Author| Dr. Maureen O’Keefe, DPT pelvic health, back pain, neck pain and TMJ disorder specialist physical therapist. Experienced with treating people who have Ehlers-Danlos Syndrome & bladder problems or pelvic floor dysfunction.
Can Ehlers-Danlos Syndrome Contribute to Bladder Problems or Pelvic Floor Dysfunction?
If you have Ehlers-Danlos Syndrome and also are experiencing some bladder problems and pelvic floor dysfunction symptoms, you may be wondering if the two issues are associated. As an experienced pelvic health physical therapist for 25 years, I have treated people who have EDS and also have bladder problems and pelvic floor dysfunction, prolapse, pelvic congestion syndrome, bladder control problems, lower back and neck pain and hip problems (such as hip labral tears, hip pain, gluteal tendinopathy). There has been research, that we will show here, that people who have Ehlers-Danlos Syndrome experience higher rates of urinary problems and pelvic pain. Fortunately, our physical therapists specialize in helping people who have EDS to gain urinary control and reduce back, hip and pelvic pain. If you have Ehlers-Danlos Syndrome and are experiencing bladder problems or pain, seeing a highly qualified pelvic physical therapist can help restore bladder function and reduce pain. We provide treatment that is customized to your needs and abilities and is safe and effective for people who have EDS. For more information about our in-person physical therapy at Purple Mountain PT in Grand Rapids, Michigan or remote consultations, call 616-516-4334 to speak with one of our staff members or contact us here.
All of our licensed physical therapists here at Purple Mountain PT have experience helping people who have Ehlers-Danlos Syndrome and also have pelvic or lower back pain, bladder problems, neck or TMJ pain.
Because bladder problems and pelvic pain are common with individuals who have Ehlers-Danlos Syndrome, our pelvic PTs have training and experience in designing effective treatment programs to help optimize bladder function and reduce pelvic, back, neck, jaw and hip pains that are common with the hypermobility and other connective tissue issues with people with EDS. Below I detail some of the bladder and pelvic floor issues that research has found for people who have EDS. I also will review some of the methods that our licensed physical therapists use. If you have Ehlers-Danlos Syndrome and are experiencing pelvic, back, hip, neck or TMJ issues and would like more information about our in-person treatment or remote consultations, call 616-516-4334 to speak with one of our staff members or contact us here.
Do you feel like with your Ehlers-Danlos Syndrome you are the only one dealing with bladder problems? You are not alone! EDS can contribute to pelvic floor dysfunction and bladder problems.
We know that people with Ehlers-Danlos Syndrome have been found to have many bladder and pelvic symptoms, including chronic pelvic pain, bladder control problems and pelvic floor dysfunction.
Research published this year (2022) asked more than 1300 people who have EDS if they experience pelvic prolapse, pain, bladder problems or sexual issues. The respondents reported the following genitourinary problems:
60% report stress urinary incontinence
54% urinary urgency incontinence
24% fecal incontinence
21% pelvic organ prolapse.
71% pelvic pain, especially dysmenorrhea, back pain and muscle and joint pain.
Nearly 50% have sexual dysfunction with 36% reporting painful sex (dyspareunia)
Kciuk O, Li Q, Huszti E, McDermott CD. Pelvic floor symptoms in cisgender women with Ehlers-Danlos syndrome: an international survey study. Int Urogynecol J. 2022 Jun 25. doi: 10.1007/s00192-022-05273-8. Epub ahead of print. PMID: 35751670.
Our licensed physical therapists treat all of the bladder problems, prolapse and sexual-related difficulties noted in this Ehlers-Danlos Syndrome study and many others, actually.
We are fully experienced in the specialty fields of pelvic health (for men, women and children) and TMJ disorder physical therapy (also women, men & children). Our PTs are also experienced orthopedic physical therapists who have treated every “common” ortho condition you can imagine anywhere in the body, including the feet, knees, shoulders, elbows. When a person who has EDS comes to us for treatment for their pelvic condition, back, neck or jaw, we include treatment to these other areas, if needed, to help your primary issues. If you are experiencing pelvic, back, hip, neck or TMJ issues and would like more information about the in-person treatment or remote consultations, call 616-516-4334 to speak with one of our staff members or contact us here.
