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By Dr Sarah Varmalis, Senior Osteopath Ehlers-Danlos Syndrome (EDS) is a group of genetic conditions that affect the body’s connective tissue. Connective tissue is what gives structure and support to things like ligaments, skin, blood vessels, and even internal organs. It’s essentially the “scaffolding” that holds everything together. In people with EDS, this connective tissue is more elastic and less supportive than usual. This often shows up as joints that move more than they should (sometimes called hypermobility), skin that may be more stretchy or fragile, and a tendency toward injuries like sprains, dislocations, or ongoing aches and pains. But EDS isn’t just about being “flexible.” Because connective tissue exists throughout the entire body, it can affect multiple systems. This means people may experience a wide range of symptoms; from joint pain and fatigue, to digestive issues, dizziness, or difficulty regulating energy levels. It can look very different from one person to another, which is part of why it’s often misunderstood or missed early on.  Learning More and Getting Diagnosed For those wanting to better understand Ehlers-Danlos Syndrome, ‘The Ehlers-Danlos Society’ is one of the most trusted resources available. They provide up-to-date information on the different types of EDS, as well as guidance around diagnosis and management. The current diagnostic criteria (particularly for hypermobile EDS (hEDS)) can be found here: https://www.ehlers-danlos.com/heds-diagnostic-checklist/ Diagnosis is not always straightforward. It typically involves a combination of medical history, physical assessment (including joint hypermobility), and ruling out other conditions. For many people, the process can take years. EDS also rarely exists in isolation. Because connective tissue is found throughout the body, it’s common to see overlap with other conditions and symptoms, including:
 An Osteopathic Approach to Ehler-Danlos Living with a condition like Ehlers-Danlos Syndrome (EDS) or ongoing chronic pain can feel confusing, frustrating, and at times, overwhelming. Many people go years trying different treatments, often being told that everything looks “normal” despite still feeling far from it. From an osteopathic perspective, the focus shifts away from chasing symptoms and toward understanding how the whole body is functioning and more importantly, where it’s struggling to adapt. What’s Actually Going On? Ehlers-Danlos Syndrome is a connective tissue condition. In simple terms, the “glue” that holds the body together; ligaments, fascia, blood vessels, even organs have a different structure. This often leads to increased flexibility, but that flexibility comes at a cost: reduced stability. Over time, the body works harder to compensate. Muscles overwork, joints become irritated, and the nervous system becomes more sensitive. This is where chronic pain can start to take hold. But here’s the key thing; pain in these conditions isn’t just about joints being “loose.” It’s about how multiple systems in the body are interacting and, in many cases, becoming overloaded. Why Traditional Approaches Don’t Always Work A lot of treatments focus purely on strengthening or stabilising joints. While that can absolutely be helpful, it often doesn’t address the full picture. In people with EDS or persistent pain, there are often underlying drivers such as:
A Different Way of Looking at the Body Osteopathy takes a whole-body approach. Rather than asking “where does it hurt?”, the question becomes “why is the body under strain in the first place?” Two techniques that are particularly useful in these cases are:
Counterstrain: Calming the Nervous System Counterstrain is a technique that focuses on tender points in the body, small areas that reflect dysfunction in muscles, nerves, blood vessels, or organs. Rather than stretching or pushing into pain, the body is placed into positions of ease. These positions are held briefly, allowing the nervous system to “reset” its perception of that area. In patients with EDS or chronic pain, this can be incredibly powerful. Why? Because the nervous system is often running in a heightened, protective state. Counterstrain helps reduce that sensitivity, allowing muscles to relax and improving how the body coordinates movement. A key part of this process is the cranial scan. By gently assessing points along the skull, practitioners can identify which systems in the body are under strain—whether that’s vascular, neurological, or visceral. It becomes a roadmap for treatment, rather than guessing where to start. The Barral Approach: Supporting the Organs When people think about pain, they rarely think about organs but they should. The Barral approach (often called visceral manipulation) looks at how organs move and interact with surrounding structures. Each organ has its own natural rhythm and mobility. When that movement is restricted, it can create tension patterns throughout the body. For example:
In EDS and chronic pain conditions, these subtle restrictions can play a much bigger role than expected. By gently improving how these structures move, the body often finds it easier to settle, stabilise, and function more efficiently. Why Gentle Treatment Matters One of the biggest misconceptions is that stronger or more forceful treatment leads to better results. In reality, for people with EDS or heightened pain sensitivity, the opposite is often true. The body responds best to:
Both Counterstrain and the Barral approach respect this. They work under the body’s tolerance, rather than pushing past it. What Patients Often Notice While every person is different, common changes patients report include:
Importantly, progress is usually gradual and layered—because the body is unwinding patterns that have often been there for years. The Bigger Picture Managing Ehlers-Danlos and chronic pain isn’t about finding a single “fix.” It’s about helping the body become more adaptable, more efficient, and less reactive over time. Osteopathy, particularly when using approaches like Counterstrain and Barral, offers a way to support that process gently and intelligently. It’s not about forcing the body into place—it’s about giving it the space and input it needs to find a better way of functioning. Matt has a strong passion for helping people recover from injury, reduce pain, and improve their overall physical wellbeing. He brings a calm, professional approach to treatment and is committed to delivering hands-on care that supports both short term relief and long term recovery. With practical experience working alongside a local football club, Matt has developed a strong understanding of sports related injuries, muscle recovery, and performance based treatment. This exposure has given him valuable insight into the demands placed on the body through training, competition, and physical activity, allowing him to better support both athletes and active individuals.  Matt enjoys working with clients from all backgrounds - whether they are managing a specific injury, recovering from sport or gym related strain, or dealing with general muscular tightness and postural discomfort from work or lifestyle factors. His treatment approach is focused on identifying the root cause of pain and dysfunction, rather than just treating symptoms. Depending on your needs, Matt may use a combination of:
Matt has a particular interest in helping clients with:
Matt takes pride in creating personalised treatment plans that support recovery, improve movement, and help clients return to the activities they enjoy with greater confidence and comfort. Whether your goal is injury rehabilitation, performance improvement, or simply reducing everyday tension and stress, Matt provides a supportive and effective treatment experience tailored to your individual needs. You can now book with Matt on Mondays, Thursdays & Sundays By Peter Pascalis, Clinical Myotherapist As a gentle, therapeutic technique, lymphatic drainage helps support immune function by removing waste from the body via little cells located throughout our bodies. Often our system can be overwhelmed with toxic insults coming from food, medicines, chemicals we use on our skin (the largest organ of our body) and the environment. There are many reasons why lymph flow is important especially in cases of post operative swelling and sports injuries.  What exactly is lymphatic fluid? Lymph fluid consists of lymphocytes (a specific white blood cell that helps to fight infections), bacteria, cellular debris, plasma proteins, and other cells. Lymphatic motion is usually slow and is dependant on respiratory motion, arterial pressure, and muscle and joint pumps working both on the veins and on the lymph vessels. What Is Lymphatic Drainage? Lymphatic drainage is a specialized massage technique that uses light, rhythmic movements to stimulate lymph flow. It focuses on specific pathways and nodes within the lymphatic system in a systematic fashion. Often it is a very relaxing treatment with clear health benefits: Benefits of Lymphatic Drainage 1. Reduces Swelling and Inflammation One of the most immediate benefits is the reduction of post-surgical swelling. By promoting fluid movement, lymphatic drainage helps prevent fluid accumulation and reduces pressure in affected areas. 2. Accelerates Healing Improved circulation of lymph fluid means better removal of toxins and cellular waste, which can speed up tissue repair and recovery. 3. Minimizes Pain and Discomfort Less swelling often translates to reduced pain. Many patients report feeling more comfortable and mobile after sessions. 4. Decreases Risk of Complications Proper lymph flow can reduce the likelihood of complications such as fibrosis (hardening of tissues) and seromas (fluid pockets). 5. Supports Immune Function By enhancing lymph movement, the body’s immune response is better supported—an important factor in preventing infections after surgery. When to Start Lymphatic Drainage In many cases, lymphatic drainage can begin within a few days after surgery or sports injury, but this depends on the go ahead from a medical practitioner. What to Expect During a Session A typical lymphatic drainage session lasts 60 minutes, and multiple sessions may be recommended for optimal results. Some patients notice immediate improvements, while others experience gradual changes over several treatments. Is It Safe for Everyone? While lymphatic drainage is generally safe, it may not be suitable for individuals with certain conditions, such as active infections, current treatments for cancer, blood clots, or untreated heart issues. Tips for Maximizing Results
