Exercise for EDS/HYpermobility
What is Ehlers-Danlos syndrome?
Ehler-Danlos syndrome, or EDS, as it is commonly known, refers to a group of heritable conditions which affect connective tissue. While there are many types of EDS, the group of conditions is usually characterised by hypermobile joints, hyperextensible skin and fragility of different tissue throughout the body. Moreover, people with EDS can present with a range different other conditions such as persistent pain, autonomic dysfunction, mast cell activation syndrome, psychological disorders and gastrointestinal dysfunction. However, the severity and presentation of EDS can vary considerably.
Joint Mobility and Stability
There are several different factors which contribute to the stability of a joint. These include:
· the size and shape of the articular surface of the joint;
· the ligaments surrounding the joint; and
· the tone and coordinated action of muscles surrounding the joint during movement5,6,7.
Just because a joint is mobile or hypermobile, does not necessarily mean it is unstable. Joint instability refers to a joints tendency to dislocate, whereas joint mobility refers movement around a joint.
How can exercise help?
For people with EDS, the hypermobility of their joints is usually associated with increased joint instability and increased risk of dislocation. However, exercise can improve joint stability through increased muscle tone and improvements in coordination. Moreover, exercise and physical activity is an important factor in reducing the incidence of other conditions such as cardiovascular disease, cancer, hypertension, diabetes and osteoporosis. It has been shown that adults with certain types of EDS tend to be less active, placing them at greater risk of these conditions.
References: Yeowell HN, Pinnell SR. The Ehlers-Danlos syndromes. Semin Dermatol. 1993 Sep;12(3):229-40. PMID: 8217561. Tinkle, B., Castori, M., Berglund, B., Cohen, H., Grahame, R., Kazkaz, H., & Levy, H. (2017, March). Hypermobile Ehlers–Danlos syndrome (aka Ehlers–Danlos syndrome Type III and Ehlers–Danlos syndrome hypermobility type): Clinical description and natural history. In American Journal of Medical Genetics Part C: Seminars in Medical Genetics (Vol. 175, No. 1, pp. 48-69). Wilk, K. E., Arrigo, C. A., & Andrews, J. R. (1997). Current concepts: the stabilizing structures of the glenohumeral joint. Journal of Orthopaedic & Sports Physical Therapy, 25(6), 364-379. Coussens, M., De Wandele, I., Pacey, V., Malfait, F., De Craemer, M., Demeyer, H., Rombaut, L., & Calders, P. (2020). Physical activity and sleep in patients with hypermobile Ehlers–Danlos syndrome and patients with generalized hypermobility spectrum disorder. Edorium Journal of Disability and Rehabilitation, 6.