In addition to focused pelvic treatment that may include manual therapy & exercises to the abdomen, pelvis, low back and hips, patients who have EDS benefit from comprehensive, whole-body treatment.
By addressing posture, overall strength, movement patterns, muscle imbalances, stability, balance, pelvic floor dysfunction, SI joint alignment and other things, we customize a treatment plan for each patient who has Ehlers-Danlos Syndrome. With Ehlers-Danlos Syndrome, your movement patterns and weakness contribute to incontinence, pelvic pain, overactive bladder, prolapse or other pelvic symptoms; it is our hope to personalize the treatment for you to get you functioning as well as possible, within the context of your EDS. Our goal is to address the many contributions to your pain, prolapse, pelvic floor dysfunction, incontinence or other issues so you can function at a higher level, experience better bladder function and learn how to protect your muscles, pelvic floor, pelvic organs and joints in the process. If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.
Many of our patients have already tried other therapies, medical interventions, alternative treatments or personal efforts and still struggle with bladder issues or pelvic pain. Because we specialize in helping people who have Ehlers-Danlos Syndrome and bladder or pain problems, we are able to provide care that is effective, comprehensive and different than other approaches.
It is our goal to get you relief from pain and bothersome bladder problems by providing comprehensive physical therapy treatment that differs from what you have tried. Our treatment plan for people who have Ehlers-Danlos related bladder and pain problems includes a variety of whole body interventions that are customized to each person’s needs. To effectively address pelvic floor dysfunction, pelvic or back pain or bladder problems, we partner with you to create a treatment plan that includes manual therapy, corrective exercise, postural training, body mechanics instruction, bladder control therapies, balance exercises, pelvic floor exercises or any other methods you may need. For individuals who have Ehlers-Danlos Syndrome we often find a high amount of muscular trigger points causing pain. Our manual therapy techniques or dry needling can be effective approaches to helping ease trigger points and their pain.
Our pelvic physical therapy program for people who have Ehlers-Danlos Syndrome takes into consideration the special accommodations or needs that a person who has EDS may require in a physical therapy program.
We provide postural support and use methods to ensure your joints are not strained during therapy. Our PTs also recognize that you may experience more fatigue with exercise and are able to create movement retraining programs that are better tolerated for your body. Some of our patients who have Ehlers-Danlos Syndrome also have POTS (positional orthostatic tachycardia syndrome) and our PTs will modify and customize your treatment program to a level that your orthostatic intolerance can tolerate. If you have Ehlers-Danlos Syndrome and are looking for a solution to your pelvic condition and would like to work with a physical therapist who is knowledgeable and experienced both with working with people who have EDS and who have pelvic floor dysfunction (bladder, prolapse, pain, fecal issues), we offer in-person treatment or remote consultations. Call 616-516-4334 to speak with one of our staff members or contact us here and get your questions answered.
71% of people who have Ehlers-Danlos Syndrome reported pelvic pain
This study specifically found a high rate of back pain, joint pain, muscle pain and menstrual cramps for people who have Ehlers-Danlos Syndrome. Chronic pelvic pain is one thing that our PTs specialize in treating, including in people with hypermobility, pelvic floor laxity, pelvic organ prolapse and chronic back and hip pain. We treat all of the pain conditions mentioned in the research and many others, such as endometriosis related pain, persistent genital arousal disorder, chronic SIJ pain, tailbone pain, Pudendal neuralgia, vaginismus, vulvodynia, chronic c-section scar pain and others. For some patients the pain is related to pelvic organ prolapse, which is also common amongst people who have Ehlers-Danlos. Our treatment is designed to improve your pain, prolapse, pelvic floor muscular support, posture and other issues. To ask us a question about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.
Common areas of pain that we treat for people who have Ehlers-Danlos Syndrome include chronic low back pain, chronic pelvic pain, SI joint pain, tailbone pain, hip pain, neck and TMJ pain.
The spine, hips and pelvis undergo tremendous forces with daily activities. For individuals who have Ehlers-Danlos Syndrome there is often excess strain occurring through these joints, nerves, connective tissue and muscles. By treating your whole body, reducing muscular trigger points, enhancing deep core muscle stabilization and pelvic floor muscle function, optimizing your postural alignment to the best of your ability and retraining movement patters, our physical therapists develop treatment plans for individuals who have EDS that can reduce your pain and enhance your bladder and bowel function. If you are interested in speaking with one of our knowledgeable staff members about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.
