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What is Ehlers Danlos Syndrome?

EDS, or Ehlers Danlos Syndrome, is a connective tissue disorder caused by a genetic variant that can make your joints overly flexible. Some of the most common symptoms of EDS include hypermobile joints or joints that stretch further than normal, hyperelastic skin or skin that stretches more than normal, a history of joint dislocations, fatigue and skin that bruises easily.

There are 13 different types of EDS, which can present with different symptoms. Because there is so much variability in symptoms, EDS is often misdiagnosed or overlooked by providers.

Hypermobile EDS (hEDS) is the most common subtype. If hEDS has been ruled out via the diagnostic criteria, an alternate diagnosis of Hypermobility Spectrum Disorder (HSD) might be made instead. EDS is diagnosed by matching your signs and symptoms as well as your family history to the according EDS subtype clinical criteria. There is currently no cure for this condition, but symptoms can be managed through lifestyle modification and treatment.

How is the pelvic floor related to EDS?

Some of the common symptoms of EDS in relation to the pelvic floor include pelvic pain, bladder dysfunction, gastrointestinal disorders, and sexual pain or dysfunction. Because the pelvic floor is made up of a combination of ligaments and connective tissue surrounding our organs, the pelvis and its contents become more mobile than they should be. In reaction to this, our body will attempt to compensate for the lack of stability and may begin to over-activate and overuse the muscles in the pelvic floor to provide more support. After all, the pelvis and the pelvic floor are responsible for providing support to the body structures above while also absorbing shock from the ground forces below with each step we take. Over time, the overuse of the pelvic floor muscles can result in muscle tightness or hypertonicity leading to pelvic pain, difficulty emptying the bowels and bladder, pelvic organ prolapse, and incontinence.

How can pelvic floor physical therapy help with EDS?

Pelvic floor therapy is an essential care component of managing symptoms related to EDS. Your therapist will provide a comprehensive evaluation by reviewing your medical history and assessing your posture as well as internal and external muscular strength, tone, endurance and coordination. A treatment plan will be based on your symptoms and goals. Treatments may include a combination of strengthening or stability exercises, manual therapy for internal and external musculature and proprioceptive training techniques. Additionally, your pelvic floor therapist may recommend certain therapeutic tools such as a pelvic wand or vaginal dilators to improve the tone or tightness of the pelvic floor muscles.

If you suspect you have Ehlers Danlos Syndrome or Hypermobility Spectrum Disorder, please contact your healthcare provider for a comprehensive assessment and diagnosis. If you would like to learn more about how we treat EDS and HSD at Wellest Integrative Health, send us an email at

-Dr. Kristin Stetzel, PT


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