Types of Splinting and Bracing for Hypermobility Syndromes.

There are many different types of splints for different uses. When deciding what will suit you there are lots of  points to consider. So here goes, my run down on different methods of supporting your joints.

Neoprene or  Elastic Supports

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These are often fairly basic lightly shaped stretchy sleeves you simply pull on, commonly available for supporting extremities like your wrists, elbows, knees and ankles. They offer light support and some proprioceptive feedback so they can help minimise the clumsy kind of injuries that bendy people get so often! Stretchy supports like these also allow for swelling after acute injuries 1 .

Pro’s

  • A simple wrist or ankle support will often set you back less than £10 I’ve even seen them in pound shops!
  • You can usually wear pull on supports like this under clothing or shoes without it being obvious at all.
  • Each support will have its own washing instructions but generally you can just pop it in the washing machine on a delicate setting like you would for clothing and you’re good to go!
  • They are widely available in sports shops and high street chemists so no need to order online or wait months to see an orthotist.

Con’s

  • Supports like this usually come in 4 colours, black, bright blue, not-quite-white and something that’s supposed to be ‘beige’. Not exactly sleek and stylish.
  •  During the hotter months of the year lining your joints with neoprene can be really sweaty and this can easily lead to skin irritation2.
  • Cheap pull on splints like this usually come in limited sizing af if you fall out side the ‘normal’ ranges you might struggle to find something that fits.
  • Pulling on supports like this can be really hard especially if you have problems with your wrists or fingers.
  • Because of the limiting shaping I find the fabric bunches up, especially behind my knees.

Off the rack (OTR) Compression

Compression clothing is usually made with tight, stretchy materials but is often much thinner than neoprene stuff. Compression is becoming increasingly popular with bendy folks, especially sporty ones. Compression stuff provides good proprioceptive feedback which can improve balance and spatial awareness. The compression stuff with reinforcements can help improve posture too. For people with PoTS (Postural Tachycardia) compression clothing can help manage blood pooling and prevent syncope too.

Pro’s

  • Improved posture and proprioception, ability to manage blood pooling and reduction in syncope.
  • The sports compression can have a sporty look and feel, I like this as, I sometimes prefer to feel like an injured athlete than simply a walking disaster!
  • The compression is lighter than neoprene supports so it can be much more comfortable.
  • Good range of colours available as ‘sports compression’

Con’s

  • Often the high quality compression clothing like ‘Skins’, ‘bio-skin’ and ‘Inteli-skin’ can be pretty expensive.
  • The lighter compression might not be supportive enough for particularly wonky joints.
  • Although my joints are pretty unstable I do have good muscle tone, this causes one bug problem. I can still hyperextend through a lot of different kinds of splints. With compression clothing there isn’t much to actually prevent you from hyperextending, its more about encouraging your joints into the correct movements.
  • Full body compression can be very hot, so if you’re heat intolerant then be careful.
  • Getting in and out of compression can be a bit of a mission, make sure you have time for a rest afterwards before you need to go out!

Custom Compression

Hypermobile EDS pics

For those who have tried OTR compression and found it good-but-not-great there is another option. Custom fit compressions stuff. Lycra Suits are becoming increasingly popular with children especially kids with dyspraxia and cerebral palsy as well as hypermobility syndromes like EDS. Orthotists seem less keen to prescribe it to adults but if you state your case many will relent and sort you out with some. You can have a full body suit or just sections like shorts or socks or gloves. This works in much the same way OTR compression does but there are a couple of major differences. Having zips and velcro added means that getting into your compression stuff is much easier, and having it custom-made means that it fits a lot better. With OTR compression tops I found that the smaller sizes supported my shoulders but squashed my boobs badly and the bigger size fit my boobs but was too loose around my shoulders. With custom-made this isn’t a problem.

