Hypermobility and Ehlers-Danlos Syndrome (EDS)

Joint hyper-mobility is the term used to describe increased mobility and range of movement in a joint.

People with joint hyper-mobility have an unusually large range of movement (ROM) in their joints.

Hyper-mobility is not rare – it’s estimated to affect one in five people (20%).

It may affect only a few joints or can be spread throughout the body.

Joint hyper-mobility is most common in children and females.

When people get older it tends to lessen as their joints get stiffer.

Many people with joint hyper-mobility have no symptoms or medical consequences and carry on as normal without the need for any medical intervention or support.

For some people, it can be advantageous.

For others, without proper management- it can be debilitating.

Joint hypermobility is caused by defects in the protein of connective tissue that give the body its strength.

This defect can affect any connective tissue in the body and in particular the collagen in tissues such as ligaments and tendons.

The defect makes the ligaments and tendons ‘stretcher’ and this, in turn, makes the joints they connect to and support, laxer.

Around 75% of people with joint hypermobility have inherited the condition.

People with hypermobile joints lack strength and stability compared with people with non-hypermobile joints.

Increased ROM and lack of support mean people can bend and twist joints more than usual, putting them at risk of injury or partial and full dislocation.

Symptoms can include:

  • Slow Injury recovery
  • Poor posture
  • Poor proprioception
  • Joint stiffness
  • Bracing
  • Pain (this can be acute and specific, or chronic and widespread)
  • Clicking in the joints
  • Fatigue
  • Thin and/or stretchy skin
  • Digestive problems such as irritable bowel syndrome and constipation

Slow Injury recovery – Injury recovery can be slower for people with joint hypermobility. In some cases, the injury may not fully recover due to repeated microtrauma. This means the person is at risk of the injury happening again.

Poor posture – Muscles tire more easily in hypermobile joints as they have to work harder to support the joint. Hypermobile people often dislike sustained postures and have poor postural alignment as they tend to rest at the end of the joint range. Although they will be able to adopt a good standing or sitting position at first, they will not be able to hold it for long.

Poor proprioception – Poor proprioception can be considered both a cause and symptom of joint hypermobility. Proprioceptive sense refers to the sensory input and feedback that tells us about movement and body position. Its receptors are located within our muscles, joints, ligaments, tendons, and connective tissues.

If people aren’t certain where their joint is within a space, it may lead to them overstretching. Equally, if people have overstretched structures within a joint, it can then lead to poor proprioception.

Joint stiffness – People may suffer from joint stiffness – which may seem unusual, given the increased range of movement in joint hypermobility. However, it’s often subjective and therefore stiff compared with someone’s ‘normal’ feeling. I feel stiff a lot.

Stiffness may be caused by a tight muscle or a muscle spasm – possibly due to overusing global muscles or by a build-up of fluid in the joint as it tries to repair the damage.

Bracing – ‘Bracing’ is a term given to breath-holding. It is a common symptom of joint hypermobility where people try to use breathing to help stabilise themselves and produce more power

Varying symptoms – For people who are symptomatic, the type and severity of the symptoms can vary from person to person – even from day to day for the same person.

Many people with joint hypermobility do not experience any of the symptoms we have mentioned here. If symptoms are present alongside joint hypermobility then it is known as Joint Hypermobility Syndrome.

Ehlers-Danlos syndromes are a group of connective tissue disorders that can be inherited and varied both in how they affect the body and in their genetic causes.

Hypermobility spectrum disorder is a group of conditions related to joint hypermobility. HSD is intended to be diagnosed after other possible answers are excluded such as EDS.

HSD and EDS can be equal in severity, both need similar management, validation and care.

There are many different levels:

  • Mild – functioning, normal, not too much pain.
  • Moderate – some issues, co-morbidities, up and down days.
  • Severe – wheelchair, hospitalisations, fed by tube.

EDS impacts 1 in 5000 people, HSD is more common.

  • Joint instability / musculoskeletal pain
  • Chronic pain
  • Fatigue
  • Postural Tachycardia Syndrome (POTs)
  • Headaches / migraines / TMJ
  • Digestive issues – IBS, acid reflux, nausea, bloating
  • Lungs – asthma, pneumonia, bronchitis, allergies
  • Heart – mitral valve prolapse, palpitations, fainting, dizziness
  • Lack of fine and gross motor control
  • Autonomic nervous system – heart rate, blood, pressure
  • Exercise intolerance
  • Mast Cell Activation Disorder
  • Subluxations/dislocations
  • Stiffness
  • Impaired proprioception
  • Emotional and psychological – anxiety, tension, stress, fear of movement, lack of confidence, feeling of isolation

Pilates is a very good method of exercise for joint hyper-mobility. This is because the medical recommendations for treatment and management of the condition closely related to the principles Pilates:

  • Centring
  • Concentration
  • Control
  • Precision
  • Breath
  • Flow
  • Awareness
  • Stamina
  • Relaxation

After extensive training and study, Becki Moore (founder of BeMoore Pilates, Yoga & Personal Training) came to understand her own hyper-mobility. As a young gymnast, Becki suffered many problems and experienced pain as a result of the lack of hyper-mobility management. Presently, she proactively implements her knowledge and understanding of hyper-mobility in her everyday practice and classes. Her focus on Pilates and Yoga enables both her students and herself to move freely and with ease.

Since teaching and practicing Pilates and Yoga, Becki has seen an exponential change in her symptoms.

  • She does not experience frequent injuries.
  • Improved proprioception
  • Decreased joint stiffness as a result of daily practice
  • Pain-“I am aware that I may experience pain/discomfort, but I also know this is temporary and I am more mindful not to push myself to my end range when experiencing new exercises. I take breaks and reduce reps. When I am in pain I make sure I take time to rest. It is all about balance.” (Becki Moore- founder of BeMoore Pilates, Yoga & Personal Training)
  • Decrease in muscle and joint fatigue
  •  Improved gross motor control

We know that is it never a one rule fits all approach.

At BeMoore Pilates, Yoga & Personal Training we have a range of skills to help manage your hyper-mobility (or EDS) and help you to lead a happier more pain-free life.

We will look at a wide range of areas and tailor a programme to suit your needs.

Training is advised on an individual basis and can be accessed through private coaching, classes and workshops.