Is Hypermobility Contributing to your Symptoms?
A person who is hypermobile is sometimes referred to as being “double-jointed, extremely flexible, or having hypermobility syndrome. Hypermobility can be asymptomatic or symptomatic, so it is important to work with a therapist who can help you determine if your hypermobility is contributing to your symptoms of pain or fatigue and, as needed, help you to better support your hypermobile body.
Mobility exists on a spectrum– some people inherit connective tissue that is really stiff and others have tissues that are quite flexible. Most people live between these two extremes, but those who are hypermobile may have injuries associated with tissue fragility, joints that move too much, and changes to the nervous system that amplify pain in an attempt to protect.
If you have recurring injuries, pain and /or fatigue, you may have a Hypermobility Spectrum Disorder (HSD) that a trained physical therapist can help to identify and treat. Conservative management like appropriate exercise and lifestyle adaptations are a mainstay of treatment of HSD, including hypermobility associated with Ehlers-Danlos Syndromes (EDS.) EDS is a medical diagnosis that requires a medical doctor to diagnose. For more information about EDS visit the EDS Society website.
Dysautonomia/Postural Orthostatic Tachycardia Syndrome (POTS)
Dysautonomia/Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system and occurs frequently in those with hypermobility, Diabetes Mellitus, Parkinson’s Disease, and after a trauma or hospitalization. It presents when changing positions or getting up from a reclining position a person can experience a rapid (within seconds) increase in heart rate and also have discomfort and/or lightheadedness. Immediate symptoms can be relieved by returning to a recumbent position, which often contributes to avoidance of upright activity and deconditioning, which makes the problem worse. Over time, the symptoms become chronic and can include extreme fatigue, nausea, and chronic pain most notable in the “coat hanger” region of the head, neck, upper back and shoulders due to insufficient blood flow to these areas.
Physical Therapy for POTS
- Individualized application of the Levine/Dallas protocol, which evidence has shown to improve tachycardia and both acute and chronic symptoms.
- Gradually progressed strengthening exercise to improve blood flow while reducing adverse effects associated with doing “too much.”
- Careful planning and pacing to allow a return to activities you enjoy and activities of daily living.