Pro’s

  •  Made especially for you so the fit should be perfect.
  • You can choose your own patterns and colours although some of the best fabrics aren’t available for adults unless you specifically ask.
  • Easy to get on and off than OTR compression due to zips
  • Highly customisable so if you need more support later down the line the suit can be sent back and added to.

Con’s

  • Very difficult to get without the help of an Orthotist. It is possible to contact the companies directly but they work almost exclusively with hospitals.
  • If you gain or lose weight you might well need a whole new suit made.
  • Because of the highly specialised nature of the garments it can take weeks to get a suit made, if you need repairs it can take weeks too.

Fabric splints with metal stays (activity splints)

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This is the sort of splint you will usually get from hospital departments, often wrist and thumb splints they are beige monstrosities made of fabric that have removable metal bits in. Outside the NHS they are available in a few different colours and styles, some have removable stays others have them sewn in. These supports work fairly similarly to the pull on elastic ones, the fabric fives light support but in this case the metal stays can prevent movement in certain directions. These splints are good for short-term use, for example, you could basically immobilize your wrist while lifting something heavy then take off the splint for lighter jobs 4 . Splints like this can be very restrictive so wearing them for too long leads to stiffness and loss of muscle tone quite quickly.

Pro’s

  • The splint does a lot of the work so you can take a lot of the strain off your joints during intense activity.
  • The metal stays can be bent to fit your body so the fit can be very specific.
  • Great for immobilizing joints during very unstable phases, like after a dislocation.

Con’s

  • Immobilizing joints for long periods of time can cause loss of muscle tone very quickly, immobilizing can also lead to stiffness 5 .
  • The restrictive nature of the splints can make some activities very difficult, if you can’t use your hands joints normally then you can end up developing odd habits and doing things awkwardly.
  • The metal support stays can dig in.
  • The fabric and velcro can be uncomfortable and cause skin irritation.
  • NHS braces like this almost always come in beige.

Hyperextension Blocking Splints

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Splints like this are my personal favourite. These are splints that are designed to allow ‘normal’ movement but block hyperextension, examples of these are hinged (cage) knee braces and oval-8 finger splints. This type of splint doesn’t provide support or compression they just stop your joints from going places they aren’t supposed to.

Pro’s

  • Provides a relatively normal range of movement 6 .
  • This kind of splint doesn’t squish or compress so if you have issues with swelling your braces will probably still fit!
  • Low surface area, hinged knee braces are very supportive while being pretty low profile, they have the hinges and straps and nothing else.
  • I actually think they look pretty sleek compared to neoprene.

Con’s

  • EXPENSIVE – I got my knee braces through the NHS but if I’d bought them myself I would have had to spend upwards of £200 each.
  • They are highly restrictive in ‘danger’ directions, they block you from twisting your knees etc so they can take some getting used to if your ‘normal’ movement patterns are very bendie.
  • They are pretty bulky and are hard to hide under clothing. I tend to just go with it and try to look cool anyway. 😉

Custom Plastic Splints

New Ankle braces, Hinged custom casted zebra print (obviously) they support my ankles exactly and flex/point to allow normal walking action.

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These come in a few different types like thermoplastic hand therapy splints or AFO’s (ankle braces) usually custom-made by medical professionals and moulded to fit your body. The plastic they are made of is heated until it turns soft and then draped over/around your body or a mould of the limb needing splinting.  7

Pro’s

  • Very very specific fit so they shouldn’t pinch or gape at all, well made custom splints are usually really comfortable.
  • You can usually chose the colour and sometimes even the patterns.
  • Having the splint made just for you means the amount of movement allowed is just what you need, in my ankle braces I can point and flex my foot but I can’t roll my ankles even when stood on one leg!

Con’s

  • The plastic can be pretty sweaty and people with very delicate skin can end up with contact dermatitis quite quickly.
  • Hinged AFO’s (Ankle/ Foot orthosis) like mine are very difficult to fit into shoes!!
  •  Some thermoplastics have a pretty low melting point, I have spoken to people who’ve melted their splints while washing up in hot water or using a hairdryer!
  • They need to be made by an expert so you’ll have to wait for an appointment, you can’t just buy them off the internet.