Treatment may be directed to your head, TM joint (jaw), neck, rib cage, shoulders, the low back, hips, knees or feet.
Bladder problems and pain problems need treatment that goes well beyond simply treating the pelvic floor muscles. To best improve the incontinence, urgency and frequency or pelvic pain that a person who has EDS is experiencing, we must include whole body treatment. We use stability exercises and hands-on manual therapy to retrain your core muscles, including the pelvic floor muscles (that attach to the coccyx and influence tailbone, SIJ and lower back pain). Often the SI joint is not aligned or functioning properly for our patients who have Ehlers-Danlos Syndrome; this SIJ dysfunction can contribute to bladder problems, including incontinence and overactive bladder (urinary frequency and urgency), which is why we always check and treat the SI joint for all of our patients who have EDS. To ask us a question about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.
For our patients with Ehlers-Danlos who have chronic pelvic pain, we have found benefit from a combined manual therapy approach with stabilization, strengthening and movement-based retraining.
By combining therapeutic hands-on treatments (to your neck, back, abdomen, hips, thighs and other areas with muscle guarding and myofascial pain) with corrective therapeutic exercise care, we are able to help you alleviate your pelvic, back and other pains. Because pelvic floor dysfunction is a special area of focus for us, we include treatment to the pelvic floor muscles, which has typically been overlooked by other treatment methods. People who have back pain, hip pain, tailbone pain or SIJ pain also have pelvic floor dysfunction. Research supports that people who have EDS typically also have weakness. If someone has pelvic pain, we need to improve strength and also need to reduce trigger points, muscle guarding and imbalanced or hypermobile joints. We do this with specific corrective exercises and hands-on manual therapy, adapted according to your tolerance if you have POTS. The whole-body, comprehensive care we provide to pelvic pain patients who have EDS offers you a path forward. Our PTs pledge to provide you personalized care that meets your needs and is customized to our findings for you. If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or if interested in scheduling an appointment, you can contact us here.
60% of the people who have EDS reported stress urinary incontinence, a leakage of urine problem that benefits from pelvic PT.
Improving stress incontinence, which is the type of leakage that occurs when you laugh, cough or sneeze, can be frustrating, without the support of a pelvic PT who specializes in this. Many patients come to us and have tried solving this problem on their own, without success. People who have Ehlers-Danlos Syndrome, hypermobility type, benefit from the personalized training and focus from our licensed physical therapists to learn how to more effectively control their bladder, stabilize their movements and manage the intra-abdominal pressure that is generated with their daily movements and exercises. If you have Ehlers-Danlos Syndrome and are experiencing pelvic issues such as SIJ pain, lower back pain, pelvic pain, pelvic organ prolapse, urinary incontinence, frequency or other bladder issues, our PTs can help you. If you are like many of our patients, you are tired of dealing with these problems and looking for a solution. You have found a place that is devoted to helping people just like you. To get your questions answered or speak with one of our knowledgeable staff, call us at 616-516-4334 to speak with a knowledgeable staff member or contact us here.
When wondering if Ehlers-Danlos can cause bladder problems and pelvic floor dysfunction, 60% stress incontinence and 54% urinary urgency incontinence rates are higher than typical and indicate there can be an EDS component contributing to bladder problems. Fortunately, physical therapy helps this.
Our PTs will work with you to identify what is going on with your bladder. Just because you have EDS does not mean you are stuck with bladder control issues. Effective, wholistic pelvic physical therapy, as described here, is helpful to improve bladder function. Your problem may involve a number of issues (incontinence, nocturia, overactive bladder, pain, urge incontinence, retention, poor stream, etc.). We specialize in helping people restore functional bladder problems of all types. Each type of bladder problem needs different treatment methods and we will give you what your bladder and body need, addressing your EDS and working to improve bladder function, pelvic floor dysfunction, core muscle deficiencies, posture or anything else. Because EDS involves a defect in the collagen proteins that provide strength and flexibility to your connective tissues, we take this in to consideration when designing a treatment program for you. If you have a hypermobile urethra or bladder, our PTs provide you natural treatments and options to support this hypermobility so that you are less likely to experience stress incontinence. If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.
