Hypermobility, EDS & Pelvic Health: What You Need to Know

Written By Samantha Chilson

If you’ve been told you’re “double-jointed,” hypermobile, or you have Ehlers-Danlos Syndrome (EDS), you may have noticed that pelvic health concerns seem to show up more often and sometimes earlier, than expected.

At our clinic, we frequently work with individuals who have hypermobility spectrum disorders (HSD) or Ehlers-Danlos Syndrome (EDS) and are experiencing symptoms like pelvic organ prolapse, bladder leakage, pelvic pain, constipation, or challenges during pregnancy and postpartum recovery.

Let’s break down why this happens and how pelvic floor physical therapy can help.

What Is Hypermobility and EDS?

Hypermobility means your joints move beyond the typical range. Some people are simply flexible. Others have connective tissue differences that affect the entire body.

Hypermobility Spectrum Disorders (HSD) and Ehlers-Danlos syndrome (EDS) are connective tissue conditions that impact collagen, which is the protein that gives structure and support to ligaments, skin, blood vessels, and organs.

When collagen is more elastic or fragile than typical, it can affect:

  • Joint stability

  • Muscle coordination

  • Organ support

  • Tissue healing

Since the pelvic floor is made of muscles and connective tissue, it’s not surprising that it can be affected too.

Common Pelvic Health Concerns in Hypermobility & EDS

1. Pelvic Organ Prolapse

Prolapse occurs when pelvic organs (bladder, uterus, or rectum) descend due to reduced support. Because connective tissue plays a key role in supporting these organs, individuals with hypermobility may:

  • Experience prolapse at a younger age

  • Notice symptoms postpartum

  • Feel heaviness, pressure, or a bulge

Pelvic floor therapy focuses on improving muscular support and pressure management We don’t just perform “Kegels,” but building coordinated strength and stability.

2. Bladder Leakage (Urinary Incontinence)

Many hypermobile individuals experience:

  • Leakage with coughing, laughing, or exercise

  • Urgency and difficulty holding urine

  • A combination of both

Interestingly, pelvic floor muscles in hypermobility are often overactive and under-coordinated, not just weak. Strength alone isn’t the answer. Working on proper timing, relaxation, and pressure control are key.

3. Pelvic Pain

Pelvic pain can stem from:

  • Joint instability (SI joint, pubic symphysis)

  • Overactive pelvic floor muscles

  • Nerve sensitivity

  • Painful intercourse

Because the body often compensates for ligament laxity by gripping muscles for stability, chronic tension is common. Therapy focuses on restoring balance where we help improve support without over-bracing.

4. Pregnancy & Postpartum Considerations

Pregnancy naturally increases ligament laxity. When you already have hypermobility, this can amplify:

  • Pelvic girdle pain

  • Pubic symphysis pain

  • SI joint instability

  • Prolapse symptoms

  • Longer postpartum recovery

Pelvic floor PT during pregnancy can help with:

  • Stabilization strategies

  • Support belts and movement modifications

  • Breathing and pressure coordination

  • Preparing for delivery

Postpartum rehab is especially important for connective tissue conditions to support healing and reduce long-term symptoms.

5. Constipation & Bowel Dysfunction

Constipation is extremely common in hypermobility and EDS. Contributing factors may include:

  • Slower gut motility

  • Pelvic floor coordination issues

  • Rectal prolapse or rectocele

  • Chronic straining

Pelvic PT addresses bowel mechanics, defecation posture, coordination training, and strategies to reduce straining, which is essential for protecting pelvic organ support.

Why Traditional Advice Often Doesn’t Work

Many hypermobile individuals are told to “just strengthen more.” But more tension isn’t always better.

In hypermobility and EDS, we often see:

  • Muscles that are tight but weak

  • Poor proprioception (body awareness)

  • Fatigue with repetitive strengthening

  • Flare-ups with aggressive exercise

Pelvic health therapy for hypermobility focuses on:

✔️ Graded stabilization
✔️ Motor control and coordination
✔️ Breath-pressure management
✔️ Energy conservation
✔️ Joint protection strategies

It’s about smart stability, not maximal effort.

The Bottom Line

If you have hypermobility or EDS and are experiencing:

  • Pelvic pressure or prolapse

  • Bladder leakage

  • Pelvic pain

  • Constipation

  • Pregnancy-related pelvic pain

You are not imagining it and you are not alone.

Your connective tissue is different. Your rehab approach should be too.

Pelvic floor physical therapy can help you build stability, reduce symptoms, and move through life (and pregnancy, and postpartum) with more confidence and less discomfort.

Take the First Step

If you’ve been diagnosed with hypermobility or EDS you could benefit from a pelvic floor physical therapist that understands how to progress your care. A pelvic floor physical therapist can create a customized plan to help you regain control and improve your quality of life. Schedule your first visit here.

Samantha Chilson
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Urinary Incontinence in Women: How Pelvic Floor Physical Therapy Can Help