Kinesiology Tape

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Kinesiology Tape is becoming increasingly popular, I first saw it on professional athletes on TV but it was a few years before I actually tried it on myself. Once I did I got hooked. I use tape a LOT.. I buy in bulk and generally have about 4 or 5 different colours around the house at any one time. Kinesiology tape provides dynamic support which can also help improve proprioception 8 . Physiotherapists can tape so if you think it might help you then ask your Physio or check out YouTube for tutorials. A lot of taping is trial and error so don’t give up if it doesn’t seem to work well to start with.

A few quick tips…

  •  When applying tape, make sure the area you’re taping is exfoliated, clean, dry and hair free. If you’ve done all of this and tape isn’t sticking you can try a tape adhesive spray. I use Mueller’s Tape Adhesive and it works for me.
  • If you’re taping so you can exercise try to tape about an hour before you start getting hot and sweaty, this gives the tape adhesive time to stick to you properly.
  • If you’re cutting your own tape from a roll then trim the corners off each section. Rounding off the edges makes it less likely that the corners will roll up and peel off.
  • The first half an inch of tape should be applied without stretching. Just stick it down and make sure its well stuck before you start adding tension. The same goes for the final half-inch, don’t stretch it just stick it down. This helps the tape stay stuck down.
  • If your tape is starting to peel at the edges don’t feel like you have to take it all off and start again just trim the peeling edges with small scissors or tape it down with micropore.

Hope some of that helps!

Pro’s

  • Tape can be hidden almost completely under clothing (depending on where you’ve taped).
  • You can choose your colours.
  • No need to keep fiddling with velcro or taking off splints so you can get changed or go to bed, just tape and leave it. (Tape can last me as long as a week or so)
  • Sporty look and feel as supposed to looking and feeling medical.
  • You can tape areas its hard to splint, like your back and shoulders.
  • You can tape under other splints for extra support.

Con’s

  •  Some people, particularly those with Classical or Vascular EDS are just simply tape resistant. A good friend of mine can only keep tape on for about half an hour before it peels off, it doesn’t matter what extra measures are in place or how good the tape is!
  • Skin irritation. A lot of people with hypermobility syndromes have quite delicate skin, some people find that peeling off the tape tends to peel off their skin too. A lot of the ‘professional sports tapes’ (that cost a lot more) tend to have stronger adhesives, this is good because they stay on longer, but for bendy folks this can just mean they peel off more skin! My personal favourites are Levo Tape and Rea Tape. Rock Tape, 3NS TEX, Kinesio and KT also come highly recommended by bendy friends.
  • Its single use, you’ll need to re-tape a joint each time so it takes longer than splinting and is also more wasteful.

There are specific types of braces that don’t really fall into any of these categories, splinting is a constantly evolving industry and more and more advanced splints are released every year. Sports splinting is becoming increasingly high-tech and low profile. There are also advanced custom-made braces that are in categories all of their own but if you’re in need of these you’ll probably have an orthotist who knows a lot more about it all than me! Hopefully this post will give you some guidance as to what splints will suit your needs.

As always I’d love to hear your experiences and if you have anything to add I’d be pleased to hear it.

I do hope this has been useful, please let me know what you think.

