Author: Aileen Curtis MSc MCSP Pelvic Physiotherapist
Did you know that Hypermobility Syndrome or Ehlers danlos syndrome (EDS) can cause the pelvic floor muscles to become tight, and can sometimes cause pain?
If you’re hypermobile, you may have joints and tissues that are more flexible which sometimes lead to:
1) Dislocations
2) Varicose veins
3) Bruises
4) Difficulty healing scars
Some people find being hypermobile can be beneficial for gymnastics, dancers, acrobatics, skating and playing music. But, this can mean risk of injury or fatigue is high, and that muscle strength for stability is very important.
In hypermobility, connective tissue has more flexibility and therefore the muscles are working harder to support the joints. This is particularly the case around the hips and pelvis, but also around the inner organs such as the bladder, bowel and vagina.
It’s possible that those with hypermobility are more likely to suffer with:
Incontinence
Prolapse of the vagina or the anus
Painful sex
Persistent pelvic pain
Digestive problems such as constipation, IBS or heartburn
People who are hypermobile may use their muscles differently, and this can cause muscle fatigue. The muscles have to work harder to support the ligaments and fascia, as they are more stretchy (and might feel less stable!).
How can physiotherapy help?
Physiotherapy can help with pacing your energy, helping you feel different joint positions and teaching you how to relax or stretch tight muscles. When it comes to the pelvic floor, this might make it easier for you to do a pee or poo, insert a tampon or have more enjoyable sex (with less pain).
If needed, a physio can recommend various internal supports (pessaries) in the vagina or external supports such as engineered clothing, (like SRC underwear or EVB shorts) until the muscles have become stronger (like a sports bra for the pelvic floor).
Does hypermobility affect how my pregnancy will be?
It is helpful to prepare for pregnancy by connecting with your pelvic floor muscles prior to giving birth, and knowing how best to contract and relax pelvic floor muscles with good coordination.
Some people with hypermobility may develop pelvic girdle pain (which can also be managed with pelvic physiotherapy).
It is important to do the right amount of activity, balanced with some relaxation of the pelvic floor, along with healthy boundaries to minimise general stress.
If you know you tend to bruise more easily with hypermobility, then let your midwife know so that they can minimise the effects of any blood loss. If you tend to get varicose veins, you can seek advice and support to manage this during your pregnancy.
Perineal massage (from 36 weeks) can reduce perineal tears, and better pelvic floor awareness can help minimise vaginal prolapses.
How can physio help digestive issues?
Physiotherapy can help with general advice on diet, medication as well as teaching you how to empty your bowels more effectively. If your pelvic floor is able to relax better, this often can help many digestive issues, like constipation.
It may be that your bladder is overactive or retains too much fluid. Physiotherapy can help with advice about fluids, bladder training and relaxing pelvic floor muscles. It is also important to flag any bladder issues to your physio or midwife during pregnancy, or during any hospital stay.
What about surgery and hypermobility?
After any surgery, like hysterectomy or abdominal birth, patients may benefit from scar advice and treatment using massage and Silicone once the scar has healed.
How about hypermobility and my nervous system?
People with hypermobility can have a nervous system which can behave in a different way, meaning it can be sensitive to pain, but less responsive to painkillers or analgesia. This can make the muscles in the pelvic floor tense up to protect you from further pain, and may need some help with pelvic physiotherapy.
If your body is working harder to move, balance and maintain good posture, this can be exhausting. Some hypermobile people also have a link with neurodiversity, which is important to recognise to avoid generalised anxiety (as the brain is also working harder!).
If you are hypermobile, it is generally a good idea to have an assessment of your pelvic floor function and find out the best way to understand your body and how to look after it.
To book in with Aileen, click here, or use the direct booking link button below.