People who suffer from joint instability often lack the ability to tell where their joints are in space. This sense, called proprioception, can lead to over-extending a joint beyond its range of motion, leading to injury and trauma.
To improve this joint position sense, physical therapists often utilize manually-resisted exercises or dynamic stabilization exercises (two specific types of manual therapy for Ehlers Danlos Syndrome and Hypermobility Disorders) to reinforce the nerve endings in the joints that give information to the brain about the joint.
These manual techniques are very safe for joints, as joints remain in their strong, neutral position and never approach end range. This has a benefit of re-educating the neuromuscular system while activating muscles and moving the joints in a safe way. Eventually, the central nervous system “learns” how to move safely, reducing the risk of injury and joint trauma.
Those with hEDS and HSD have joints that are inherently unstable because the collagen in their ligaments is dysfunctional, so those folks can’t rely on ligaments to do what they’re supposed to. We need to teach the muscles and tissue to help in a safe and non painful way. Sometimes, muscles will overreact and spasm, which can cause pain, limitation in range of motion and function, and headaches.
There are manual therapy techniques to reduce these spasms, from soft tissue mobilization to more advanced techniques of dry needling and cupping.