The Hypermobility-Hypomobility Continuum

Manual Therapy and Alternative Medicine Solutions for Ehlers Danlos Syndrome and Other Connective Tissue Disorders

This book is for manual therapists as well as parents of children with hypermobility and individuals who wants self-care ideas to feel and function better. Some sections are more technical than others. If you are not a manual therapy practitioner and something is confusing, perhaps discuss it with a physical therapist or a massage therapist. I teach classes in-person and on zoom. My practice is in Spokane, WA and I work with clients in Eastern Washington, Northern Idaho, and Western Oregon as well as travel in the U.S., Canada, Europe, and Asia to work with clients. There are free training videos on the Good Health Physical Therapy, Portland, Oregon Facebook page. This book focuses on Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorders (HSD) and other kinds of connective tissue disorders and joint issues including Marfan Syndrome, Osteogenesis Imperfecta (OI), Systemic Sclerosis (Scleroderma), Rheumatoid Arthritis (RA), Osteoarthritis (OA), Lupus Erythematosus (SLE), and Long COVID. These techniques can be useful for children with Down syndrome and other hypomobility issues and weaves together several ideas including:
1. Gentle and light touch can stimulate the body’s attention to an area, encourage healing, and improve function. Visualization can also be helpful. From Traditional Chinese Medicine comes the saying, “Where the mind goes (attention, visualization, touch), energy follows. Where energy goes blood follows.” And better blood flow encourages healing and function.
2. Proprioception (the internal sense of where we and our joints or body are in space) and Interoception (sensations coming from within the body) influence joint alignment and stability. This influences wear and tear factors, mobility, and pain.
3. When a joint is hypermobile, something else lacks mobility. Hypermobility is a compensatory mechanism. The hypomobile joint is more mobile than it should be, not because the connective tissue is more flexible or elastic. The connective tissue is damaged, over stretched, and more fragile. Increase connective tissue health with better blood flow (cardiovascular health), more nutrients (digestive health) and oxygen (respiratory health), and better detoxification (immune, digestive, and kidney health). Treating the symptoms of connective tissue conditions like Ehlers Danlos syndrome (EDS) can feel like treating one fire after another where the client has different symptoms popping up before and after treatment. Stop chasing fires. Do treatments and exercises that address underlying lack of elasticity.
4. People with genetically driven conditions still eat, sleep, move, exercise, travel, and do everything else that human beings do. Genetics are only one part of the picture, what we do in our life also influences, sometimes significantly, the quality of our life. An individual’s genetic material and what parents pass on to their children can and does change all the time. “Ehlers Danlos syndrome is an intriguing group of inherited collagen and extracellular matrix protein disorders with a wide array of phenotypic expressions. EDS is most often an autosomal dominant trait, but up to 50% of patients can have a de novo mutation.“ Consider, if Ehlers Danlos syndrome occurs as a result of a new case not genetically linked to the parents, could a reverse mutation occur just as easily. Could a person who inherited Ehlers Danlos syndrome not pass it on to their children? Fifty percent is substantial and needs to be considered. Let me know if there is anything I can do to help. Kimberly Burnham