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The Manual Touch Physical Therapy

Whole Body Approach

Reclaim movement, function and life
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Hypermobility, hEDS, and EDS: Understanding Joint Flexibility and Pain Management

January 6, 2025 By Denise Schwartz Leave a Comment

I don’t remember learning about hypermobility syndromes when I was in PT school in the 80s or even having seen this diagnosis as recently as 2010. It didn’t show up on my radar until I had a patient with Ehler-Danlos Syndrome in 2011. In recent years, I have been noticing that more and more of my patients have hypermobility. I can’t explain why I am seeing this more often other than, now that I know better, I do better.

The first clue I look for when diagnosing hypermobility is in their history and a description of their symptoms and how they got them. They may have chronic pain, tend to be injury-prone since childhood, have had injuries that take a long time to heal, have complaints of tightness coupled with high flexibility, or have been to many health professionals to help them feel better with various diagnoses.

What is Hypermobility Syndrome?

hypermobility and chronic pain stretch hand the manual touch Hypermobility syndrome occurs when joints have an unusually large range of motion. This can sometimes lead to pain, muscle fatigue, or even frequent injuries. Some people with hypermobility can move their joints in ways that look a bit extreme—like bending fingers backward or extending knees beyond the usual straight line. This joint instability can lead to chronic pain and difficulty with everyday activities. To initially test to determine if you are hypermobile, try using the Beighton Scoring System.

For those experiencing discomfort, managing it starts with knowing your body’s unique needs and working with professionals who can help you build joint strength and stability to prevent injury.

Examples of Hypermobility

By the time my client Sean came to me, he had had 5 years of constant sacroiliac (SI) pain when sitting. He had seen multiple medical professionals without relief. His SI pain began after rolling over in bed. He works out regularly but cannot do overhead lifting over 25 lbs, as his shoulders “feel like they will pop out”. He also complained of very tight hamstrings but would describe himself as flexible.

Have you ever been called “double-jointed” or noticed that you can bend certain joints in ways others can’t? Like my patient, Craig, who was told his shoulders looked like they were dislocating while swimming the butterfly, or Dana, as a teenager, could do the splits way past straight and has had hamstring pain ever since.

While it might seem like a neat trick, being extremely flexible can actually be a sign of a condition called hypermobility syndrome—or, in some cases, a more complex condition like hypermobile Ehlers-Danlos Syndrome (hEDS) or Ehlers-Danlos Syndrome (EDS). Each of these conditions comes with challenges, but understanding their differences can help you manage symptoms, find ways to reduce pain, and stay as active and healthy as possible to prevent future complications such as joint replacement surgery.

Hypermobile Ehlers-Danlos Syndrome (hEDS)

Hypermobile Ehlers-Danlos Syndrome (hEDS) is a genetic condition that goes beyond hypermobility and affects connective tissues throughout the body, not just in the joints. People with hEDS experience symptoms like digestive issues, fatigue, easily bruised skin, and slow wound healing. While many of these symptoms seem unrelated, they stem from the same underlying problem—hEDS affects collagen, an essential protein in connective tissue that provides stability and strength throughout the body.

One of the biggest challenges with hEDS is getting a proper diagnosis through genetic testing. Symptoms of hEDS overlap with other conditions such as fibromyalgia, which can make diagnosis tricky. However, recognizing these signs and seeking the right support is essential. The approach to managing hEDS often requires more comprehensive treatment to address the condition’s varied symptoms.

Ehlers-Danlos Syndrome (EDS)

Ehlers-Danlos Syndrome (EDS) is actually a group of genetic disorders affecting connective tissue in the body, not just in the joints but also in the skin, blood vessels, and even organs. There are 13 recognized subtypes of EDS, with hypermobile EDS being one of them. People with EDS may notice that their skin is fragile, that they bruise easily, or that they have difficulty maintaining joint stability. In more severe cases, EDS can even lead to complications in blood vessels or organs, highlighting the need for an individualized approach to treatment.
While there’s no cure for hypermobility or EDS, physical therapy can play a major role in managing symptoms.

Managing Hypermobility and EDS through Physical Therapy

Physical therapy can be a powerful tool for managing hypermobility and EDS. It helps individuals strengthen the muscles surrounding hypermobile joints, reducing the risk of injury and improving stability and ultimately preventing subluxations (partial joint dislocation) or full dislocations. The focus is on building core stability, joint control, and alignment, creating a foundation of strength that supports hypermobile joints without putting too much strain on them. In addition, a lot of education will be provided to learn how to best manage your flexible body with movement, exercise, everyday activities, and positioning. After 2 months of PT Sean now has intermittent and less intense SI pain, as well as improved postural alignment that also contributed to his pain.

“Previous rounds of PT left me with multiple injuries and little progress. So when a colleague of mine told me about IMT, I quickly looked into IMT and found Denise Schwartz at The Manual Touch. This past year I have made progress in physical therapy for the first time since being symptomatic with EDS, and I know that in the positive and uplifting environment in which Denise provides I can continue to make gains.

