Hypermobile Ehlers-Danlos Syndrome (hEDS) & Hypermobility Spectrum Disorders (HSD)
Specialist physiotherapy for hypermobility, joint instability and persistent pain in Billericay, Essex
Hypermobile Ehlers-Danlos syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) are complex conditions that can have a significant impact on movement, joint stability, pain, physical activity and quality of life.
At The Arthritis Clinic, we have a particular interest in the assessment and physiotherapy management of people living with hEDS and HSD.
Our clinical interest is supported by ongoing academic research. Michael Dare, Founder and Director of The Arthritis Clinic, is currently undertaking a PhD focused on Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders, with research exploring the lived experiences of people with these conditions and the evidence for physiotherapy and other conservative approaches to managing pain and improving quality of life.
This combination of advanced musculoskeletal physiotherapy experience and ongoing research allows us to provide an informed, individualised approach to the physical challenges associated with hypermobility.
What are hEDS and HSD?
Hypermobile Ehlers-Danlos syndrome (hEDS) is a heritable connective tissue disorder characterised by generalised joint hypermobility, joint instability and a range of associated symptoms. There is currently no single genetic test that confirms hEDS, and diagnosis is based on established clinical criteria and exclusion of alternative diagnoses.
Hypermobility Spectrum Disorders (HSD) describe symptomatic joint hypermobility where the person’s symptoms cannot be better explained by another condition. HSD can involve one or several joints, or more widespread joint hypermobility, and may be associated with joint instability, recurrent injuries and persistent pain.
Importantly, being hypermobile does not necessarily mean that someone has a disorder. Many people are naturally flexible without experiencing pain or functional problems. HSD and hEDS become particularly relevant when hypermobility is associated with symptoms such as pain, instability, injury or functional limitation.
How can hEDS and HSD affect you?
Everyone with hEDS or HSD is different. Some people may experience relatively localised musculoskeletal problems, while others may have symptoms affecting multiple areas of the body.
Common musculoskeletal problems can include:
- Joint pain and muscle pain
- Joint instability
- Recurrent sprains and strains
- Subluxations or dislocations
- Reduced confidence with movement
- Muscle fatigue and overactivity
- Problems with proprioception and movement control
- Reduced strength and muscular endurance
- Persistent or recurrent pain
- Difficulty returning to exercise or sport
- Reduced physical activity and deconditioning
Some people also experience symptoms outside the musculoskeletal system, including fatigue, headaches, gastrointestinal symptoms or autonomic symptoms. These may require assessment and management from other healthcare professionals as part of a wider multidisciplinary approach.
How can physiotherapy help?
Physiotherapy can play an important role in the management of hEDS and HSD.
The aim is not simply to make a hypermobile person more flexible. In many cases, excessive stretching may not be appropriate because increasing movement at an already hypermobile joint can potentially contribute to instability.
Instead, physiotherapy generally focuses on improving strength, stability, movement control, proprioception, confidence and physical capacity, while helping you understand how to manage your symptoms. Exercise is considered an important component of physical therapy for people with hEDS and HSD.
Your physiotherapy programme may include:
Individualised assessment
We assess your symptoms, movement patterns, strength, joint control, functional limitations and the activities that are important to you.
Strength and conditioning
A carefully progressed strengthening programme can help improve muscular support around hypermobile or unstable joints and improve your ability to perform everyday activities, exercise and sport.
Movement control and proprioception
We can work on how you control your joints and movement, particularly where poor joint awareness or movement control contributes to symptoms.
Load management and pacing
Understanding how much activity your body can tolerate is an important part of managing persistent symptoms. We can help you gradually increase activity without repeatedly exceeding your current capacity.
Exercise rehabilitation
Exercise should be individualised rather than based on a standard programme. We can help you develop a progressive programme around your goals, whether that is returning to the gym, walking further, participating in sport or simply becoming more confident with everyday movement.
Pain management
We can help you understand the factors contributing to your pain and develop strategies to improve function while gradually building physical capacity.
Joint protection and support
Where appropriate, we can discuss strategies such as taping, bracing or other forms of external support alongside strengthening and movement retraining.
Education and self-management
A major part of physiotherapy is helping you understand your condition and giving you practical strategies that you can use independently.
A research-informed approach to hEDS and HSD
Our interest in hEDS and HSD extends beyond clinical practice.
Michael Dare is undertaking a PhD researching Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders, with a particular interest in the experiences of people living with these conditions, their journeys through healthcare, and the evidence surrounding physiotherapy and conservative treatment.
His research includes investigation of the available evidence for physiotherapy and other conservative interventions for pain and quality of life, alongside qualitative research exploring the lived experiences of people diagnosed with hEDS and HSD.
This ongoing research helps inform our clinical thinking and reinforces an important principle: there is no one-size-fits-all approach to hypermobility.
Current guidance also recognises that people with hEDS and HSD can have very different symptoms and that management should be individualised around the person’s needs and goals.
You do not have to live with pain or instability alone
Receiving a diagnosis of hEDS or HSD can sometimes leave people unsure about what they can safely do, particularly if previous exercise programmes have increased their symptoms.
Our approach is to work with you rather than simply give you a list of exercises.
We aim to help you understand:
Why am I experiencing these symptoms?
What can I safely do?
How can I become stronger and more physically capable?
How can I manage flare-ups and changes in symptoms?
How can I return to the activities that matter to me?
The goal is to help you develop the knowledge, confidence and physical capacity to manage your condition as independently as possible.
Physiotherapy for hEDS and HSD at The Arthritis Clinic
If you have hEDS, HSD or symptomatic joint hypermobility and are experiencing pain, instability, recurrent injuries or difficulty returning to activity, we can provide an individualised musculoskeletal physiotherapy assessment and rehabilitation programme.
Book an assessment with The Arthritis Clinic to discuss your symptoms, your goals and how physiotherapy may be able to help.
Please note: hEDS and HSD can involve symptoms outside the musculoskeletal system. Where symptoms require investigation or specialist management beyond physiotherapy, we can advise on appropriate onward referral and multidisciplinary care.