How Osteopathy Can Benefit People with HSD & EDS

What is Osteopathy?

Osteopathy is a form of holistic manual therapy that focuses on the entire body - not just the musculoskeletal system, but also the deeper systems that support and interact with it. These include the fascial, vascular, visceral, neural, and respiratory systems.

It aims to release tension, strain, or adhesions that have developed, which may be limiting your body's ability to function optimally.

Osteopathy for Hypermobile Bodies

Now, here's the interesting part - while osteopathy often helps the general population by improving mobility, people with Hypermobility Spectrum Disorder (HSD) and Ehlers-Danlos Syndromes (EDS) are often already dealing with too much mobility due to connective tissue laxity.

So how can osteopathy help people with hypermobility conditions?

I find it ironic that a therapy designed to get things moving more actually plays such a vital role in helping people whose main issue is that things are moving too much. But what I’ve noticed is that, because connective tissue isn’t offering reliable stability, the body tries to compensate. Hypermobile bodies often create tension or "gripping" in areas where they normally wouldn’t - almost like trying to self-stabilise.

This compensation might involve increasing proprioceptive input or stabilising a joint that

would otherwise be too loose. And while this might seem helpful, it can disrupt the original

function of those structures, triggering a cascade of other issues.

The Diaphragm: A Case Study in Compensation

A classic example I often see in the HSD & EDS population is when the thoracic diaphragm (your primary breathing muscle) is used as a stabiliser rather than a breathing muscle.

Normally, the diaphragm moves up and down with each breath, allowing the lower lobes of the lungs to expand and draw in more oxygen. This movement also helps to:

• Gently mobilise abdominal organs, aiding digestion and motility

• Stimulate the vagus nerve, which regulates the autonomic nervous system

• Maintain proper pressure balance between the thoracic, abdominal, and pelvic cavities

But, when the diaphragm is recruited for stability instead of breathing, it can’t perform these

roles properly.

Breathing shifts to the upper chest and rib cage, recruiting secondary muscles like those in the shoulders, neck, and jaw. This leads to increased tension and discomfort, and can contribute to:

• Neck pain and headaches

• Poor jugular vein drainage, increasing intracranial pressure

• Forward head posture, worsening upper cervical instability (UCI)

• Shallow, rapid breathing that reduces oxygen intake, often leading to fatigue and dizziness

This loss of diaphragm mobility can also affect other systems:

• Fluid dynamics: Impaired venous and lymphatic return can worsen compression syndromes (like MALS), and also contribute to blood pooling, pressure headaches, and general fatigue due to fascial congestion.

• Digestive issues: Without the diaphragm’s natural 'visceral massage', digestion slows down. This may result in reflux, bloating, constipation, or a general feeling of sluggishness in the gut.

• Autonomic nervous system dysregulation: The vagus nerve isn’t stimulated properly, which can impact POTS, gut motility, immune responses (MCAS), and overall autonomic balance. This is often a key area I focus on in HSD/EDS patients - and where I tend to see the most significant improvements with osteopathic treatment.

This is just one example of how interconnected the body is. A loss of mobility in one

region, like the diaphragm, can have a global impact on the function of multiple systems.

Osteopathy vs Physiotherapy

Osteopathy isn’t a replacement for physiotherapy, but rather it works well alongside to

complement and help maintain the work being done - and vice versa!

Strength and stability are absolutely essential in managing HSD & EDS. But when osteopathy helps to support proper movement and function to these deeper systems, it can make physiotherapy more effective, because the body isn’t fighting against hidden restrictions. Osteopathy can also help improve exercise tolerance, reduce recovery time, and generally help people feel more capable in their day-to-day lives.

I always like this analogy: if your body were a car, physiotherapy is like the mechanic

who tunes up the engine and suspension with precision tools and exercises. Osteopathy, on

the other hand, is like the mechanic who listens to how the car feels, gently realigns the

wheels, figures out why the engine’s being overworked - and maybe even asks the car

about its childhood trauma.

Sam Slatem, Osteopath

Sam Slatem is an HSD & EDS-informed Osteopath practicing at the Connected Health Alliance Wollongong Clinic. She has a special interest in supporting people with hypermobility-related conditions and symptoms, particularly those experiencing neck issues such as Upper Cervical Instability, vascular compression syndromes and gastrointestinal symptoms.

Click to view Sam's availability and to make a booking.