I feel very fortunate to have Denise in my life as a physical therapist who listens to me, is patient, compassionate, and who continuously strives to provide the best care possible for my condition.” – Megan B. Arlington Heights

A personalized physical therapy plan will include strength, neuromuscular control (how your body works together), proprioceptive (knowing where your body is in space), and balance exercises that can be adjusted based on each person’s needs. For people with hEDS or EDS, physical therapy emphasizes not just general strength but also the precise control needed to prevent injuries from repetitive movements or poor posture. With the right guidance, physical therapy becomes a tool to help you live with hypermobility or EDS more comfortably and confidently.

Everyday Tips for Living with Hypermobility, hEDS, or EDS

Making small adjustments, like using proper body mechanics, taking breaks during repetitive tasks, and even using supportive devices when needed, can be incredibly helpful. Finding ways to relieve strain on your joints can also prevent further discomfort. Connecting with online communities, such as The Ehlers-Danlos Society, can provide additional resources and support. Sometimes, learning from others with similar experiences can offer valuable insights and encouragement.

Living with hypermobility or EDS can make daily life a little more complicated and not easy, but with the right care and a better understanding of your condition, an active, pain-free life is within reach. Whether it’s through physical therapy, lifestyle adjustments, or connecting with a supportive community, there are effective ways to manage your symptoms.

If you’re experiencing hypermobility-related symptoms or have been diagnosed with EDS, a comprehensive physical therapy plan could be the next step in your journey toward building strength, stability, and resilience. We at The Manual Touch have great experience working with patients with hypermobility issues.

Get in touch the manual touch physical therapy hypermobility

Filed Under: Chronic Pain, Health & Wellness, Integrative Manual Therapy

About Denise Schwartz

Denise Schwartz, PT, IMT, C is the owner of The Manual Touch Physical Therapy. For over 30 years, she has been helping patients reduce pain and improve quality of life using a whole body approach. Denise specializes in chronic pain, spinal conditions, running/triathlon injuries and prevention, balance/vestibular disorders, functional exercise, kinesiotaping, and various non-traditional and traditional & manual therapies. Contact Denise at denise@themanualtouch.com

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I saw Denise at The Manual Touch recently for sciatic pain, that only the day before I saw Denise kept me from walking; I could only hobble for short distances before I would sit down and collapse. After some tissue work and gentle exercise with Denise, she put Kinesiotape around the affected area. I immediately noticed stability and pain improvement and could walk so much better that I was able to complete shopping trips to 4 stores I had been planning but did not think I could do. To me, the t… Read more
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Testimonials

I saw Denise at The Manual Touch recently for sciatic pain, that only the day before I saw Denise kept me from walking; I could only hobble for short distances before I would sit down and collapse. After some tissue work and gentle exercise with Deni… Read more
https://themanualtouch.com/wp/testimonial/m-d-evanston-il
I was in Florida for vacation and developed an upper respiratory infection. I had annoying coughing and congestion in my chest. This went on for several days, and it was not getting better. It felt like I had a mucous plug stuck in my chest that woul… Read more
https://themanualtouch.com/wp/testimonial/a-b-riverwoods
The best physical therapist I’ve ever experienced is Denise Schwartz in Wheeling at the Manual Touch. I have seen Denise twice for over 6 months to treat 2 bouts of frozen shoulder that occurred 8 years apart. In addition to my shoulder, she has also… Read more
https://themanualtouch.com/wp/testimonial/b-h-elmhurst-il
As a young elite athlete I was involved in numerous accidents resulting in scar tissue causing loss of flexibility and restrictions as an adult. After each treatment I feel so much less restriction and experience greater range of motion.
https://themanualtouch.com/wp/testimonial/s-northbrook-il
Last winter our daughter Maddie had had several eye and ear infections, and all required topical and oral antibiotics.  These were instigated by a plugged tear duct.  A pediatric ophthalmologist said there was little chance the duct would open up o… Read more
The physical therapy I received at The Manual Touch PT helped reduce my sciatica pain to a manageable level in just a few sessions.  The exercises I was given strengthened and trained my muscles to prevent further back problems allowing me to return… Read more
Just a note to thank you for the time you spent with me Saturday in evaluating my running technique and body alignment.  Your suggestions are already making sense and having an early impact.  After our meeting, I went out for a 5K run and found you… Read more
I have been receiving PT therapy for pain and autoimmune disorders for over 18 months at The Manual Touch.  This also affects my kidneys and my lungs and other organs as I swell with fluid that my lymph system doesn’t seem to handle well.  I depe… Read more
Excellent, professional assessment and treatment for an older woman who’s had lots of failed therapy. Kind and compassionate and caring! Thanks.
I can honestly say that Denise was the first physical therapist to listen to my story.   She has demonstrated more patience and compassion than any other therapist that I’ve ever met. For the past 8 years, I have been symptomatic with Ehlers Danlo… Read more
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