Joint Hypermobility Conditions

If you have ever been told that you are “double jointed” or you remember getting attention as a child for how easily you could plop into a split or make joints move in ways that not everybody could, you might just have either hEDS or HSD.

How Do I Know If I Have HSD or hEDS?

Hypermobility Spectrum Disorders (HSD) fall on a spectrum and include those with relatively minor symptoms as well as those with severe symptoms. Also, not everyone with HSD/hEDS will have the same markers.

You can use this self-test (Beighton Score) to determine whether you may have Generalized Joint Hypermobility (JH). You are considered to have (HSD) if you meet these criteria for JH AND have pain and/or musculoskeletal conditions. If you meet the criteria but do not have symptoms then you simply have Joint Hypermobility.

hEDS falls within the HSD spectrum but is typically associated with more severe symptoms that affect your daily life. You can use this diagnostic criteria check-list to help you decide if you should talk to a specialist about whether you might have hEDS or another type of EDS

If you feel that you meet these criteria you should share this article with your non-specialist providers to help guide them in making an appropriate diagnosis or referral. If you have a complex, severe, or puzzling case, you may need to seek help from an EDS specialist such as Dr. Spanos in Chapel Hill (if you are in NC). Dr. Spanos also has many other wonderfully informative articles on his website such as; this article that can help you find the right physical therapist and advocate for yourself and another on medical management of patients with HSD/hEDS that you can give to your PCP to help them help you!

Why Does The Right Diagnosis Matter?

People with different forms of hypermobility frequently experience pain in multiple regions of the body and may receive a diagnosis of fibromyalgia or other catch-all diagnosis that are not as effective in leading you to the correct treatment and may just mask symptoms rather than treating the cause. Delaying appropriate treatment may mean more severe issues later in life.

The good news is that there is A LOT that can be done to help you decrease and manage the symptoms of hEDS/HSD if you just have the right guidance.

Note from Dr. Keeli Gailes

“As a person who lives with HSD I have become a specialist in this area out of necessity. I can, therefore, pull on both my learned knowledge and my lived experience to help you come up with real-world solutions. I will also break the cycle of gas-lighting around how “great” it is to be “so flexible” and teach you real-world practices that can help you live your best life!

Having been a gymnast and a dancer in my early life, I understand the pressures that are put on young people with hypermobility to over-perform and “show-off” this talent. I hope to be able to work with young people to help them learn how to respect their limits and protect themselves from future pain through targeted strengthening and setting appropriate limits”

Young smiling woman showing her bent arm. Hypermobility of elbow joint concept

The “Trifecta” – EDS, MCAS, and POTS

In recent years we have learned that there is a strong connection between Ehlers Danlos Syndrome (EDS), Mast Cell Activation Disorder (MCAS), and Postural Orthostatic Tachycardia Syndrome (POTS). Thanks to genetic testing, we have also learned that these 3 are all linked by the same genetic mutation. You may have HSD/hEDS and NOT have any of these other symptoms but they are worth mentioning due to the high prevalence.

When it comes to managing these conditions, knowledge is power. If you are dealing with this trifecta, you need to:

  1. Arm yourself with knowledge
  2. Have a medical specialist on your team
  3. Have a physical therapist who specializes in treating EDS/HSD on your team.

How We Treat HSD/EDS

Spasm/Musculoskeletal Pain Management

Most musculoskeletal pain is caused by spasms in your muscles. When you have HSD/hEDS you do not have as much stability from your ligaments and other connective tissue so your muscles work “overtime”. This often leads to more frequency of muscle spasms and associated pain.

We use GENTLE manual techniques including trigger-point release, dry-needling (if appropriate) or other approaches to alleviate the spasms and decrease the associated pain.

APPROPRIATE Strengthening At An Intensity And Format That Works For You

Building BALANCED strength is the best way to prevent return of spasms and help stabilize your joints to minimize/prevent joint subluxations and dislocations.

We take care to determine the appropriate exercises and intensity level to allow you to strengthen without causing further spasm and pain or injury.

We teach the importance of incorporating your deep-core into all exercise to improve your stability and strength through the rest of your body.

Chronic Pain Management Education

If you have been dealing with pain for 3+ months you are also dealing with “Persistent Pain” AKA “Chronic Pain”.

Learning how to treat the pain that is generated by the brain’s expectations, as well as the physical causes, are crucial to making progress in decreasing overall pain.

Lifestyle Modifications

We help you understand and modify potential triggers of your pain or other “trifecta” symptoms so you can start to modify your behaviors to help you decrease and better manage your symptoms.

We can help you learn how to best support yourself physically to allow you to participate in the activities that make life meaningful to you!


In certain cases, bracing is necessary to allow for movement without subluxation/dislocation. We can help you find an orthotist and/or product that will meet your individual needs.

Contact Us Today For a Free Consult

The board-certified therapists at Garner Pelvic Health are here to help you. If you have any specific questions or want to see if we are a good fit for your unique situation

Sign up for the waitlist for our next HSD/hEDS workshop as an inexpensive way to learn ways of better caring for yourself if you live with any type of joint hypermobility!