Does Ehlers-Danlos affect fascia?

Introduction to EDS and Fascia

Ehlers-Danlos Syndrome (EDS) presents a variety of challenges, from joint hypermobility and skin fragility to chronic pain. For those with hypermobile Ehlers-Danlos Syndrome (hEDS), understanding the link between fascial health and symptom relief offers a valuable pathway for managing discomfort. In this article, we explore the connection between fascia and EDS and how optimizing fascia mobility can help alleviate some of the symptoms associated with this condition.

What is Fascia?

Fascia is a three-dimensional network of connective tissue that surrounds muscles, nerves, and organs, providing structural support and aiding movement coordination. It plays a vital role in maintaining the body’s integrity by distributing tension across muscles and joints. Often compared to "clingfilm" for the way it wraps around tissues, fascia is rich in collagen and hyaluronic acid, which allow it to stretch and glide smoothly as we move​​.

In people with hEDS, fascia is particularly vulnerable to dysfunction because of the underlying defects in connective tissue. This can lead to fascia restrictions, pain, and a reduced ability to maintain joint stability​.

How Fascia Affects EDS Symptoms

Fascia is not just a passive structural support; it is highly innervated and plays a critical role in proprioception—the body’s awareness of its position in space. In hEDS patients, impaired proprioception is common due to changes in the fascia, making it difficult to build joint stability and control movements​. This can contribute to frequent injuries, joint dislocations, and pain​.

Furthermore, studies show that fascia is a key source of pain in hEDS. The condition can cause myofascial pain, where the fascia becomes stiff or thickened due to abnormal collagen deposition and adhesions. These changes impair fascia's ability to glide properly, leading to painful restrictions​. Trigger points, or tender nodules within the fascia, are often found in hEDS patients, contributing to widespread discomfort​.

Reduced Tissue Stiffness and Fascia Restrictions

Research highlights that patients with hEDS often have reduced tension and stiffness in the muscle-tendon complex, contributing to joint instability and pain​. The smooth gliding of fascia is impaired by abnormalities in hyaluronic acid, which can clump between layers of collagen, causing adhesions that restrict movement and increase pain​​. Restoring fascia mobility can alleviate these symptoms and improve overall function.

A recent study on the iliotibial tract (ITT) in hEDS showed reduced inter-fascial gliding compared to non-hEDS counterparts. This reduced gliding can contribute to joint instability and myofascial pain, further complicating mobility for hEDS patients​.

‍

The Importance of Fascial Health in EDS Management

Enhancing Joint Stability

Joint stability is a critical concern for people with hEDS, where loose, hypermobile joints are prone to dislocation and subluxation. Fascia plays a crucial role in maintaining stability by transmitting tension evenly across the body​. When fascia becomes restricted or adhesions form, joint instability increases. Fascial manipulation therapies that target these restrictions help restore the tissue’s natural gliding properties and enhance joint stability​.

Reducing Myofascial Pain

Myofascial release and other manual therapies can break up adhesions in the fascia, improving its elasticity and reducing pain​​. Techniques like soft tissue mobilization have been shown to release tension, allowing for more effective movement and less discomfort. For hEDS patients, managing fascial restrictions is essential to long-term pain relief and improved mobility​​.

Improving Proprioception

Since proprioception is often impaired in hEDS, improving fascia mobility can have a significant impact on movement control. Proprioceptive training, which focuses on enhancing the body’s awareness of its movements, can improve stability and reduce the risk of injury​. Therapies that promote proper muscle contraction and tension distribution through the fascia are essential for building proprioceptive function​.

‍

Personalized Strategies for Fascia Care in EDS

Biomechanics and Gait Training

Correcting movement patterns and addressing gait issues are vital for reducing strain on hypermobile joints. Targeted exercises can help evenly distribute tension across the body and reduce the risk of further injury. Biomechanics training, which emphasizes proper alignment and joint loading, is particularly beneficial for those with EDS​.

