Physical Therapy for Ehlers-Danlos Syndrome (EDS)

Ehlers- Danlos Syndrome (EDS) is a group of genetic connective tissue disorders that results from impaired production of collagen, a protein that is important for every physiological system. EDS often manifests clinically as increased skin elasticity (“stretchy skin”), loose joints and decreased strength of blood vessels.

EDS has multiple subtypes. The most common subtype seen in physical therapy is hypermobility type (EDS-HT). 

Symptoms of EDS-HT include:

• Excessive joint laxity resulting in recurrent joint subluxations/dislocations Subluxations/dislocations can occur spontaneously or as a result of minimal trauma
• Early onset osteoarthritis and joint irritation
• Headaches related to increased muscle tension/guarding in the neck and jaw muscles
• Chronic muscle, joint, ligament or tendon pain

How can Physical Therapy help manage EDS?
Symptoms can be managed through a multidisciplinary approach, including physical therapy.  Physical therapists play an important role in managing this by providing extensive patient education, exercise prescription, and pain management techniques. 

Physical Therapy treatments include:

• Education regarding activity modifications and lifestyle adjustments to prevent injury, and associated complications.
• Aerobic Exercise consists of cardiovascular exercise and lower weight, higher repetition strengthening exercises to increase joint stability.
• Strength Training to increase muscle strength and resting muscle tone in order to counteract excessive laxity of joints.
• Braces and assistive devices to support joints and prevent subluxations/dislocations and improve functional mobility.
• Manual therapy to decrease pain associated with muscular, myofascial and/or chronic joint pain.

References

1. Engelbert, R. H., Juul-Kristensen, B., Pacey, V., de Wandele, I., Smeenk, S., Woinarosky, N., Sabo, S., Scheper, M. C., Russek, L., & Simmonds, J. V. (2017). The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome. American journal of medical genetics. Part C, Seminars in medical genetics, 175(1), 158–167. https://doi.org/10.1002/ajmg.c.31545
2. Gazit, Y., Jacob, G., & Grahame, R. (2016). Ehlers-Danlos Syndrome-Hypermobility Type: A Much Neglected Multisystemic Disorder. Rambam Maimonides Medical Journal, 7(4), e0034. https://doi.org/10.5041/RMMJ.10261

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