A great time for a lymphatic treatment With winter around the corner this is a great time to get a lymphatic drainage as it supports immunity, reduces seasonal fluid retention, and boosts energy sluggishness caused by cold weather and inactivity. Gentle, rhythmic massage increases lymph flow, aids detoxification, and reduces stiffness. By Rachael Bird, Myotherapist Myotherapy, which involves manual therapy techniques to address muscle tension and pain, can be a useful adjunct to the treatment of all types of headaches/migraines, particularly when muscle tension or trigger points contribute to or exacerbate these symptoms. While myotherapy is not a primary treatment for migraines, it can help manage muscle-related aspects of the condition and provide relief from secondary symptoms.  Here's how myotherapy can be integrated into the treatment of headaches/migraines: Migraines Usually on one side of the head. This type of headache affects muscles of the face, scalp, neck, and jaw. Muscle Relaxation Myotherapists can use various techniques, such as massage, stretching, and deep tissue work, to relax tense muscles in the neck, shoulders, and head. Muscle relaxation can help reduce the frequency and severity of migraine attacks, especially if muscle tension is a trigger for your migraines. Trigger Point Therapy Myotherapists are trained to identify and release trigger points—small, tight knots in muscles that can refer pain to other areas of the body. Trigger points in the neck, shoulders, and upper back can contribute to migraine symptoms. Targeted therapy to release these trigger points may alleviate some of the associated pain and tension. Postural Education Myotherapists can assess your posture and recommend changes or exercises to improve it. Poor posture can lead to muscle tension and migraine triggers. Correcting posture can help reduce the likelihood of migraines. Stress Reduction Myotherapy sessions often incorporate relaxation techniques, such as deep breathing and mindfulness, to help manage stress. Stress is a common migraine trigger for many individuals, so stress reduction can be an important component of migraine management. Pain Relief Myotherapy can provide temporary relief from migraine-associated muscle tension and discomfort, helping you feel more comfortable during an attack. It's essential to remember that myotherapy is a complementary therapy and should be used in conjunction with a comprehensive migraine management plan, which may include: Medications Your healthcare provider may prescribe acute migraine medications (abortive) and preventive medications to reduce the frequency and severity of migraines. Lifestyle Modifications Identifying and avoiding migraine triggers, maintaining a regular sleep schedule, managing stress, and staying hydrated are important lifestyle changes that can help reduce the frequency of migraines. Dietary Changes Some individuals may find relief by avoiding specific trigger foods or additives that can exacerbate migraines. Biofeedback or Relaxation Training These techniques can help individuals learn to control physiological responses and manage stress, which can be beneficial in migraine management. Regular Check-Ins Ongoing communication with your healthcare provider is crucial to assess the effectiveness of your migraine treatment plan and make necessary adjustments. Before starting myotherapy or any complementary therapy for migraine management, consult with a healthcare provider to ensure that it is safe and appropriate for your specific condition. They can also help you integrate myotherapy into your overall migraine treatment plan effectively. Cluster Usually around the eye, this might cause the eye to water. This type of headache affects the muscles around the eye, temples and neck. Cluster headaches are primarily neurological in nature, and their underlying causes involve abnormal activation of the trigeminal nerve and changes in blood vessel dilation in the brain. The pain associated with cluster headaches is intense and severe, and it is not primarily related to muscle tension or musculoskeletal issues. Therefore, myotherapy is not typically used as a standalone treatment for cluster headaches. However, some individuals with cluster headaches may experience muscle tension and discomfort in the head, neck, or shoulder region during or after headache attacks. In such cases, myotherapy or physical therapy may be considered as part of a broader treatment plan to help relieve muscle tension and improve overall comfort. Here are some ways myotherapy or physical therapy may be integrated into the management of cluster headaches: Muscle Relaxation Techniques Myotherapists or physical therapists can teach relaxation techniques, stretches, and exercises to help reduce muscle tension in the head, neck, and shoulders. These techniques may be useful in managing secondary muscle discomfort associated with cluster headaches. Posture