Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome (EDS) Care at North Carolina Physical Therapy

Ehlers-Danlos Syndrome (EDS) is a group of hereditary connective tissue disorders characterized by joint hypermobility, tissue fragility, and impaired collagen integrity. While symptoms vary by subtype, many individuals with hypermobile EDS (hEDS) experience widespread musculoskeletal pain, joint instability, proprioceptive deficits, autonomic dysfunction, and gastrointestinal or pelvic floor challenges.

At North Carolina Physical Therapy, we understand that managing EDS requires far more than generalized strengthening or vague exercise prescriptions. We specialize in comprehensive, patient-specific care that addresses the full-body impact of connective tissue disorders—while supporting your autonomy, safety, and long-term function.

A Whole-Body, Systems-Based Approach

EDS affects more than just joints. Our evaluations take into account the interconnected systems involved , including:

Neuromuscular system: joint stability, muscle imbalances, coordination, and proprioception

Autonomic nervous system: symptoms of dysautonomia such as orthostatic intolerance, fatigue, or GI motility issues

Digestive and pelvic health: associated conditions such as pelvic organ prolapse, dyssynergia, constipation, or urinary frequency

Respiratory mechanics: breath pattern dysfunction, poor pressure regulation, and chest wall mobility

Pain processing: central sensitization, hyperalgesia, and nervous system regulation

We collaborate with each patient to understand their medical history, symptom patterns, lived experiences, and daily function —then develop a plan that’s structured, flexible, and supportive.

What Treatment Looks Like

Our treatment for EDS may include:

• Neuromuscular re-education to improve joint stabilization, motor control, and proprioception

• Breath and intra-abdominal pressure (IAP) retraining for core regulation and energy efficiency

• Manual therapy to address myofascial restrictions, muscle guarding, and nervous system sensitivity

• Joint protection strategies and safe strength progression using submaximal loads and motor control emphasis

• Lymphatic drainage techniques to support tissue health and reduce fluid retention, particularly in patients with Mast Cell Activation Syndrome (MCAS) or overlapping dysautonomia

• Pelvic floor therapy for symptoms of pain, prolapse, bowel or bladder dysfunctionAutonomic symptom support, including pacing, positional tolerance training, and regulation tools

• Education on activity modification, orthotic needs, and realistic energy budgeting (spoon theory-informed)

Compassionate, Collaborative Care

We understand that many individuals with EDS have experienced medical dismissal, or trauma. Our space is safe, validating, and trauma-aware. We believe in working with you—not on you—and always consider your feedback, preferences, and energy levels when designing care.

We also support diagnostic clarity, communicate with referring providers, and help patients prepare for surgical rehab if needed (e.g., prolapse repairs, orthopedic stabilization procedures, or GI motility-related surgeries).

Start Feeling Supported

If you live with Ehlers-Danlos Syndrome and are ready for care that addresses your whole system, your real life, and your goals, we’re here to help. Whether you’re newly diagnosed or have been managing EDS for years, you deserve care that’s thoughtful, informed, and empowering.