Ehlers-Danlos syndromes (EDS) and Exercise

As an Exercise Physiologist, my approach to working with EDS clients begins with understanding the unique challenges they face. One of the hallmark features—joint hypermobility—can cause frequent dislocations or subluxations, poor proprioception (joint awareness), and postural instability. This means standard exercise routines may not only be ineffective but potentially harmful without appropriate modification.

The goal of exercise therapy in EDS isn’t to increase flexibility, but rather to build stability, strength, and confidence in movement. Programs are tailored to individual needs, focusing on activating deep stabilising muscles, improving joint control, and reducing mechanical strain. Low-impact, controlled strength training is at the core of treatment—starting with isometric holds and progressing gradually to dynamic movement. We prioritise core stability, glute activation, and postural alignment to reduce the load on vulnerable joints.

Cardiovascular fitness is also crucial, particularly for those with Postural Orthostatic Tachycardia Syndrome (POTS), which commonly co-occurs with EDS. In these cases, we start with recumbent or seated cardio, such as cycling or rowing, and slowly build tolerance to upright activities.

Importantly, the psychological component of exercise should not be overlooked. Many clients with EDS have a history of pain or fear associated with movement. Rebuilding trust in their body through achievable, symptom-informed goals is a key part of recovery. Education is vital—learning to recognise early signs of overuse, understand pacing strategies, and use pain as a guide (not a barrier) helps clients take ownership of their health.

Exercise for EDS is not about “pushing through” pain—it’s about working with the body, not against it. With the right support and structured progression, people with EDS can experience better function, reduced pain, and greater confidence in daily movement. As an Exercise Physiologist, it’s a privilege to be part of that journey.

Vicky Graham

Accredited Exercise Physiologist

True North Wellness