Ehlers Danlos Syndrome (EDS) is a collection of various connective tissue disorders. Although considered rare, they cause aches, pains, and other complications that often cause patients to seek osteopathic treatment; so we see a lot of EDS patients, relatively speaking.
Hypermobility and EDS
One of the most prevalent subtypes of EDS is the hypermobility type. This subtype leads to general aches and pains, as well as a higher incidence of dislocations or subluxations. You can read more about how hypermobility is associated with muscular aches and pains (and management strategies) here.
This type may be identified as the result of recurrent injuries or other symptoms. Sometimes it is only considered when a patient notices that their skin is unusually stretchy, as illustrated above.
Diagnosing Hypermobile Ehlers Danlos Syndrome
There are no blood or genetic tests available for identifying this type of EDS, so diagnosis is done clinically by a rheumatologist. This does not mean that tests are not helpful- they are important for ruling out other potential causes for your symptoms. The diagnostic criteria, as described by the Ehlers Danlos Society, covers three points:
- Generalized joint hypermobility (GJH); and
- Two or more of the following features must be present (A & B, A & C, B & C, or A & B & C):
Feature A—systemic manifestations of a more generalized connective tissue disorder (a total of five out of twelve must be present)
Feature B—positive family history, with one or more first degree relatives independently meeting the current diagnostic criteria for hEDS
Feature C—musculoskeletal complications (must have at least one of three); and
- All these prerequisites must be met: absence of unusual skin fragility, exclusion of other heritable and acquired connective tissue disorders including autoimmune rheumatologic conditions, and exclusion of alternative diagnoses that may also include joint hypermobility by means of hypotonia and/or connective tissue laxity.
Possible Complications of Hypermobility
Areas commonly affected by hypermobility include:
- the shoulder– prone to dislocation through trauma or position. The likelihood of reoccurrence after the first dislocation can be especially high
- the knee cap, which may move off-centre, especially where there is muscular imbalance in the quadriceps
- pelvic organ prolapse, especially after pregnancy and childbirth, but possible without too
- rib joints, which may be susceptible to costochondritis and other conditions
Managing Hypermobile Ehlers Danlos Syndrome
As with other causes of hypermobility, strength training can be very helpful for supporting the ligaments that can’t restrict movement as well as they should. Your osteopath can help to formulate an exercise routine that targets your most problematic areas, with ongoing modifications to ensure they’re serving you well. For areas that are especially prone to complications like joint dislocation or subluxation, it may be a long and ever-changing process to hit your strength goals.
Alongside exercise, we can help with any areas that might be tight or restricted, thus putting further strain on the more mobile areas.
More information about Ehlers Danlos Syndrome can be found here at the Ehlers Danlos Society website.
Click here to make an appointment in Wiltshire for your hypermobility symptoms