Soft Tissue Mobilization and Myofascial Release

Soft tissue mobilization techniques, such as myofascial release, can break down fascial adhesions and promote more natural movement. These therapies are essential for improving flexibility and reducing the chronic pain associated with fascial restrictions​​.

Improving Proprioception Through Movement

Exercises that enhance proprioceptive awareness, such as balance training and controlled movement patterns, support better joint stability and muscle engagement. These exercises should focus on gentle, controlled movements that avoid overstretching already hypermobile joints​​.

‍

Conclusion: Optimizing Fascial Health for EDS Relief

Fascia plays a critical role in the well-being of individuals with hEDS. By addressing fascial restrictions through targeted therapies, patients can reduce pain, improve joint stability, and enhance proprioception. Understanding the connection between fascial health and EDS is essential for developing effective treatment strategies. As research continues to explore these relationships, personalized approaches that focus on restoring fascia mobility hold promise for improving the quality of life for those with EDS.

‍

FAQs

Does Ehlers-Danlos affect fascia?

Yes, Ehlers-Danlos Syndrome (EDS) affects the connective tissues, including the fascia, due to defects in collagen production. In hypermobile EDS (hEDS), the fascia can become thickened and restricted, leading to pain, decreased flexibility, and joint instability. This can impair the fascia’s ability to glide smoothly, contributing to myofascial pain and other symptoms​​​.

What autoimmune disease affects the fascia?

Systemic sclerosis (scleroderma) is an autoimmune disease that can affect the fascia. This condition leads to excessive collagen production, which causes the fascia to thicken and restricts movement, resulting in pain and stiffness.

What tissue is most affected by Ehlers-Danlos syndrome?

Connective tissue, including collagen-rich structures like fascia, tendons, ligaments, and skin, is most affected in Ehlers-Danlos Syndrome. These tissues provide support and stability to the body, and defects in collagen weaken them, leading to the characteristic symptoms of EDS​.

Is fibromyalgia a fascia disease?

While fibromyalgia is not directly classified as a fascia disease, some research suggests that fascia may play a role in fibromyalgia symptoms. Patients with fibromyalgia often have myofascial pain, where fascia-related dysfunction contributes to chronic pain​.

What is dysfunctional fascia?

Dysfunctional fascia refers to fascia that has become restricted, thickened, or adhered due to injury, overuse, or abnormalities in tissue composition, such as excess collagen deposition. This dysfunction impairs the fascia’s ability to glide smoothly, causing pain and limiting mobility​​.

What vitamin deficiency causes myofascial pain?

A deficiency in Vitamin D has been linked to musculoskeletal pain, including myofascial pain. Vitamin D plays a role in muscle and bone health, and low levels can contribute to chronic pain and dysfunction in the fascia and connective tissues.

What can be mistaken for myofascial pain?

Fibromyalgia, chronic fatigue syndrome, and arthritis are conditions that can often be mistaken for myofascial pain. All of these conditions share symptoms like widespread pain, stiffness, and fatigue, making it important to differentiate them through proper diagnosis.

‍

Sources

1. Langevin, Helene M. “Fascia Mobility, Proprioception, and Myofascial Pain.” Life, vol. 11, no. 5, 2021, https://www.mdpi.com/2075-1729/11/7/668
2. Fede, Caterina, et al. “Evidence of a New Hidden Neural Network into Deep Fasciae.” Scientific Reports, vol. 11, no. 1, 2021, https://doi.org/10.1038/s41598-021-92194-z.
3. Wang, Tina J., and Antonio Stecco. “Fascial Thickness and Stiffness in Hypermobile Ehlers-Danlos Syndrome.” American Journal of Medical Genetics Part C: Seminars in Medical Genetics, vol. 187, no. 4, 2021, pp. 446-452, https://doi.org/10.1002/ajmg.c.31948.
4. Wang, Tina J., et al. “Change in Gliding Properties of the Iliotibial Tract in Hypermobile Ehlers-Danlos Syndrome.” Journal of Ultrasound, vol. 26, 2023, pp. 809-813, https://doi.org/10.1007/s40477-023-00775-7.