Upper Extremity Presentation in HSD/EDS

Presented by Heather Purdin and Patricia Stott

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Video Runtime: 144 Minutes, Learning Assessments: 44 Minutes

A patient with HSD/EDS commonly experiences pathologies developing in the upper extremity due to laxity combined with functional use. Laxity, subluxations, and dislocations can be more common in those with HSD/EDS, and increased use of the hypermobile upper extremities can lead to overuse injuries. Finding the appropriate individualized support and therapeutic strategies for upper extremity issues in HSD/EDS can not only improve function and pain, but quality of life as well.

Meet your instructors

Heather Purdin

Heather Purdin has been a practicing PT in an outpatient setting for 26 years and has a special interest in chronic pain, fibromyalgia, and connective tissue disorders. She is president of the Oregon Area Ehlers-Danlos Society. She is also president of Good Health Physical Therapy & Wellness, a private practice specializing…

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Patricia Stott

Patricia Stott treats primarily those with HSD/EDS and those considered highly sensitive patients at her own practice, Elevation Wellness, outside the Denver metro area in Colorado. Also trained in functional and herbal medicine, she works on health and wellness through holistic strategies with these patients, both in person…

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Chapters & learning objectives

1. Upper Extremity Pathologies in HSD/EDS

This chapter will review the pathologies of the upper extremity seen more commonly in those with HSD/EDS. Prevalence and rationale for etiology discussed when available.

2. Shoulder and Shoulder Girdle Presentation and Approaches in HSD/EDS

Gravity affects the shoulder and its girdle with hypermobility such that cues for posture have to be altered from the general population’s cues. Muscles commonly thought to need inhibition will need strengthening to stabilize the hypermobile shoulder.

3. Cervicothoracic Presentation and Approaches in HSD/EDS

Hypermobile shoulders cause drag on the shoulder girdle, creating mechanical faults, nerve entrapments, and subluxations at the cervicothoracic (C/T) junction. Supporting the shoulders adequately can relieve issues at the C/T junction and thoracic outlet, along with strengthening the scapular elevators. Tone-reducing strategies for the scalenes and upper rib alignment are key to pain-free mechanics.

4. Elbow Presentation and Approaches in HSD/EDS

We will review the more common elbow pathologies that can occur with increased laxity in the HSD/EDS population. Treatment and support strategies will be reviewed for optimal outcomes.

5. Wrist Presentation and Approaches in HSD/EDS

Wrist instability is not uncommon in those with HSD/EDS. We will review pathologies more commonly seen in the clinic and discuss comprehensive intervention strategies.

6. Thumb Presentation and Approaches in HSD/EDS

Thumb involvement tends to be quite common in those with HSD/EDS. Efficient support and treatment interventions can significantly improve function in this population and protect the health of the joints over time.

7. Hand and Finger Presentation and Approaches in HSD/EDS

Maintaining dexterity and function can be very difficult for someone with HSD/EDS if this is a problematic area for them. Finger instability can often be overlooked when the patient is dealing with other pain responses affecting activities of daily living. It is important to investigate needed support and strengthening in the hand and fingers to improve quality of life and prevent a decline in function with aging.

8. Upper Extremity Patient Presentation in HSD/EDS

A patient will present a personal case story to elaborate on the extent to which the hands can be affected and which combined treatment strategies work for long-term management.

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