Hypermobility and the fascia

Tina Wang crop

by Dr Tina Wang

Hypermobility Spectrum Disorders (HSD) and Hypermobile Ehlers-Danlos Syndrome (hEDS) affect the body’s connective tissue, associated with changes in the extracellular matrix (ECM) within the fascial system. These changes lead to inflammation and increased pain.

One significant alteration is decreased stiffness and increased extensibility of connective tissues. Additionally, deep fascia, which envelops muscles, thickens without the usual muscle stiffening seen in non-hypermobile individuals, making diagnosis challenging.

Individuals with HSD/hEDS may experience reduced gliding between fascial layers, straining joints. This can result in joint instability, pain, and a higher risk of injuries.

Moreover, there’s an imbalance in the muscle-tendon unit. Tendons, connecting muscles to bones, deform during activities like walking or running. However, in HSD/hEDS, tendons elongate more under stress, resulting in lower muscle tension and tendon stiffness.

Addressing these fascial changes poses significant challenges in managing HSD/hEDS. Approaches should focus on addressing breathing patterns and maintaining stability-tension balance. Optimal joint loading requires activating muscles, particularly those in the abdomen and diaphragm.

Traditional stretching methods may not effectively address these issues. Biotensegrity-based approaches aim to establish proper tension throughout the fascial network, improving joint stability.

Additionally, tailored training programs targeting connective tissue and promoting tendon adaptation can help balance the muscle-tendon unit. Engaging in exercises subjecting tendons to longer strain durations triggers tendon adaptation.

In summary, HSD/hEDS involve complex connective tissue changes, challenging diagnosis and management. A comprehensive approach focusing on restoring balance within the body’s fascial system and muscle-tendon unit is essential. Understanding these mechanisms can help develop more effective strategies to improve the quality of life and mobility of individuals with HSD/hEDS.

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Dr Tina Wang

Dr Tina Wang crop

Dr. Tina J Wang is a medical doctor board certified in the specialty of Physical Medicine & Rehabilitation. She is a fascia researcher and has a special focus on Hypermobility Spectrum Disorders including Hypermobile Ehlers-Danlos Syndrome. Her published research focuses on ultrasound characteristics of fascial dysfunction to improve clinical understanding, diagnostics, and treatments of myofascial pain syndromes, Ehlers Danlos Syndrome and Hypermobility Spectrum Disorders.

Dr. Wang is an Assistant Professor at medical schools in the Southern California area and is core faculty for the musculoskeletal curriculum including the use of ultrasound based diagnosis and interventions.

Dr. Wang is also a yoga practitioner and studies under the the lineage of T Krishnamacharya and TKV Desikachar and studies Ayurveda with Dr. Anupama Kizhakkeveett at the Southern California University of Health Sciences.

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