Our PTs work one-on-one with you, never leaving you to exercise on your own. We continually are instructing you and coaching you towards improved engagement of the necessary deep core and postural muscles with the pelvic floor to control urine better.
You can expect treatment that may be exercise based with some hands-on treatments. Patients come to us with many questions and a deep desire to solve their problem. If this sounds like you, please call us at 616-516-4334 to speak with one of our knowledgeable staff members and get your questions answered, or submit them here.
Fortunately, we know that pelvic floor physical therapy can alleviate incontinence, painful sex, prolapse symptoms and overall pain.
Because there is a strong amount of bladder problems, such as incontinence or urgency and frequency, with pelvic floor dysfunction in people who have Ehlers-Danlos Syndrome, our PTs are experienced in seeing these problems and helping you improve.
We treat all of our patients, including those who have Ehlers-Danlos Syndrome, with one-on-one, private appointments that include pelvic floor muscle retraining, strengthening of your core, postural correction and gentle hands-on manual therapy. We teach you what exercises to do at home, with very specific instructions for how to perform them safely. We take into consideration the unique needs of people who have EDS and partner with you to ensure your therapy is meeting your expectations. Physical therapy can improve bladder function, including issues such as incontinence, overactive bladder or incomplete emptying. At Purple Mountain PT, this is our specialization and our experienced physical therapists are ready to help you. We offer in-person or remote consultations, for those who qualify. Call 616-516-4334 to talk to one of our staff members or contact us here.
54% of the people in the EDS study reported urinary urge incontinence
Our clinical experience indicates that some people who have EDS experience the pelvic floor muscles going into high tone and stiffness to compensate for hypermobility. This extra activity of the pelvic floor muscles can cause the bladder to perceive that you need to urinate and, over time, urinary urgency, frequency or urge incontinence can develop. Our physical therapy program to help this problem is comprehensive and effective. If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or contact us here.
This 54% rate of urge urinary incontinence for people who have Ehlers-Danlos Syndrome is much higher than the general population, where published rates range from approximately 7-12% of people.
Our PTs love to help urinary urgency, frequency and urge incontinence. Often people who have this condition also are getting up at night to urinate, which causes sleep disruptions. Our treatments for this include a variety of methods to retrain your bladder, so it can calm down, fill up and store urine without giving you urgency and urge incontinence. The treatment for this is largely hands-on care, like everything else we do it is whole-body treatment. We will assess your EDS and determine if you have hypermobility, postural issues or movement patterns that are contributing to your bladder frequency and urgency and urge incontinence and include care for this, as well. We offer in-person or remote consultations, for those who qualify. Call 616-516-4334 to talk to one of our staff members or contact us here.
Why pelvic physical therapy is a safe, natural treatment for your bladder problems, pelvic pain and pelvic floor dysfunction.
Looking at the rates of genitourinary symptoms in people who have Ehlers-Danlos Syndrome can be discouraging, especially if you are reading this article and find yourself one of the many people who have these symptoms. You are not stuck with these problems just because you have EDS. We can improve your muscular control, joint stability, strength, postural alignment and other factors that cause bladder problems and pelvic floor dysfunction. Physical therapy has always been a natural option for recovery and offers a number of benefits. If you are interested in receiving support from Purple Mountain Physical Therapy, our licensed physical therapists specialize in helping adults and children, including people who have Ehlers-Danlos Syndrome. Our focus areas include pelvic health conditions, spine (neck or back), chronic pelvic pain or TMJ disorders. We offer in-person or remote consultations, for those who qualify. Call 616-516-4334 to talk to one of our staff members or contact us here.
If I have Ehlers-Danlos, why pelvic floor physical therapy can help you, including bladder issues.
We know that Ehlers-Danlos can contribute to you experiencing a number of bladder problems, including leakage or urgency and frequency. When these problems have been ongoing, the pelvic floor muscles persist in their dysfunction. Pelvic PT is here to help.
- Unlike surgery or pharmaceuticals, our physical therapists work with you using safe, natural and effective treatments that enhance your function and give you some control over your body.
