Using Splinting with Hypermobility Syndromes

PhotoGrid_1449152857030Using splinting is one common strategy for managing the symptoms of Hypermobility Syndromes such as Ehlers Danlos.

People with a hypermobility syndromes (HMS) often have very poor proprioception, this basically means we don’t really know where our own arms and legs are so we tend to have a lot of accidents compared to ‘normal’ people. Supporting our joints can help improve this proprioception so we are less likely to have accidents.

People with severe hypermobility can be prone to joint subluxations and dislocations, splinting can help keep joints in place or restrict movement so that we can’t get into risky positions that are likely to cause joint injuries.

Joint supports particularly compression ones can also generate warmth, this can help keep muscle aches at bay and ease joint pain.

Finally, splints can be used to immobilise a joint which can be beneficial during the acute phase following a bad dislocation.

My personal approach to splinting is not to detract from my body’s existing function but to stop my joints from getting into un-natural positions. In short, splinting stops me from doing any more damage to my already wonky body.

There are lots of different types of splints and they all work slightly differently. This is designed as a guide to splinting in general and is not designed to over-rule any advice you’ve been given by your own healthcare team.

Most of my own splints are ‘activity splints’, these are the most commonly used splints for people with joint instability. They are designed to support joints during specific activities. As an example, I might wear hinged knee braces while walking, if I’m not walking I don’t need to wear the splints.

Although I own a range of splints for most parts of my body I only wear splints when there is a risk to my joints. If I’m having a bed day or I’ve settled down on the sofa for a few hours I will remove pretty much all of my splints. There’s no need to cover myself in velcro and metal if I’m not actually at risk of injury. I don’t splint my knees and ankles if I know I’ll be resting or using my wheelchair. I won’t splint my wrists if I know I’m just walking and not carrying anything.

If you wear splints all the time your body will become dependent on them, prolonged splinting needs to be accompanied by appropriate physiotherapy exercises (please see a physio if you’re splinting but not receiving any exercises). If your splints do a lot of the functional work for you then your muscles won’t be doing much and you’ll lose muscle tone surprisingly quickly.

This approach, taking splints off when not in use, does mean I spend extra time taking braces off and putting them back on and it also means I have to travel with a handbag full of splints but in the long run, it’s worth it. I have not become dependent on my splints despite regular use and I’ve actually become strong enough to stop using some completely.

There are some exceptions to the ‘remove if not in use’ rule.

If I’ve recently had a severe joint injury such as a total dislocation I often use splinting as a way to immobilize my joints while they recover. The recovery time varies depending on the joint and the type of injury but this is a short-term solution. Usually only a few hours, a day at most. With a hypermobility syndrome it’s important to know when to seek medical help. If you often subluxate or dislocate things like I do then you might not need to seek help. Short term immobilization allows the soft-tissue around a joint to recover a bit, can improve stability, reduce pain and prevent repeat-injury but it should be done very carefully. If you’re at all unsure it’s best to seek medical help.

Other types of splinting that break the ‘remove when not in use’ rule include splints used post-surgically. If you’ve been told to keep splints on then do so. With some surgeries it’s really important to keep the affected area completely still until you’ve seen your surgical team and been given the all clear.

There are also types of splints that are designed to be worn while resting, these splints prevent or correct positioning problems. They are commonly used to correct contractures or to prevent injuries during sleep.

Along side the potential loss of muscle tone there are other risks to splinting. Skin problems are a lot more common in bendie folks than in the general population, if you take delicate skin and apply a sweaty compression layer for hours at a time you can end up with sore patches, blisters and fungal infections, If this is an issue for you then maybe a different type of splinting would be better for you.

The next issues is not as serious but is very irritating. If your splints contain velcro you will never be able to wear tights or stocking safely again.

Splinting can be an effective way of managing chronic instability but it should always be used alongside physiotherapy. Splinting won’t correct joint issues but physiotherapy actually can, using both together allows for safe muscle-building and injury prevention. Many areas in the UK now allow for self-referrals but you can always speak to your GP.

As always questions and comments are welcome.

JBOT

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2 thoughts on “Using Splinting with Hypermobility Syndromes

  1. Ring splints are another exception to the ‘remove when not in use’ rule for me – all they do is physically stop me hyperextending my PIP & DIP joints and improve my proprioception. If I’m within an acceptable range of motion they don’t support or affect my joints.

    They’re also the single most helpful thing I’ve ever done to improve my quality of life with EDS.

    1. I love mine too! It’s difficult to find splints that literally just block unnatural motion without supporting the soft tissues in some way. I often try to do small, safe activities without my splints while avoiding hyperextension just to try and improve my proprioception.

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