Table 7.

Nonpharmacologic Treatments for Hypermobility spectrum disorders (HSDs)10,3339

Joint braces and musculoskeletal tapingMay help stabilize joints
Biofeedback to improve postureImprove joint symptoms and proprioception
Osteopathic manipulative treatmentReduce joint pain, improve proprioception, increase blood flow. Avoid treatment more than 3 times per week due to potential for increasing joint laxity.
ProlotherapyInjections in the tendon or ligamentous attachment can trigger a brief inflammatory response and subsequent reparative cascade to generate new collagen and strengthening the relaxed connective tissue. May also reduce pain from increased joint stability.
TENS unitMay be helpful for muscle pain
Compressive clothingCompression stockings may help combat orthostatic intolerance and tachycardia. Compression garments may help support loose joints and provide additional proprioceptive input.
Orthotic shoe insertsMay improve underlying proprioceptive abnormalities, improve ankle/foot/knee alignment, reduce joint pain and risk of sprains or other injuries.
  • Core and joint stabilization.

  • Caution with activities that can cause overstretching like yoga or gymnastics.

  • Closed kinetic chain exercises (like biking or elliptical trainer).

  • Care to avoid overtraining.

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