Whole body

What It Is

Ehlers-Danlos syndromes (EDS) are a group of rare inherited conditions that affect connective tissue (NHS, 2022). Connective tissues support the skin, tendons, ligaments, blood vessels, internal organs and bones, giving them strength and elasticity (NHS, 2022). In EDS, the body makes weaker connective tissue, so it can't support the body as it should (Cleveland Clinic, 2026).

Most types of EDS cause joints that move further than normal (hypermobility), so the joints can be loose and unstable (MedlinePlus Genetics, 2022). However, not every type does: vascular EDS, for example, does not cause joint hypermobility (Cleveland Clinic, 2026).

Since 2017, EDS has been classified into 13 types, most of which are rare (MedlinePlus Genetics, 2022; NHS, 2022). Hypermobile EDS is the most common type. Other types include classical, vascular, kyphoscoliotic, arthrochalasia and dermatosparaxis EDS (NHS, 2022; MedlinePlus Genetics, 2022). Taken together, all types of EDS affect at least 1 in 5,000 people worldwide (MedlinePlus Genetics, 2022).

Many people with EDS have joints that are overly flexible and skin that is stretchy, soft and fragile and bruises easily (MedlinePlus Genetics, 2022). In classical EDS, wounds can split open easily, heal slowly and leave wide scars (NHS, 2022).

In some rare types, especially vascular EDS, the walls of blood vessels and organs such as the intestines and the womb (during pregnancy) can tear, which can be life threatening (NHS, 2022; MedlinePlus Genetics, 2022). The eyes can also be affected in some types (NHS, 2022).

Ehlers Danlos Syndrome Anatomy

EDS is caused by faults in certain genes that weaken connective tissue, including the proteins (such as collagen) that support the bones, skin, joints, internal organs and blood vessels (NHS, 2022; MedlinePlus Genetics, 2022). There is no cure, but many of the symptoms can be managed, and treatment aims to prevent complications such as dislocations (Cleveland Clinic, 2026; NHS, 2022).

In the types of EDS that cause hypermobility, people may describe themselves as double jointed or as having very loose joints. These joints can be prone to sprains, partial dislocations (subluxations) or full dislocations, and joint pain and clicking are common (NHS, 2022; MedlinePlus Genetics, 2022). The skin may be fragile, bruise easily or be very stretchy (MedlinePlus Genetics, 2022).

The Beighton score is used to assess the degree of hypermobility. It is scored out of 9 points (The Ehlers-Danlos Society, 2026):

Can you bend your little finger backwards beyond 90 degrees? Score one point for your left little finger, and another point for your right little finger. Total = 2 points.
Can you straighten your elbow beyond 10 degrees backwards? Score one point for each elbow. Total = 2 points.
Can you bend your thumb back to touch your forearm? Score one point for each side. Total = 2 points.
Can you lock your knees out so they bend backwards beyond 10 degrees? Score one point for each side. Total = 2 points.
Can you bend forwards and place both palms flat on the floor without bending your knees? Score one point.

Total points = 9.

A score of 5 or more in adults (6 or more in children before puberty, and 4 or more in adults over 50) is a sign of generalised hypermobility (The Ehlers-Danlos Society, 2026). A high score does not necessarily mean you have EDS. Joint hypermobility is fairly common, affecting around 1 in 30 people, and it is unlikely to be caused by EDS if you have no other symptoms (NHS, 2022).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Manage Ehlers Danlos Syndrome

Exercises to strengthen the muscles around your joints help to avoid injuries and manage pain (NHS, 2022; Cleveland Clinic, 2026). I can help with a gentle strengthening programme, hands-on work for sore, overworked muscles, and advice on pacing and bracing. See the My Approach tab for how I work.

1. Physical Therapy

Joints with weak connective tissue are more likely to dislocate. A physiotherapist can teach you exercises to strengthen the muscles around your joints, avoid injuries and manage pain (NHS, 2022; Cleveland Clinic, 2026). A brace may also be recommended for extra joint support (Cleveland Clinic, 2026). I can help you work out whether one might help you and how to get it. Lower-risk activities such as swimming or Pilates may be recommended to help you stay fit (NHS, 2022).

2. Everyday Activities and Support

It's important to be careful with activities that put a lot of strain on your joints, but also not to be overprotective and avoid living an otherwise normal life (NHS, 2022). An occupational therapist can help you manage daily activities and advise on equipment, and if tiredness is a problem you can be taught ways to pace your activities (NHS, 2022). Counselling and cognitive behavioural therapy (CBT) may be useful if you are struggling to cope with long-term pain (NHS, 2022).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Specialist assessment: your family doctor or nurse practitioner may refer you to a joint specialist (rheumatologist), or to a genetics service if a rarer type of EDS is possible (NHS, 2022).
Medicines for pain: your family doctor or nurse practitioner can talk with you about whether any medicines might help with pain.
Hospital scans: for certain types of EDS, regular scans in hospital can check for problems with internal organs and blood vessels (NHS, 2022).
Surgery: occasionally an operation may be needed for damaged joints. In some types of EDS, wounds can be slow to heal (NHS, 2022).
Genetic counselling: this can help you learn how your type of EDS is inherited and what the chances are of passing it on (NHS, 2022).

