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hEDS & HSD and the PT Role

Dr. Alexandria Gosnell

What is hEDS and HSD and the Role of PT

Hypermobility Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorder (HSD) are both conditions related to connective tissue disorders, specifically characterized by joint hypermobility, joint instability, and chronic pain. Joint hypermobility refers to the ability of joints to move beyond the normal range of motion.

hEDS is considered a heritable disorder, meaning it can be passed down through generations. It is one of several subtypes of Ehlers-Danlos Syndrome (EDS), a group of genetic connective tissue disorders. Individuals with hEDS often experience joint hypermobility, skin hyperextensibility (stretchiness), and tissue fragility.

HSD, on the other hand, falls within the broader spectrum of hypermobility-related disorders. It shares many features with hEDS but may not meet the specific diagnostic criteria for hEDS. HSD is diagnosed when hypermobility-related symptoms are present but do not fully meet the criteria for other types of EDS.

Both hEDS and HSD can manifest with a wide range of symptoms affecting various parts of the body. These symptoms may include joint pain, fatigue, gastrointestinal issues, cardiovascular problems, and more. Because of the diverse nature of symptoms, managing these conditions often requires a multidisciplinary approach involving various healthcare providers, such as rheumatologists, orthopedists, physical therapists, and pain specialists.

It’s essential to note that there are currently no disease-specific treatments for HSD. Instead, management focuses on alleviating symptoms and improving quality of life. Treatment plans are tailored to individual needs and may include physical therapy, pain management strategies, bracing or splinting, lifestyle modifications, and sometimes medications to manage specific symptoms like pain or gastrointestinal issues.

Ways Physical Therapy can help management for hEDS and HSD symptoms include:
1. Treating acute issues: Addressing acute soft tissue trigger points and injuries promptly.
2. Pain management: Utilizing techniques such as soft tissue work, gentle mobilizations,
electrotherapy, and joint/tissue support to alleviate pain where possible.
3. Education and behavior modification: Empowering individuals with knowledge about
their condition and strategies for self-management, reducing reliance on medical
intervention or medication.
4. Strengthening exercises: Improving the endurance and strength of postural support and
joint-stabilizing muscles to enhance stability and control.
5. Balance and coordination training: Implementing exercises to improve balance,
coordination, and spatial awareness.
6. Fitness and stamina improvement: Enhancing overall fitness and stamina to support
daily activities and promote an active lifestyle.
7. Posture and gait correction: Educating individuals on proper posture and gait mechanics
to prevent or correct abnormalities and reduce strain on joints.
8. Facilitating return to normal activities: Supporting individuals in returning to their regular
activities and promoting independence and self-management.

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