PT for Hypermobility
Outlined below is to expect at the beginning and throughout your treatment. We have maintained a 1-1 treatment model so the ever changing symptoms that correspond with hypermobility syndromes can be addressed. The phases of treatment are laid out here so you can get a better understanding of how we provide treatment for such a widely varied amount of impairments.
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PT for hypermobility is HARD and takes a very large commitment from the patient to alter habits, postures, and make lifestyle modifications. PT is not designed to "cure", but to help you learn how to interpret signals and respond accordingly whether it be altering a sitting position, getting up and walking more frequently, carrying things differently...all with the aim to decrease further injury, rehabilitate, protect, or maintain the body you were born with.
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Our goal for you is to teach you about the benefits and assets you have and how to make them work for you instead of "powering through" and trying to fit into a mold that may not be designed for you or your body.
Phase 1 - Setting the Stage
(first 4 weeks)
PT Evaluation - 60 min:
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During the initial evaluation you and your therapist will go over your medical history, current concerns, what treatment have/haven't worked, and what your ultimate goals are.
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The physical assessement will look at current movement patterns, identify any weakness and compensations of larger muscles taking over where the small muscles are getting overpowered, your posture will be assessed as will your gait and balance.
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Exercises: Please feel free to discuss your previous history of exercise as we will review why these may or may not have been successful in the past due to compensations from pain, alignment, weakness, or just habit. You'll likely receive 3 exercises to try at home to address what was discovered to be a driving concern for the deficits identified limiting your abilities.
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Follow up visits - 45/55 min:
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You'll begin your first follow up visit reviewing what happened since the last visit and reviewing the exercises. Please feel free to ask questions regarding the home plan and giving feedback about the education provided from the initial evaluation.
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Based off of what you and your therapist discussed, you'll receive manual treatment as needed if muscle spasms are present, joint mobilizations if needed and range of motion is altered, and motor control training with manual resistance to ensure that the correct small muscles are activated prior to performing larger more functional movements.
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Then, you may move around and see what has changed due to the treatment and review the exercises making modifications as needed.
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The MOST IMPORTANT part of your treatment will be how you alter your home/work/social life based on what you've discussed in treatment and the consistency with exercises. Your PT is not able to "fix" anyone - our role is to guide you to be empowered and equipped with the tools you need to be successful with your goals. We'll provide treatment to progress you to autonomy, but dependency on your therapist can be limiting to progress in the long run.
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Phase 1 will transition to Phase 2 after 4 weeks of ensuring the proper stabilizers are active, posture is optimized, and education about body mechanics is understood.
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We will treat one body region at a time. That body region will go through all phases and it may happen sooner (aka you may get through phase 1 in 2 weeks vs 4) so you can transition to other body regions if desired. All phases must be completed per body region for full effect and maximizing outcomes despite symptoms changing day to day. If a serious injury is experienced, initial plan can be altered to address the most limiting symptoms.
Phase 2 - Intentional Movement
(weeks 4-8)
Re-evaluations - 45/55 min:
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Around the 4-6 week mark you may have a re-evaluation to review what your initial measures were and what your progress has been. You'll also discuss what has been helpful and what barriers you may have to your treatment. During this session you'll review your goals and decide if the trajectory of your treatment needs to be altered in any way.
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Compliance is key. You may have aches and pains with some exercises prescribed, we ask that you discuss your sensations with your therapist during your treatment time a this can aid in discovering what may be driving your symptoms. If you have increased symptoms this should be discussed so it can be worked through, not a reason to cease exercising.
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The only way to improve your symptoms is through active participation. Passive modalities relieve pain in the short term and can be addicting such as manual muscle release work and joint mobilizations, but what will maintain the progress is active exercising.
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This phase is to integrate the stage set in phase 1 and begin to use it. Intention is everything because you'll be moving with a different mindset and goal likely utilizing different muscles that may have never worked before. It will be mentally and physically challenging, but the more effort invested the greater the outcome.
Phase 3 - Time for Fun
(weeks 8-12)
This phase is when you get to begin to push the envelope slowly. You'll try things you wanted to enjoy, you'll get to spend less time micromanaging your body and see what healthy movement habits begin to work their way into your day to day.
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The goal will be less manual treatments, more strength, balance, and functional exercises.
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Your therapist will review real-life scenarios and help problem solve through them to reduce risk of reinjury.
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You'll trial activities that will simulate how you will use that body region in "real life."
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Your frequency of visits will be more spaced out over these 4 weeks to see how you tolerate independent management.
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After 12 weeks we find is most successful if individuals take 6 weeks off of therapy before beginning the next round of PT if you'd like to have another body region treated so that the initial treatment can fully integrate into your daily life and long term success can be obtained.
