“Physical Therapy for EDS:
How your posture and
thorax/ribcage affects your PT
program”
Patricia Meegan, DPT
February 2, 2016
Planned Topic…
• “Physical Therapy for EDS”
• “The Thorax” and the connection
with the trunk, ribcage and posture –
how it all works in simple terms.
The Problem….
• Posture is BORING
• Big topic to cover
– Posture is a ‘head to toe’ thing…
• Specific to each person
… you would stop listening after 5 min!
Focus for presentation
Posture Overview
Decoding some PT terms
Structure vs. Function
Ribcage Connections
“EDS is more than just joints”
“Interconnected-ness of everything”
The story that inspired lecture topic…
General PT Guidelines
• “I want to find a PT who knows all about
EDS”
• Individual attention – not a factory
• Knowledge of manual therapy
• “Low and slow”
• Find someone you are comfortable with –
willing to learn with you on the journey
• PT is specific to each person or situation
Manual Therapy Techniques
Joint Mobilization
Muscle Energy Technique
Myofascial Release
Strain Counterstrain
Craniosacral Therapy
Visceral Mobilization
Cranium
Thoracic Outlet
Thorax
Diaphragm
Abdomen
Pelvic Floor
Body is built like a machine…
“Why do I have a headache??”
Structure and Function
• Structure governs function & function
influences structure…
Analogy
Typical House EDS House
What is fascia?
• Highly complex web of connective tissue
• “The fabric that holds the whole body today”
• 3 general categories
– Superficial fascia
– Deep investing fascia
– Visceral fascia
Subluxation vs Dislocation
• When a joint comes • Full and complete
partially out of disruption of the joint
alignment (<100%) surface which does
• When a joint slips not immediately fix
out of alignment itself
then immediately • More severe and
relocates by itself dangerous
“The Thorax”
Ribs Important?
• Protect vital organs
• Attachment site for muscles
• Ribs do move
• Breathing
– It’s a big deal!
The Diaphragm
Diaphragm movement…
Just look and appreciate
the layers of
connections… you
cannot separate one
area of the body from
another… multiple
overlapping layers of
muscles – all train
together in coordination
to hold you up for
“posture” to occur
Things don’t move by themselves…
Rib Motions
Ribs 1-5 = Pump Ribs 6-10 = Bucket
Spine & Ribs
Rib Subluxation
Clinical Correlation
Rib Subluxation
• Costovertebral
junction
• Dysautonomia
reaction
• Somatovisceral
dysfunction
Dysautonomia
• Picture of ANS
• Blanket term for
malfunction of the
autonomic nervous
system
• ANS goes haywire
• Affects every system
– EDS affects every
system
Why does it work?
Not always joint pain….
Team Approach
• Patients with EDS are complicated
• Physical therapist deal with PT related matters
• Everything is related – but each member of your team
will treat within their scope of practice
• Each have a role to play
• YOU are a key member of your team
– “I cannot fix you”
General Tips For Posture Support
Bras and EDS
• Weight of the bra should be supported by the BAND not the
straps
– The tighter the band – the less weight the straps have to support
• Wider straps
– Keeps weight distribution along more even surface
• Crossed straps
– Bringing straps closer to center of body will centralize pressure
• Closures
– Back clasp; front clasp; zipper front
• Posture support bra; compressive tank tops
• PERSONALIZED solution
• Proper fitting is KEY
THE END