JBOT

Reference List

1.
Boyd A, Benjamin H, Asplund C. Principles of Casting and Splinting. American Family Physician . http://www.aafp.org/afp/2009/0101/p16.html. Published 2009. Accessed 2017.
2.
Stern E, Callinan N, Hank M, Lewis E, Schousboe J, Ytterberg S. Neoprene splinting: dermatological issues. Am J Occup Ther. 1998;52(7):573-578. [PubMed]
3.
Sensory Dynamic Orthosis garments. JobSkin. https://www.jobskin.co.uk/sensory-dynamic-orthosis-garments. Accessed 2017.
5.
Pratt D. JOINTS OF THE HAND AND FINGERS—THEIR STIFFNESS, SPLINTING AND SURGERY. Calif Med. 1947;66(1):22-24. [PMC]
6.
Hyperextension Blocking Splints. Silver Ring Splint Company. http://www.silverringsplint.com/problems-addressed/hyperextension/. Accessed 2017.
7.
Colditz J. Low-Temperature Thermoplastic Splints/Orthoses Made by Therapists: An Overview of Current Practice. oandp.com. http://www.oandp.com/articles/2004-10_03.asp. Published 2004. Accessed 2017.
8.
Hosp S, Bottoni G, Heinrich D, Kofler P, Hasler M, Nachbauer W. A pilot study of the effect of Kinesiology tape on knee proprioception after physical activity in healthy women. Journal of Science and Medicine in Sport. 2015;18(6):709-713. doi: 10.1016/j.jsams.2014.09.004
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38 thoughts on “Types of Splinting and Bracing for Hypermobility Syndromes.

  1. Hi did you have any luck with your splints? I’m awaiting my orthotics appointment with the NHS and having the same knee problems as yourself
    Thanks
    Jacqui

  2. Could you tell me what make/model those hyperextension blocking knee splints are? I see their Donjoy…I’m just trying to get an idea so I know what to suggest to my physiatrist/doctor.

    I know with bracing and EDS it’s not so wise and physio is key (I’m assuming that’s why the make/model was left out for these, as to not encourage everyone to get hyperextension blocking splints? XD) and so I’m desperately trying to find myself a knowledgeable PT/OT team here….but unfortunately if I don’t make the suggestions and “drive “ my medical care I’m simply dismissed around here. I’m facing a very broken system here in eastern Canada; it’s like pulling teeth accessing any resources. I will most likely have to emigrate for better health care as I’m declining and not getting any help (despite a diagnosis of hEDS!) But I cant take my knees shifting side to side ITS DRIVING ME NUTS, leading to more deconditioning… *sigh* I never should have left the UK.

    1. The ones in this post are Donjoy 4titude braces. I actually have Ossur CTi OTS ones now. I know the medi ones are pretty popular among bendie folks too. Basically any cage style hinged brace is likely to restrict hyperextension, it just depends what other issues you’ve got going on too 🙂

  3. Hi JBot, I just found your blog and it’s very informational. I recently had my AFO ankle brace molded and picked it up …..I didn’t realize it was going to be as wide as the dang boot! I have to go and buy some shoes….:/ I spent a good deal on my current 3 pair of tennis shoes. 🙁 I’m looking for a wrist support & thumb support all in one right now (which is why your blogged popped up). 🙂 Thumb dislocating issues & wrist spraining by just starting the car or putting a plate in the drainer needs to stop…its becoming too problemsome. I need to look into taping my shoulder, esp at night. It would help a lot….I wonder if my chiropractor could help show me how to place the tape since she’s always placing my shoulder back in as well as my elbows….I have 2 rolls just laying around…may as well use it. 🙂

    1. Happy my blog could help! I have a pinterest tape board, there’s a link in my Kinesiology tape article which might come in handy! Widefit shoes for ankle braces is a serious pain! I’m really hoping my next pair will be less bulky!

  4. Hi, I am a sufferer of bad hypermobility, especially in both knee joints. They seem to move around and even dislocate whenever I am active which causes extreme pain leading to a fibromyalgia flare up. I feel that both symptoms are linked. It’s taking ages to get anyone to try to deal with this here in the U.K. though OT have helped a little bit. We have an appointment with Orthotics in a few months but I could do with help in the mean time because day to day life is very difficult and painful. Are there any recommendations for splints and knee support/braces for this type of condition as there are a lot of sports injury ones which I fear won’t be right for me.

    1. Hi Laura, I’m in the UK too so I do know how you feel there. Splinting can be a real issue for this and it’s great that you’ve got an orthotics appointment coming up. In the mean time have you tried something like Kinesiology Tape?

