functional capacity, stability, and control, leading to greater self-management and independence. https://www.ehlers-danlos.org/information/physical-therapy-for-hypermobility/

Holistic Pain and Wellness Management

Chronic pain is managed through a combination of physical and psychological strategies:

• Cognitive Behavioral Strategies: Pacing, stress management, and avoiding negative thinking patterns.

• Relaxation: Techniques like mindfulness meditation, biofeedback, Tai Chi, and yoga help with physiological quieting.

• Team Approach: Referrals to other professionals are often necessary, including an Occupational Therapist, Nutritionist, Psychologist, and Gastroenterologist.

Finding Specialized Care in Holly Springs and the Triangle

Living with HSD is challenging, but with the right knowledge, care team, and management strategies, you can significantly improve your quality of life.

If you are an individual with symptomatic hypermobility or a suspected connective tissue disorder in the Holly Springs, NC area (including Fuquay-Varina, Apex, and Cary), it’s crucial to find a practitioner who understands the complexity of HSD.

Your Physical Therapist is your frontline expert for building stability and safe movement patterns.

CD Physical Therapy is here to help. As a Physical Therapist who works with patients who have Hypermobility Spectrum Disorder and Ehlers-Danlos Syndrome, I provide comprehensive evaluations and highly individualized treatment plans to help you build a strong, stable foundation and manage your symptoms.

If you are struggling to find a diagnosis or need a specialized management plan in the local area, please reach out.

www.cdphysicaltherapy.com - 984-257-0034 - info@cdphysicaltherapy.com