Member May 2026: Advancing Care for Hypermobility: Evidence-Based Treatment Breakthroughs in Physical Medicine Rehabilitation-Session Recording

Video Transcription

Video Summary

The session introduced evidence-based care for hypermobility, focusing on hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD). Dr. Jennifer Hankinson explained that hypermobility exists on a spectrum, with hEDS being a clinical diagnosis and HSD capturing symptomatic patients who do not meet full hEDS criteria. Common symptoms include chronic widespread pain, recurrent subluxations, fatigue, dysautonomia, gastrointestinal issues, anxiety, depression, and fear of movement. Diagnosis often relies on the Beighton score plus other features such as skin laxity, easy scarring, and joint instability.<br /><br />She emphasized that physiatrists are well positioned to lead care because of their function-focused, multidisciplinary approach. The strongest evidence supports therapeutic exercise, especially a whole-body rehabilitation model rather than treating isolated joints. Key principles include starting slowly, progressing slowly, using closed-chain and core-stabilization exercises, improving proprioception, and avoiding high-impact or overly stretchy movements. Inspiratory muscle training and aquatic therapy were highlighted as helpful adjuncts, especially for fatigue and dysautonomia.<br /><br />The talk also reviewed prolotherapy as a possible adjunct for refractory ligamentous laxity, though evidence is limited and it should not replace rehabilitation. Dr. Hankinson stressed the importance of building a coordinated team, including physical therapy, occupational therapy, pain psychology, cardiology, gastroenterology, genetics, and primary care when needed.<br /><br />Other topics included pain management strategies, adaptive equipment, psychological support, and common barriers such as fragmented care, insurance limits, and provider skepticism. She closed by noting major evidence gaps and calling for more research into optimal exercise protocols and long-term outcomes.

Keywords

hypermobile Ehlers-Danlos syndrome

hypermobility spectrum disorder

evidence-based care

therapeutic exercise

whole-body rehabilitation

proprioception

joint instability

dysautonomia

prolotherapy

multidisciplinary care

physical therapy