    2. Hi did you have any luck with your splints? I’m awaiting my orthotics appointment with the NHS and having the same knee problems as yourself
      Thanks
      Jacqui

  5. Hi! I too have hinged afos just like yours, they’re also zebra print, although my padding inside is blue, so my zebras look a bit cold (poor circulation, perhaps even more appropriate for a bendy). Anyway, where do you find best to buy shoes please? I’ve been wearing dcs, but my splint has burst through the side already in 3/4 of a year of wearing them. Thanks for your post!
    Jenny

    1. I try to avoid wearing high-cut shoes, they tend to get eaten by the hinges. I have had a few pairs of formal shoes from Wider Fit Shoes, for general use I have some RocketDog canvas trainers which are surprisingly accomodating!

  6. hi just found this. im cureenlty on wiaitng for my hinged afos for my legs in 11 days. cani haveore infomation how they are please do theyhurt. how easy is itto move the foot.
    are theygrippy.
    askingas only ever had fixed ones before and i was achild when i got them.

    1. I wish I could help more Laura-Beth but every set is different. Usually they are not grippy becasue AFO’s are designed to be worn with shoes. They shouldn’t hurt but if they do they can be adjusted. Speak to your orthotis for more info 🙂

      1. thank you so much. iv asked on a hypermobilty facebook site and seems none of them have had them. i came across your site from pintrist and found you had ankel flexing ones. and was intrested. my seurgen said they wrre the better. ones.
        iv had the tape before for my knees and like you say, i am one of the ones that is allergic to it i came out in a rash.
        my brother has got a mild form of hypermobilty in his knees he swars by bike knee pads to hold his.
        thank you

  7. Hello,
    I am an occupational therapist and jeweler.

    During my every day therapeutic work, I help many patients by designing, constructing and fitting the hand/finger splints, customized to answer their particular functional and medical needs.
    Many EDS patients ask for more aesthetic solutions than usually offered plastic splints.

    As a result, I desided to pursue the ultimate splint design – practical and fashionable.

    After many trials and errors, I came up with the concept of JewelSplint.

    JewelSplints are made of sterling silver.

    A very important feature of the JewelSplint is its adjustability.
    One can slightly adjust the width and length of the splint when first received and during the day, when the temperature variations affect the finger size.

    In addition,
    It allows ventilation
    Light-weight
    Aesthetic
    Looks jewel
    And most important: allows optimal joint position and prevents hyper-extension.

    I would like to invite you to visit JewelSplint:

    https://www.etsy.com/shop/JewelSplint

    Don’t hesitate to contact me for any questions.

    1. I’ve taken a look and your splints are really lovely but the problem is the cost of them. Most folks in the UK with EDS are on long term disability benefits and don’t have much spare money at the end of the month. I couldn’t afford to pay £75+ per ring when I need at least ten of them. There is another silver splint maker called zomile. She’s in the UK so the postage is low and better still, she only charges £30-£45 for each ring.

  8. Hi, internet rando with EDS here! I was wondering what brands you’d suggest for hip compression? My doctor’s never even heard of it, this is all new territory for both of us, but my hips are getting worse and worse… having some support would be great!

    Thank you!

    1. Hello. For light support I’d actually recommend Spanx! Actual spanx brand pants are surprisingly supportive and give a lot of proprioceptive feedback. If they aren’t cutting it then sports compression like underarmour or similar is the way to go.. If that’s still not doing the job then bioskin or custom fit are your best options. As with all splinting, this isn’t a solution it’s a management strategy. If you’re not in physio already I recommend you ask for a referral.
      Hope that helps

  9. Hi I’m so stuck with my splinting. I have EDS HM with classical and periodontal crossover. I have no idea when to use my splints.
    I have asked my healthcare professionals and got no answers :'(
    I work and have major hip and knee issues. My hips do need surgery but I won’t do it so when to use crutches/chair/ankle braces/compression knee brace or my cage ones????
    Any ideas?

