Physical therapy for hypermobility!

Because of the ubiquitous nature of collagen, hEDS will present with a variety of different signs and symptoms. Therefore current best practice management of hEDS is essentially an individualised problem-solving approach. A multidisciplinary approach to rehabilitation is recommended, including occupational therapists, podiatrists, physical therapists, osteopaths, sports therapists, nurses and psychologists depending on the individual’s needs.

Principles of management include:

* Treating the treatable, for example acute soft tissue lesions and injuries.

* Relieving pain where possible through the use of soft tissue work, gentle mobilisations, electrotherapy and support of joints and tissues.

* Education and behaviour modification to enable individuals to manage the condition with minimal reliance on medical input or medication.

* Improving the endurance and strength capacity of the postural support and joint-stabilising muscles.

* Improving balance and coordination.

* Improving stamina and general fitness.

* Re-educating posture and gait to avoid or correct abnormalities in biomechanics.

* Facilitating a return to normal activities and functioning and promoting an active lifestyle.

Frequently hypermobile individuals will present with a mixture of hypomobile (stiff) and hypermobile segments or joints.

Manual therapy including mobilizations of stiff hypermobile joints can be helpful, as can soft tissue massage, trigger point work and myofascial release to alleviate pain associated with muscle spasm. Relaxation and visualization techniques can help the individual to manage pain and can be very useful at night-time if they have difficulty sleeping due to pain and discomfort.

Clearly exercise and participation in physical activity is an important management strategy and has a health promoting role, therefore it is imperative that professionals who work in this domain are aware of the condition, can assist prevention and work collaboratively within a multidisciplinary team to help manage children and adults with hEDS and their associated problems.