
Exercise is an important component of health and wellness in many chronic conditions, and especially for hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD). The American College of Sports Medicine (ACSM) recommend 150 min/week of moderate intensity cardiovascular exercise. This is generally a good guideline for most patients. Our physical therapy experience recommends that we begin with light cardiovascular exercise not exceeding 50% of maximum intensity. Considering the common complications of joint injury with hEDS and HSD, it is important to remember to perform low impact activities such as walking, stationary bicycle, swimming or elliptical. It is ideal to recover back to baseline with in 2-3 hours following activity (if you do not, modify by decreasing time and/or intensity of exercise). Another avenue of exercise we like to employ is Resistance Training. See below points for further information. Your physical therapist at Mayo Clinic will be able to guide you further on exercise and help develop an individual treatment plan.
Resistance Training:
- Perform exercises in mid-range (50% of your available range of motion only) with minimal pain.
- Begin with 10 repetitions and increase weekly by 3-5 repetitions. Continues to progress until you can perform 2 sets of 20 repetitions prior to adding resistance/making exercise more difficult.
- Perform resistance exercises 2 sessions a week (per body region) not exceeding 5 exercises daily. You should expect mild soreness following 2-3 days.
Coaching:
Do you need more help reaching your goals of health, including exercise? A certified health and wellness coach can help. This is a unique Integrative Medicine service at Mayo Clinic that can be tremendously beneficial for patients with EDS/HSD. If you would like to learn more, watch this video, and reach out to your provider team to sign up!
Author: Jon Erik Shanklin, P.T., D.P.T.
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When I was first diagnosed, I initially found this post very helpful because I had such minimal knowledge of heads/HSD, and desperately needed guideline recommendations for exercise. However, I now realize this exercise advise is completely inaccurate and potentially harmful. 150 hours per week of exercise is a lot for the average EDS patient and can only be achieved after YEARS of slow and stable progress. Furthermore, I have multiple highly qualified medical professionals (including a rheumatologist and orthopedic surgeon) warn me to never use an elliptical because of the proclivity towards hip subluxation for hypermobile people. This caution can be applied towards many exercises but apparently ellipticals should always be avoided.
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