What Is Ehlers-Danlos Syndrome?
Ehlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders caused by defects in collagen synthesis and structure. Since collagen is the primary structural protein of virtually every tissue in the body — skin, joints, blood vessels, ligaments, tendons, and organs — EDS produces wide-ranging effects across multiple body systems.
There are 13 recognized subtypes of EDS, with Hypermobile EDS (hEDS) being by far the most common. EDS affects an estimated 1 in 5,000 people, though the actual prevalence is believed to be significantly higher due to widespread underdiagnosis.
At Pittsburgh Physical Medicine, we have significant experience treating patients with EDS and hypermobility spectrum disorders — an area requiring specialized knowledge that many general chiropractic and PT practices lack.
Why EDS Is Different: The Hypermobility Problem
For most musculoskeletal conditions, joint instability is a secondary problem — the primary issue might be a muscle imbalance, a structural deformity, or a training error. In EDS, joint instability is the fundamental, systemic problem — caused by defective collagen that makes ligaments too lax to properly stabilize joints.
This creates a paradox: EDS patients have joints that are too mobile, yet they are often more restricted and more painful than patients with normal joint mobility. This is because hypermobile joints are unstable joints — the muscles surrounding them go into chronic protective spasm to compensate for the lack of ligamentous support, creating tension, pain, and restricted movement despite the underlying laxity.
Common EDS Symptoms We Treat
- Chronic widespread musculoskeletal pain
- Joint subluxations and dislocations (partial or complete joint slippage)
- Headaches — cervicogenic, tension, and headache from atlantoaxial instability
- Neck pain and cervical instability
- Temporomandibular joint (TMJ) dysfunction
- Costochondritis (rib pain)
- Sacroiliac joint dysfunction
- Fatigue and post-exertional malaise
Critical safety note: Standard high-velocity chiropractic manipulation is generally contraindicated in EDS due to ligament laxity and risk of increasing instability. We use low-force, stabilization-focused techniques specifically appropriate for hypermobile patients.
Our Approach to Treating EDS
Low-Force Stabilization Techniques
Rather than high-velocity manipulation, we use gentle mobilization, soft tissue techniques, and low-force adjusting methods that address joint dysfunction without placing excessive stress on already-lax ligaments.
Neuromuscular Stabilization Training
The cornerstone of EDS management is building the muscular stability that the ligamentous system cannot provide. Dr. Crockatt designs progressive neuromuscular programs focused on deep stabilizer activation, proprioceptive training, and controlled loading — never into ranges of motion that stress hypermobile joints.
Pain Neuroscience Education
EDS is associated with central sensitization — the nervous system becomes hypersensitive to pain signals. Understanding this mechanism is a therapeutic intervention in itself and helps patients manage flares more effectively.
Suffering from Ehlers-Danlos Syndrome and Chiropractic?
Our team at Pittsburgh Physical Medicine treats this condition with chiropractic care, physical therapy, and soft tissue techniques — under one roof in East Liberty, Pittsburgh.
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