Could your client have a connective tissue disorder?

By Jeannie Di Bon – Movement Therapist and Hypermobility Specialist

Could your client have a connective tissue disorder? What are the signs and symptoms we need to look out for?  This article gives an overview of Ehlers-Danlos Syndrome (EDS) which is one of the heritable disorders of the connective tissue.

A connective tissue disorder is described as a condition that affects the parts of the body that connect the structures of the body together (Mayo Clinic 2021). Our connective tissues are made up of two proteins: collagen and elastin. Collagen is a protein found in the tendons, ligaments, skin, cornea, cartilage, bone and blood vessels. Elastin is a stretchy protein that resembles a rubber band and is the major component of ligaments and skin. With EDS, the underlying concern is the abnormal structure or function of collagen and certain allied connective tissue proteins (EDS Society 2021). 

Imagine this scenario: a new female [more females have EDS than males – we believe largely due to the impact of female hormones on the tissues] client arrives and completes her medical form.  As you review the form you discover your client has described the following medical history:

• Chronic, widespread pain – not resulting from any particular trauma or accident.  The pain can often be made worse by exercise.
• Joint pain and muscular tightness.  On palpation, her muscles feel tight and yet she complains of joint subluxations sometimes – particularly around her menstrual cycle. 
• Very flexible – she enjoys yoga.
• Headaches and migraines on a daily basis.
• Dizziness upon standing or over exertion from exercise.  She sometimes faints suddenly.
• Heat intolerance – she does not like hot weather or saunas.  This sort of heat makes her nauseous and faint with heart palpitations.
• Chronic fatigue – even after sleep, she feels tired.
• Difficult child births – with subsequent pelvic floor issues.
• Wears orthotics due to pronated feet and has frequent ankle sprains.
• Frequent chest infections and pneumonia.
• Mitral value prolapse in heart.
• Allergies and food intolerances.  She has tried various diets but still has bloating and pain.   She was diagnosed with IBS at an early age.

This list of physical symptoms could be quite unnerving initially for any teacher or therapist, regardless of teaching experience. 

Our role is not to diagnose our clients – unless we are also medically trained.   But being aware of the possible symptoms which are often multisystemic, you may realise your client has a connective tissue disorder like Ehlers-Danlos Syndrome (EDS).  They may not even be aware of this themselves due to poor medical awareness and training about this condition.   Awareness of such a condition is going to impact any therapy or movement programme you are planning to implement.

Common connective tissue disorders you may come across are:

• Ehlers-Danlos Syndrome
• Marfan Syndrome
• Osteogenesis imperfecta
• Epidermolysis bullosa

These disorders are not curable, so it is really a case of helping our clients with management of the symptoms. 

I will be discussing this and other EDS topics at my January webinar with the Fascia Hub. 

January 2021

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