- Whole-body treatment methods are can benefit a person who has hypermobility, weakness, postural misalignments, improper breathing patterns and more.
- Bladder control for individuals with Ehlers-Danlos may involve stress incontinence, urinary urgency and frequency, incomplete emptying, recurrent urinary tract infections or other issues (constant urge, bladder pain, for example). We have treatment programs to help each of these bladder problems. These are adapted and customized according to each person’s needs, tolerance and findings, including if you have EDS.
- Our physical therapists help bring clarity, education on optimal bladder habits and methods to keep your bladder and pelvic floor happy and healthy. Patients tell us that PT has given them hope and helped them function at a higher level again. Often people who have EDS feel at a loss for how to change their bladder problems, pelvic organ prolapse or pelvic floor dysfunction. Our licensed physical therapists create a focused, pragmatic and effective treatment plan for you.
Our physical therapists help people who have Ehlers-Danlos Syndrome, pelvic floor dysfunction and bladder problems.
Our goal for individuals who come to us and have EDS, bladder problems, chronic pelvic pain or TMJ pain is to provide you safe, effective, whole body physical therapy treatment to reduce pain, improve your quality of life and optimize the bladder’s function. This includes the bladder’s ability to fill up, store urine without leaking and effectively contract to freely empty urine. One important aspect of our treatment model is that we provide one-on-one treatments, up to 55 minutes each visit, with your doctor of physical therapy. This allows you to establish a trusted relationship with your provider and to advance your program each week. We offer in-person or remote consultations, for those who qualify. Call 616-516-4334 to talk to one of our staff members or contact us here.
Because Bladder Problems and Pelvic Floor dysfunction are higher for individuals who have Ehlers-Danlos Syndrome, we believe that pelvic PT should be the standard of care for you. In an ideal world, the medical community would routinely recommend physical therapy for bladder and pelvic floor dysfunction for people who have Ehlers-Danlos Syndrome.
Many people find out about our physical therapy on their own. Some people google and find us, other people have friends and family tell them about us, others find us on Instagram (@purplemountainpt) or Facebook. Even when patients are referred to pelvic physical therapy, the research has found a lot of you choose not to go. We get it. We understand you might be scared or anxious to go to pelvic PT. Our physical therapists offer trauma-informed and compassionate care and we will work with you to devise a plan together. Patients tell us they wish they had found us sooner, because the treatment has helped them so much. We are the natural, safe, solution that enhances your bladder control, builds strength, improves posture, resolves pelvic floor dysfunction, alleviates pain and gives you hope. Suffering with these private, embarrassing pelvic floor problems is not your highest quality of life. We are here to help you. If you would like more information about our in-person physical therapy (in Grand Rapids) or our remote consultations, call us at 616-516-4334 or submit your questions here.
If you tired of leaking urine, chronic pelvic pain, prolapse or urge incontinence and you have EDS, our PTs are here to help you.
We are Purple Mountain Physical Therapy, a speciality pelvic health and TM joint PT clinic located in Grand Rapids, MI. We offer in-person treatment and remote consultations. You don’t need to suffer with these pelvic problems, there is high quality, safe and effective treatment from one of our physical therapists. Our team of PTs is devoted to pelvic health, including helping people who have Ehlers-Danlos Syndrome. We can help you improve bladder dysfunction, including overactive bladder, stress incontinence, urge incontinence, nocturia, difficulty emptying, poor stream and bladder pain. Nothing makes us happier than helping you to feel better and more confident how to manage your Ehlers-Danlos for lifelong wellbeing. We will educate you, teach you, coach you, improve your strength, address your movement patterns and provide you with comprehensive care that is safe and effective for your particular needs. Getting started is easy. Just call 616-516-4334 to speak with one of our knowledgeable staff and get your questions answered. Or submit an inquiry here.
Dr. Maureen O’Keefe, DPT founder of Purple Mountain Physical Therapy and specialist in pelvic floor dysfunction, neck, back and TMJ disorders. All of our physical therapists have advanced post-graduate training to help individuals who have EDS.
Additional articles that may be of interest:
Arunkalaivanan AS, Morrison A, Jha S, Blann A. Prevalence of urinary and faecal incontinence among female members of the hypermobility syndrome association (HMSA). J Obstet Gynaecol J Inst Obstet Gynaecol. 2009;29(2):126–128. 10.1080/01443610802664747.