    1. Sorry your healthcare folks haven’t been more useful!! Basically I tend to use splints when theres a risk, if I’m lifting something heavy theres a risk to my wrists so I’ll brace them. I also splint post-injury to avoid further damage, if I dislocate my knee I might brace while I’m waking for the next few days to avoid doing it again!
      Splints can also be used for positioning and postural feedback.. have you read both of my posts on splinting?
      I wish I could be more helpful but everyone is different and without knowing your specific problems and the types of splins you have I can’t really offer any specific suggestions. X

  10. Thanks so much for this post. I have EDS amongst a number of other conditions and am really struggling with the idea of splinting and wheelchairs etc. I have a neoprene splint for my knee, but the ones that lock hyperextension seem like a dream come true… Are they consultant prescribed things or gp prescribed things if you don’t mind my asking? I just have no idea how this all works…

    Such an informative piece! Thank you very much!

    Zoe

  11. Thank you for this very informative post. I’m a “bendy,” and now that I’m close to 40, my hypermobility (combined w/ fibromyalgia, which I thought ironic) is becoming more painfult and dangerous (more prone to sprains, longer healing time, and often re-sprain/strain during healing time).
    There’s been times I’d like just a full suit that keeps my body the way it’s “supposed to be.”
    Now that I’m learning about the severe problems/co-morbidities of being a “bendy” (I love that term, by the way), I’m going to check in with my *regular* doctors so I can stop having to do the urgent care visits because my joints have gone “wacky” again.

    1. Glad I could help:) Yeah compression and tape / splints can really help. Ideally with hypermobility conditions we learn to self manage to avoid urgent care. Its a tough condition to live with but we all get there in the end 🙂

  12. This is a really informative post! Thank you. My 12 year old daughter has EDS (dx’ed age 6) and we have been through many different aids/splints over the years. We are currently waiting on an appointment to get her measured for some compression gloves (OT and Orthotists debating who should supply them!) I think I’ll be looking into trying some taping over the summer as her compression skins are too hot and sweaty but her shoulders really need some support! x

    1. Thank you for taking the time to comment, I’m glad I could help. I opt for tape in the summer for the same reasons, plus you can buy tape in lots of pretty colours and it cheers me up haha! best of luck to her with the compression gloves, I have some for intermittent use and they really do help! 😀 Xx

  13. Nice superhero look with the knee splints! This is really helpful overall, thanks. Where did you get the silver finger splints?

  14. Hi Jo, this is a great post, really informative and it’s great to know what’s out there – I’ve only just been diagnosed with EDS so don’t have all the ‘experience’ that you do! Just wondered if you have any experience of splinting at night? I’ve been given wrist splints – the fabric kind with metal stays (and am waiting on ankle splints), to wear overnight so I don’t have to keep waking up to pop myself back into place! I’m loving waking up with my wrists in the right place, but they really rub in certain places- I’ve started wearing tubifast bandage that I had leftover from hospital underneath them, which seems to help but just interested if you have any better tips/pros/cons seeing as you are much more an expert than me!
    Thanks for your great blogs – it’s so helpful to have a really positive one out there! When newly diagnosed it’s a bit overwhelming reading all the information about difficulties and possible problems, so this is just perfect – realistic and practical advice but still really positive 🙂 Thanks!

    1. I have never tried night splints myself I tend to just use pillows for support or tape. However, my friends who’ve had night resting splints have had custom moulded splints from hand therpy. The custom moulded ones don’t tend to rub because they are made to fit you, typically the fabric ones with metal stays aren’t used for sleeping in, they are used more for doing activities in. I’d ask the person who gave them to you they might be able to swap them or adjust them for you. Tubigrip is good for lining or just trim some cotton sleeves or arm warmers to fit. I’m so glad you found my blog posts useful and thank you for your lovely feedback. Best of luck with the splinting! Xx

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