Correction Poor posture can contribute to muscle tension and headaches. Myotherapists or physical therapists can work with individuals to improve their posture, which may help reduce the frequency and severity of muscle-related discomfort. Stress Management Stress can exacerbate muscle tension and headache symptoms. Myotherapy and physical therapy sessions may include stress management techniques to help individuals cope with stress and anxiety. Pain Relief Some manual therapy techniques used in myotherapy, such as massage or trigger point therapy, may help provide temporary relief from muscle tension and discomfort during a cluster headache episode. However, these techniques are unlikely to provide significant relief from the headache pain itself. By Rachael Bird, Myotherapist Repetitive movements are an inherent part of many professions and daily activities. From office workers typing on keyboards for hours to athletes practicing their chosen sport, repetitive movements can take a toll on various parts of the body, including the shoulder. In this article, we will explore the effects of repetitive movements on the shoulder, a complex and delicate joint that plays a crucial role in our daily lives.  The Shoulder Joint: A Remarkable Structure The shoulder is a highly mobile joint that allows us to perform a wide range of activities, from lifting objects to throwing a baseball. It consists of three bones: the humerus (upper arm bone), the scapula (shoulder blade), and the clavicle (collarbone). These bones are connected by a network of muscles, tendons, and ligaments, which work together to provide stability and movement to the shoulder joint. Effects of Repetitive Movements on the Shoulder Muscle Fatigue and Tendonitis: Repetitive movements can lead to muscle fatigue, especially in the muscles surrounding the shoulder joint. Over time, this can cause inflammation and irritation of the tendons, a condition known as tendonitis. Tendonitis can result in pain and limited range of motion in the shoulder. Rotator Cuff Injuries: The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Repetitive overhead movements, such as those performed by athletes in sports like tennis or baseball, can strain and damage the rotator cuff. This can lead to rotator cuff injuries, characterized by pain, weakness, and difficulty raising the arm. Impingement Syndrome: Repetitive movements can narrow the space between the acromion (a bony projection of the scapula) and the rotator cuff tendons. This can result in a condition known as impingement syndrome, where the tendons become pinched and inflamed. Impingement syndrome causes pain when lifting the arm and can lead to further shoulder problems if left untreated. Frozen Shoulder (Adhesive Capsulitis): Repetitive movements or lack of movement due to immobilization can lead to a condition called frozen shoulder. In this condition, the capsule surrounding the shoulder joint becomes thickened and tight, causing pain and stiffness. Frozen shoulder can significantly limit shoulder mobility and can take months to resolve. Arthritis: Overuse of the shoulder joint can accelerate the wear and tear of the cartilage that cushions the bones. This can lead to the development of arthritis in the shoulder, resulting in pain, swelling, and reduced joint mobility. Preventing and Managing Shoulder Issues from Repetitive Movements Prevention and proper management are key to minimizing the negative effects of repetitive movements on the shoulder: Ergonomics: In workplaces that involve repetitive tasks, ergonomic adjustments can help reduce the strain on the shoulder. Proper chair and desk height, keyboard placement, and regular breaks can make a significant difference. Strengthening Exercises: Regularly performing exercises that target the muscles around the shoulder joint can help improve stability and reduce the risk of injury. Physical therapy programs can be beneficial for individuals with repetitive motion-related shoulder issues. Rest and Recovery: Adequate rest and recovery time are essential, especially for athletes and individuals with physically demanding jobs. Giving the shoulder time to heal and recuperate can prevent the development of chronic issues. Proper Technique: Athletes and individuals involved in repetitive activities should pay attention to their technique. Proper form can reduce the risk of overuse injuries. Medical Attention: If you experience persistent shoulder pain or mobility issues, it's essential to seek medical attention. Early diagnosis and treatment can prevent the progression of shoulder problems. In conclusion, repetitive movements can have a significant impact on the shoulder joint, leading to a range of issues from muscle fatigue and tendonitis to more severe conditions like rotator cuff injuries and arthritis. Understanding the risks and taking preventive measures, such as ergonomic adjustments and strengthening exercises, can help individuals mitigate these effects and maintain shoulder health. When shoulder problems do arise, prompt medical attention and appropriate rehabilitation are crucial for a full recovery and a return to pain-free mobility. |
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