Chan C, Krahe A, Lee YT, Nicholson LL. Prevalence and frequency of self-perceived systemic features in people with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type. Clin Rheumatol. 2018;38:503–511. 10.1007/s10067-018-4296-7
Coussens M, Lapauw B, Banica T, De Wandele I, Pacey V, Rombaut L, Malfait F, Calders P. Muscle Strength, Muscle Mass and Physical Impairment in Women with hypermobile Ehlers-Danlos syndrome and Hypermobility Spectrum Disorder. J Musculoskelet Neuronal Interact. 2022 Mar 1;22(1):5-14. PMID: 35234154; PMCID: PMC8919651.
Gilliam E, Hoffman JD, Yeh G. Urogenital and pelvic complications in the Ehlers-Danlos syndromes and associated hypermobility spectrum disorders: A scoping review. Clin Genet. 2020 Jan;97(1):168-178. doi: 10.1111/cge.13624. Epub 2019 Sep 1. PMID: 31420870; PMCID: PMC6917879.
Kciuk O, Li Q, Huszti E, McDermott CD. Pelvic floor symptoms in cisgender women with Ehlers-Danlos syndrome: an international survey study. Int Urogynecol J. 2022 Jun 25. doi: 10.1007/s00192-022-05273-8. Epub ahead of print. PMID: 35751670.
Knoepp LR, McDermott KC, Muñoz A, Blomquist JL, Handa VL. Joint hypermobility, obstetrical outcomes, and pelvic floor disorders. Int Urogynecol J. 2013;24(5):735–740. 10.1007/s00192-012-1913-x.
Kohn A, Chang C. The Relationship Between Hypermobile Ehlers-Danlos Syndrome (hEDS), Postural Orthostatic Tachycardia Syndrome (POTS), and Mast Cell Activation Syndrome (MCAS). Clin Rev Allergy Immunol. 2020 Jun;58(3):273-297. doi: 10.1007/s12016-019-08755-8. PMID: 31267471.
Le Huec JC, Aunoble S, Philippe L, Nicolas P. Pelvic parameters: origin and significance. Eur Spine J. 2011 Sep;20 Suppl 5(Suppl 5):564-71. doi: 10.1007/s00586-011-1940-1. Epub 2011 Aug 10. PMID: 21830079; PMCID: PMC3175921.
Mastoroudes H, Giarenis I, Cardozo L, et al. Lower urinary tract symptoms in women with benign joint hypermobility syndrome: a case–control study. Int Urogynecol J. 2013;24(9):1553–1558. 10.1007/s00192-013-2065-3.
(2019) The prevalence of urinary incontinence, Climacteric, 22:3, 217-222, DOI: 10.1080/13697137.2018.1543263
Mou T, Warner K, Brown O, Yeh C, Beestrum M, Kenton K, Emi Bretschneider C. Prevalence of pelvic organ prolapse among US racial populations: A systematic review and meta-analysis of population-based screening studies. Neurourol Urodyn. 2021 Jun;40(5):1098-1106. doi: 10.1002/nau.24672. Epub 2021 Apr 9. PMID: 33834519.
Roeder, M., Thiel, S., Baumann, F. et al. Increased augmentation index in patients with Ehlers-Danlos syndrome. BMC Cardiovasc Disord 20, 417 (2020). https://doi.org/10.1186/s12872-020-01684-x
Rombaut L, Malfait F, De Wandele I, Taes Y, Thijs Y, De Paepe A, Calders P. Muscle mass, muscle strength, functional performance, and physical impairment in women with the hypermobility type of Ehlers-Danlos syndrome. Arthritis Care Res (Hoboken). 2012 Oct;64(10):1584-92. doi: 10.1002/acr.21726. PMID: 22556148.
Scheper MC, Nicholson LL, Adams RD, Tofts L, Pacey V. The natural history of children with joint hypermobility syndrome and Ehlers–Danlos hypermobility type: a longitudinal cohort study. Rheumatology. 2017;56(12):2073–2083. 10.1093/rheumatology/kex148.
, , , . (2022) Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review. BMC Women’s Health 22:1.