Welcome back to the Bendy Club blog! Joint dislocations can be a common and painful recurring issue for individuals with Hypermobility Spectrum Disorder (HSD) and Ehlers-Danlos Syndrome (EDS). Knowing how to prevent and manage these dislocations is crucial for maintaining your joint health and quality of life. Let’s dive into practical tips and strategies to help you stay safe and manage dislocations effectively.
What is a Joint Dislocation?
A joint dislocation occurs when the ends of your bones are forced out of their normal positions. This can cause severe pain, swelling, and difficulty moving the affected joint. For those with HSD and EDS, joint dislocations can happen more frequently due to the laxity of their connective tissues. More commonly hypermobile people experience what is called a subluxation vs a full dislocation. A subluxation is basically a partial dislocation but the 2 bones of the joint are still technically in contact with each other. Subluxations can cause the same symptoms but generally the degree of joint laxity is less severe.
Recognizing the Signs of Dislocations
Being able to recognize the early signs of a dislocation can help you seek immediate care and minimize damage. Look out for:
- Intense pain at the affected joint
- Visible deformity or abnormal position of the joint
- Swelling and bruising
- Inability to move the joint or limb
- A feeling of instability or that the joint is “giving out”
Action Steps for Prevention and Care
1. Strengthening Muscles Around Joints
Strengthening the muscles surrounding your joints can provide better support and reduce the likelihood of dislocations. Engage in targeted physical therapy exercises designed for hypermobile individuals. Focus on low-impact, muscle-strengthening activities like Pilates or resistance training with bands. Therapy programs need to be tailored to prevent joint subluxations and dislocations. Make sure to reports any joints with increased laxity to your therapist so they can modify your exercises keeping your joints safe.
2. Using Supportive Devices
Wearing braces, SI belts, Kinesio tape, or compression garments can provide additional stability to your joints, helping to prevent dislocations. Ensure you use these devices correctly and consistently, especially during activities that place stress on your joints. I have found rock tape to be very helpful for those with recurrent joint subluxations and dislocations allowing patients to do more activity with the external support the kinesio tape provides
3. Practicing Good Posture and Body Mechanics
Maintaining proper posture and using correct body mechanics can reduce the strain on your joints. Be mindful of how you sit, stand, and move. Avoid positions or activities that place excessive stress on your joints. Hypermobile patients tend to position themselves in pretty “weird” positions. For example wrapping their legs around each other when sitting, leaning back on their arms and hyperextending the elbows, standing with hyperextended knees and excessive lumbar lordosis. All these positions put extra strain on the joints promoting further joint laxity.
4. Avoiding High-Risk Activities
Certain activities and sports may increase the risk of dislocations. Avoid high-impact sports or activities that involve sudden, jarring movements. Instead, focus on low-impact exercises that strengthen your body without putting your joints at risk.
5. Look into Regenerative Medicine
For those with recurrent joint dislocations and subluxations that continue despite using external support (braces and taping), proper positioning, and well done physical therapy to increase muscle mass, regenerative medicine with Prolotherapy and Platelet Rich Plasma (PRP) can be greatly beneficial. I have treated numerous people with hypermobility with regenerative medicine and seen some really impressive results. When performed correctly (meaning that the medical provider is using image guidance and injecting in all the supportive tissues of the affected joint, not just intraarticularly) these procedures can increase the strength and stability of lax ligaments and tendons decreasing the recurrence of joint subluxations and dislocations.
Immediate Care for a Dislocated Joint
If you suspect a full joint dislocation, it’s important to act quickly:
- Seek Medical Attention: If the joint does not easily go back into the correct position you should visit a healthcare professional or emergency room immediately. Many with HSD/EDS can easily get the joint back into position themselves with minimal manipulation. If this does not work you should not continue trying to get it back in position.
- Immobilize the Joint: Use a splint or sling to keep the joint in place and prevent further damage. This is okay to do for a short period of time meaning hours to days to allow the joint to rest, but should not be used for long periods of time as this will further increase muscle atrophy making the instability worse in the long run.
- Apply Ice: Use ice packs to reduce swelling and manage pain while waiting for medical care. Heat may feel soothing as well. Both heat and ice can be potentially helpful in this situation depending on personal preference.
Long-term Management and Support
- Regular Physical Therapy: Continuous engagement in physical therapy can help strengthen muscles and improve joint stability over time.
- External Support: Using bracing and kinesio tape is my go to with patients suffering with recurrent joint subluxations and dislocations.
- Pain Management: Work with your healthcare provider to develop a pain management plan that may include medications, physical therapy, or Regenerative Medicine injections like PRP. I generally don’t recommend steroid (cortisone) injections to those with HSD/EDS unless absolutely necessary. Steroids decrease the strength and stability of the surrounding tissues making laxity worse in the long run.
- Education and Advocacy: Educate yourself about your condition and advocate for your needs with healthcare providers, employers, and educators.
Patient Story: Emily’s Journey
Emily, a 28-year-old with HSD, experienced frequent shoulder dislocations that significantly impacted her daily life. Through the use of Rock Tape, consistent physical therapy and some PRP injections to really stabilize her shoulder joint, Emily strengthened her ligaments, tendons and muscles reducing the frequency of her dislocations and improving her overall quality of life.
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Warm regards,
The Hypermobile Solutions Team
References
Dislocation/subluxation management. The Ehlers Danlos Society. (2023a, May 23). https://www.ehlers-danlos.com/dislocation-subluxation-management/
Managing dislocations and subluxations in hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders. The Ehlers-Danlos Support UK. (2017c, December 6). https://www.ehlers-danlos.org/information/managing-dislocations-and-subluxations-in-hypermobile-ehlers-danlos-syndrome-and-hypermobility-spectrum-disorders/
GUIDE: Physical therapy guide to hypermobility spectrum disorders. Choose PT. (2023, October 16). https://www.choosept.com/guide/physical-therapy-guide-benign-hypermobility-joint-syndrome
Home. The Ehlers Danlos Society. https://www.ehlers-danlos.com/
What is HSD?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-hsd/
What is eds?. The Ehlers Danlos Society. https://www.ehlers-danlos.com/what-is-eds/
Jovin, D., Atwal, P., Herman, K., Block, N., Maxwell, A. J., Mitakides, J., Maitland, A. M., Saperstein, D., Hamilton, M., Schofield, J., Koby, M., Klinge, P., McElroy, A., Bluestein, L., Chopra, P., Tishler, J., Pocinki, A. G., Varga, J., Dempsey, T., … Lane, K. (2020). Disjointed: Navigating the diagnosis and management of Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders. Hidden Stripes Publications, Inc.
Smith, C., & Wicks, D. (2017). Understanding Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder: (previously known as Ehlers-Danlos Syndrome Hypermobility Type & Joint Hypermobility Syndrome, respectively). Redcliff-House Publications.
Cox, C. (2022). Holding it all together when you’re Hypermobile. Journey2Joy.
Disclaimer
This blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user’s own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.