Ehrlos-Danlos Syndrome and Hypermobility Spectrum Disorders

Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorders (HSD) are connective tissue disorders primarily affecting collagen, a protein that provides structure and strength to tissues. Here’s an overview of each:

1. Ehlers-Danlos Syndrome (EDS)

EDS is a group of genetic disorders characterized by hypermobile joints, stretchy skin, and fragile tissues. There are several subtypes of EDS, with the most common being Hypermobile Ehlers-Danlos Syndrome (hEDS). Each subtype has unique symptoms and varying severity.

Symptoms often include joint hypermobility, joint pain, frequent joint dislocations, fragile skin, poor wound healing, and sometimes vascular or organ fragility (in specific subtypes like vascular EDS).

EDS is typically genetic, often involving mutations in genes responsible for collagen production.

2. Hypermobility Spectrum Disorders (HSD)

HSD encompasses a range of conditions related to joint hypermobility, where symptoms are present but don’t meet the strict criteria for hEDS. People with HSD may experience similar symptoms to those with EDS, but HSD is typically less severe and not associated with the same level of connective tissue fragility as EDS.

Joint pain, frequent sprains or strains, joint instability, and fatigue are common. Like EDS, HSD can impact quality of life and increase the risk of injury.

What is the Role of Physiotherapy for EDS/HSD Patients?

Physiotherapy can play a vital role in improving function, reducing pain, and enhancing quality of life for EDS and HSD patients.

1. Joint Stabilization and Strengthening

Low-impact strengthening exercises, with a focus on core and joint stabilizing muscles, can reduce dislocations and hyperextension risk.

Proprioceptive exercises can help to improve body awareness and control and help to prevent injuries.

2. Pain Management

Techniques such as gentle manual therapy to relieve pain without overstretching.

Modalities like ultrasound, TENS, etc can also be helpul in managing acute pain.

3. Education on Joint Protection

Educating patients on movement patterns and postural corrections to avoid joint overuse.

Lifestyle modifications for pacing activities and avoiding positions that increase joint strain.

4. Custom Exercise Programs

Creating individually tailored exercise programs that improve stability, maintain flexibility, and avoid injury.

Emphasis on tailored exercises that support joint health without overloading tissues.

5. Postural and Balance Training

Balance exercises to help with proprioception and stability.

Postural retraining to reduce stress on the musculoskeletal system.

6. Pain Relief Techniques for Scar Tissue

Utilizing modalities like cupping therapy, especially in areas where scar tissue contributes to discomfort and movement restrictions.

By providing these interventions, a physiotherapist can help EDS/HSD patients reduce injury risks, manage pain, and build the strength and stability necessary for an improved quality of life.