How I can help (see the My Approach tab)

Strengthening exercises to support loose joints

Gentle hands-on work for tight, overworked muscles

Advice on pacing, joint protection and braces

Tips

If you have a family or personal history of EDS and are thinking about starting a family, you may want to speak with a genetic counsellor to assess your risks (NHS, 2022).
You may be advised to avoid contact sports, heavy lifting and high-impact exercise to reduce your risk of dislocations (NHS, 2022; Cleveland Clinic, 2026).
To prevent falls and injuries at home, keep doorways and walkways free of clutter.
Avoid trailing electric cords and loose rugs, which increase your risk of tripping and falling.
To protect skin that is easily damaged, wear sunscreen when outside and use a mild soap (Cleveland Clinic, 2026).
In the hypermobile, classical and vascular types, there is a 1 in 2 (50 percent) chance of each child inheriting the condition from an affected parent. In kyphoscoliotic EDS, which needs a faulty gene from both parents, the chance is 1 in 4. A person can only pass on the same type of EDS that they have (NHS, 2022).

Treatment

My Approach

EDS is managed by your doctor and specialists, and your type of EDS shapes what is safe. I work alongside them, focusing on the muscles that work overtime to hold loose joints steady, the stiff areas that compensate for them, and building the strength that gives your joints the support their ligaments can't.

I start by assessing how your joints move, which ones are loose and which are stiff, your strength and posture, and how your skin copes with pressure. Tell me which type of EDS you have and what your medical team has advised. If you have vascular EDS, or a type that affects blood vessels or organs, I keep the work light and follow your team's guidance. After surgery, I need your surgeon's okay before hands-on treatment.

Hands-On Treatment

Gentle massage and sustained pressure on tight, tender muscles around loose joints, followed by warmth
Gentle mobilisation for stiff areas next to a loose joint, never for the loose joint itself
No stretching of loose joints, and light pressure with no cupping or tools where skin bruises or tears easily

Strength and Daily Life

Holding exercises in a well-supported position first, then moving exercises once your muscles can control the joint
A home programme, alongside lower-risk activity such as swimming or Pilates
Pacing, joint protection and avoiding stretches that force joints to their end range
Help working out whether a brace might help and how to get one

A joint that swells quickly after an injury should be checked by a doctor. If a joint dislocates, don't push it back yourself; call 911 or go to the emergency room (see When to get emergency help).

What to Expect

Typical Course

Typical course: Most people start with weekly visits, with a reassessment at about 4 to 6 weeks, then space visits out as they manage more on their own. Building strength around loose joints is gradual, so expect changes over a few months, alongside your medical team's plan.

What I Focus On

Joint-Safe Hands-On Care

Stiff-Area Mobilisation

Stabilising Strength

Pacing & Joint Protection

Working With Your Team

Please read

When to See a Doctor First

When to get emergency help

Dislocations are the most common complication of EDS. Never try to push a joint back into place yourself if you think it is dislocated; call 911 or go to the emergency room at your nearest hospital (Cleveland Clinic, 2026).

Sources

References

NHS (2022) Ehlers-Danlos syndromes (EDS). Available at: https://www.nhs.uk/conditions/ehlers-danlos-syndromes/ (Accessed: 7 October 2026).
MedlinePlus Genetics (2022) Ehlers-Danlos syndrome. Available at: https://medlineplus.gov/genetics/condition/ehlers-danlos-syndrome/ (Accessed: 7 October 2026).
The Ehlers-Danlos Society (2026) Assessing joint hypermobility. Available at: https://www.ehlers-danlos.com/assessing-joint-hypermobility/ (Accessed: 7 October 2026).
Cleveland Clinic (2026) Ehlers-Danlos syndrome (EDS). Available at: https://my.clevelandclinic.org/health/diseases/17813-ehlers-danlos-syndrome (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooEhlers Danlos Syndrome

What It Is

Ehlers Danlos Syndrome Anatomy

Self-Care & Treatment

How to Manage Ehlers Danlos Syndrome

1. Physical Therapy

2. Everyday Activities and Support

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Strength and Daily Life

Typical Course

When to See a Doctor First

When to get emergency help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooEhlers Danlos Syndrome

What It Is

Ehlers Danlos Syndrome Anatomy

Self-Care & Treatment

How to Manage Ehlers Danlos Syndrome

1. Physical Therapy

2. Everyday Activities and Support

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Strength and Daily Life

Typical Course

When to See a Doctor First

When to get emergency help

References

Related Conditions

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Anterior Wedge Fracture to the Vertebra

Bone Tumor

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