Ehlers-Danlos Syndrome (EDS)

Validating Care for Ehlers-Danlos Syndromes

Living with Ehlers-Danlos Syndromes (EDS) can be an incredibly challenging journey, often filled with misdiagnoses and misunderstood symptoms. EDS is a group of inherited connective tissue disorders that affect everything from your skin and joints to your blood vessels and internal organs. The hallmark of most types is joint hypermobility, but the condition is far more complex than that.

At Velca, we provide a safe, knowledgeable, and collaborative environment for conservatively managing the component of your EDS symptoms. We see you, we hear you, and we understand that your needs are unique. Our team of physiotherapists, chiropractors, massage therapists, podiatrists and counselors works together to help you improve your quality of life, manage your pain, and feel more in control of your body.

Understanding Ehlers-Danlos Syndromes

EDS is caused by faults in the structure or processing of collagen, the "glue" that holds your body together. This can lead to a wide and varying range of symptoms, including but not limited to:

• Significant joint hypermobility, with frequent and painful subluxations or dislocations.

• Soft, fragile skin that may bruise or tear easily.

• Chronic, widespread musculoskeletal pain and debilitating fatigue.

• Autonomic dysfunction, such as Postural Orthostatic Tachycardia Syndrome (POTS), causing dizziness and fainting.

• Gastrointestinal problems and other systemic issues.

• Varying mental health/neuro-diversity

  We do not have the expertise or skills to treat/manage all aspects of EDS and frequently refer to the appropriate specialists and General Practitioners.

  Our hEDS/HSD assessment follow the official EDS diagnostic guidelines as well as additional musculoskeletal related testing. The hope is to provide you with a road-map with a clear path forward, with the ultimate goal being you managing your symptoms on your own.

Our Integrated & Compassionate EDS Management Plan

Effective EDS management requires a multi-faceted approach that respects the fragility of your body's tissues. Our practitioners are educated in the specific needs of the EDS population and collaborate on your care depending on your wants/needs/symptoms.

• Physiotherapy:
  Physiotherapy is essential for managing EDS. Our physios act as your guide, helping you build a robust yet gentle program focused on stability and control, not flexibility. We utilize evidence-based protocols focusing on:

  • Safe, progressive strengthening to create "muscular armor" around unstable joints.

  • Proprioceptive training to enhance your brain's awareness of where your joints are in space.

  • Pain education and management, including strategies for bracing, pacing, and preventing injury.

  • Hands on treatment, to reduce pain and increase function when needed.

  • Conservative management of scoliosis using the Schroth method

• Chiropractic: Gentle Support
  Our chiropractors approach EDS with the utmost care. They do not perform traditional high-velocity adjustments on hypermobile joints. Instead, they focus on:

  • Using very gentle, low-force techniques (like instrument-assisted adjustments or mobilization) to address fixated joints that may be causing compensatory pain. Each person with EDS is unique, and we tailor our approach to you.

  • Improving nervous system regulation to help with pain signalling and autonomic function.

  • Working on cranio-cervical stability where appropriate.

  • Relieving rib pressure by using manual techniques to get your rib symptoms to settle.

  • Using manual care to reduce tension and decrease pain.

• Women's Health Physiotherapy: Pelvic Health and Beyond

  The connective tissue laxity behind EDS doesn't stop at the joints most people think of — it also affects the ligaments and fascia that support the pelvic floor and pelvic organs. In practice, this can show up as pelvic girdle pain, pelvic organ prolapse, bladder or bowel symptoms, or pain with intercourse. Our women's health physiotherapy service addresses this directly:

  • Assess and treat pelvic girdle instability, which is often more pronounced during and after pregnancy in people with EDS/HSD.

  • Retrain pelvic floor function, addressing both underactivity (which can contribute to prolapse or incontinence) and overactivity (a common compensatory pattern when surrounding ligaments can't do their job on their own — the same "muscular armour" principle used elsewhere in your care).

  • Provide individualised guidance through pregnancy and postpartum recovery, accounting for the higher rates of pelvic girdle pain, joint subluxation, and slower tissue healing seen in EDS.

  • Support bladder and bowel symptoms linked to laxity in the connective tissue that supports the pelvic organs.

  • Address pain with intercourse, where it relates to pelvic floor dysfunction or joint hypermobility.

  • Coordinate closely with your physiotherapist and chiropractor, so pelvic stability work reinforces, rather than conflicts with, your broader stability program.

• Massage Therapy: Soothing and Supportive Care
  The chronic muscle tension and pain from EDS can be exhausting. Our massage therapists are trained to use techniques that are safe for fragile tissues. Their role is to:

  • Use gentle techniques to release tight, spasming muscles that are working overtime to guard your joints.

  • Promote relaxation and help calm an overstimulated nervous system.

  • Assist with lymphatic drainage and circulation without stressing the skin or joints.

• Podiatry: Protecting Your Foundation
  Your feet and ankles are foundational to how forces travel through the rest of your body — and in EDS, they're often a significant source of pain and instability in their own right. Our podiatry team works alongside your physiotherapist and chiropractor to:

  • Assess gait and foot biomechanics to identify how hypermobile, unstable feet may be driving compensatory pain further up the chain, in your knees, hips, or lower back.

  • Provide custom orthotics that give your feet the external structural support that lax ligaments can't reliably provide on their own.

  • Advise on supportive footwear suited to protecting hypermobile joints during daily activity and exercise.

  • Deliver careful, low-trauma skin and nail care, mindful of the skin fragility that can accompany EDS.

  • Manage secondary overuse conditions, such as plantar fasciitis or forefoot pain, that often develop from years of compensatory movement patterns.

• Counselling: Supporting the Whole Person
  Living with EDS isn't only a physical experience. Chronic pain, unpredictable symptoms, disrupted sleep and, for many people, years of misdiagnosis or having real symptoms dismissed before reaching a diagnosis, all take a genuine psychological toll. Our counselling service supports that side of your journey, working alongside your physical care rather than apart from it:

  • Processing the emotional impact of a complex or long-delayed diagnosis, including the experience of having symptoms doubted before being taken seriously.

  • Building pain-focused coping strategies — such as pacing and acceptance-based approaches — to help you live well alongside chronic pain rather than being ruled by it.

  • Support for anxiety, low mood, or health-related distress, which can be more common when living with an unpredictable, often invisible, chronic condition.

  • A direct line back to your physiotherapist, chiropractor, and podiatrist, so your psychological support is informed by what's actually happening in your body.

• Shockwave Therapy: A Targeted Pain Management Option
  Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that can help with specific, localised areas of chronic pain — most commonly stubborn tendon and soft tissue conditions like plantar fasciitis, Achilles tendinopathy, or lateral elbow pain. These conditions can develop in EDS as a result of years of joint instability and the compensatory overuse this creates.

  Additionally, ESWT has been shown to help with pain in patients with fibromyalgia, see a study here. In our clinic we have found that it can be an effective tool in pain management for some patients.

  Because connective tissue in EDS behaves differently, shockwave is never a blanket or first-line treatment in our clinic — it's a considered option for the right presentation:

  • Case-by-case assessment of whether a specific area of chronic pain is actually suitable for shockwave, rather than assuming it is.

  • Individualised treatment settings, with intensity adjusted for tissue fragility rather than a standard protocol.

  • Used for localised tendon and soft tissue pain, not as a treatment for joint instability or hypermobility itself.

  • Integrated with your wider plan — shockwave supports, rather than replaces, the stability-focused physiotherapy and chiropractic work that remains central to managing EDS.

Many of our EDS patients have questions before seeing us. Please reach out if you have any by clicking here.