Strength Through Stability: Physical Therapy for Ehlers-Danlos Syndrome

Mark Jamantoc
11 minutes ago
2 min read

What Is Ehlers-Danlos Syndrome?

Ehlers-Danlos Syndrome (EDS) is a group of connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. For individuals living with EDS—particularly the hypermobile type (hEDS), which is the most common—daily activities can be challenging due to joint instability, frequent dislocations, chronic pain, and fatigue.

But there is hope. Physical therapy plays a central role in improving function, reducing pain, and building long-term stability in people with EDS.

The Role of Physical Therapy in EDS

Unlike traditional orthopedic conditions that focus on increasing range of motion, physical therapy for EDS emphasizes the control and stability of hypermobile joints. The goal is not to stretch more—but to strengthen and stabilize.

Key Goals of PT in EDS:

Improve neuromuscular control
Enhance joint proprioception
Strengthen postural and stabilizing muscles
Reduce pain and prevent dislocations/subluxations
Educate patients on pacing and joint protection

What Does the Research Say?

Recent evidence supports targeted strengthening and proprioceptive retraining as the foundation of care for hEDS.

🧠 Neuromuscular Training Works

A 2021 systematic review published in Musculoskeletal Science and Practice showed that proprioceptive and neuromuscular exercises significantly improve pain and function in hypermobile individuals with EDS [(Palme et al., 2021)].

🏋️ Progressive Strength Training is Safe

A 2022 study in BMC Musculoskeletal Disorders found that low-load, high-repetition strength training, when properly supervised, was both safe and effective for increasing joint support and muscle endurance in patients with hEDS [(Ferrell et al., 2022)].

🦵 Targeting Key Stabilizers Helps

Evidence suggests that strengthening deep core muscles, scapular stabilizers, and hip abductors has a measurable effect on reducing joint pain and instability, particularly in the shoulders, knees, and spine [(Coussens et al., 2020)].

Our Approach at Praxis Physical Therapy

At Praxis, we understand that each person with EDS presents uniquely. That’s why we take an individualized, evidence-based approach focusing on:

✅ Joint-Specific Strengthening – Starting with isometrics and progressing to dynamic closed-chain movements.

✅ Postural Retraining – Teaching optimal alignment to reduce passive strain on joints.

✅ Pacing and Load Management – Educating patients on how to gradually increase activity without flaring symptoms.

✅ Stabilization Tools – Utilizing bands, Pilates-based movements, and bodyweight drills to challenge control in safe ranges.

✅ Collaborative Care – Working closely with rheumatologists, pain specialists, and genetic counselors to coordinate care.

Success Through Strength

Although Ehlers-Danlos Syndrome has no cure, movement is medicine—when delivered carefully. With a supportive physical therapist and a well-designed plan, people with EDS can experience less pain, fewer subluxations, and more confidence in their bodies.

If you or someone you know is struggling with joint instability or living with EDS, our team at Praxis is here to help.

References

Palme, M. et al. (2021). Physical therapy management for hypermobility spectrum disorder and hypermobile Ehlers-Danlos Syndrome: A systematic review. Musculoskeletal Science and Practice, 54, 102394.
Ferrell, W. R., et al. (2022). Safe and effective strengthening programs in hEDS: A pilot study. BMC Musculoskeletal Disorders, 23(1), 102.
Coussens, M. et al. (2020). Stabilization training for hypermobility disorders: A clinical commentary. Journal of Orthopaedic & Sports Physical Therapy, 50(5), 249–258.