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The Efficacy of Powerlifting for Ehlers-Danlos Syndrome Management

Writer's picture: Josh HezzaJosh Hezza

Updated: Jan 23



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The Efficacy of Powerlifting for (some of the Symptoms of) Ehlers-Danlos Syndrome Management: Why the Conjugate Method Works


Ehlers-Danlos Syndrome (EDS) presents unique challenges in strength and conditioning due to its impact on connective tissue integrity, joint stability, and overall musculoskeletal health. Among the various approaches to managing EDS through exercise, powerlifting—when approached with a nuanced and individualized strategy—offers significant potential for improving stability, strength, and quality of life. If you’re ready to take the next step in your strength journey, consider reaching out to a qualified coach or exploring resources tailored to EDS and powerlifting. By starting slowly and seeking the right guidance, you can unlock your potential and achieve meaningful progress toward your goals. In this context, the Conjugate Method emerges as an ideal training system, offering a varied and adaptable framework that can cater to the specific needs of individuals with EDS while avoiding the pitfalls of repetitive stress.

As someone with EDS who has experienced these challenges firsthand, I can attest to the frustration of feeling perpetually under-prepared or not suitably fit to handle the demands of linear powerlifting periodisation. For years, I thought my inability to progress was a reflection of insufficient general physical preparedness (GPP). However, the reality was that my condition was not being managed effectively. Through years of coaching and personal experience, I have come to understand the profound benefits of tailoring strength training to the unique demands of EDS. It is from this perspective that I speak, offering not only technical insights but also the lived experience of navigating these challenges.

This article explores the efficacy of a sensible powerlifting training approach for managing Ehlers-Danlos Syndrome, with a focus on the Conjugate Method as the optimal system. Additionally, we’ll discuss how such an approach can address coexisting conditions like lipoedema and neurodivergence, both of which often require similar attention to variability, individualisation, and a holistic perspective. When implementing a powerlifting programme for individuals with Ehlers-Danlos Syndrome (EDS), several considerations are paramount to ensure safety, progress, and long-term adherence. Due to the unique challenges presented by EDS, it is essential to approach training with a focus on individualisation, gradual progression, and proactive management of symptoms. This is just a brief overview of the key considerations, with many more installments planned to explore each issue in greater depth.

Understanding Ehlers-Danlos Syndrome and Its Challenges

Ehlers-Danlos Syndrome (EDS) encompasses a group of inherited connective tissue disorders characterised by joint hypermobility, skin hyperextensibility, and tissue fragility (Mast et al., 2009). The condition results from genetic mutations that affect collagen or collagen-associated proteins, which are essential for providing strength and structure to connective tissues throughout the body. Among its subtypes, hypermobile Ehlers-Danlos Syndrome (hEDS) is the most prevalent and, while it does not yet have an identified genetic marker, it remains clinically distinct due to its characteristic symptoms and impact on daily functioning.

Individuals with hEDS commonly experience a range of symptoms that significantly affect their quality of life. These include:

  1. Joint Instability and Frequent Subluxations or Dislocations - Joint instability arises from weakened or lax ligaments, which fail to provide adequate support to the joints. This leads to frequent subluxations (partial dislocations) or complete dislocations, which can occur during everyday activities, such as walking or reaching for objects. These incidents are not only painful but also contribute to long-term damage to the joints and surrounding tissues, increasing the risk of osteoarthritis and chronic joint pain.

  2. Chronic Musculoskeletal Pain - Chronic pain is one of the most debilitating symptoms of hEDS and often stems from a combination of factors, including joint instability, muscle fatigue, and nerve irritation. Pain may be widespread, affecting multiple joints and muscles, and is often accompanied by heightened sensitivity to pressure or touch. This constant discomfort can lead to poor sleep quality, increased fatigue, and mental health challenges, such as anxiety and depression.

  3. Muscle Weakness and Fatigue - Muscle weakness and fatigue are common in individuals with hEDS due to the excessive demands placed on muscles to stabilise hypermobile joints. Over time, the muscles become overworked and less effective at maintaining joint alignment, further exacerbating instability and the risk of injury. Fatigue can also result from autonomic dysfunction, such as Postural Orthostatic Tachycardia Syndrome (POTS), which frequently co-occurs with hEDS, compounding the challenge of maintaining physical activity.

  4. Impaired Proprioception and Balance - Proprioception, the body’s ability to sense its position and movement in space, is often impaired in hEDS. This deficit can result in clumsiness, poor coordination, and an increased risk of falls. Balance issues may also stem from the instability of weight-bearing joints, such as the knees and ankles, further limiting mobility and confidence in performing everyday tasks (Tinkle et al., 2017; Castori et al., 2012).

These interconnected challenges can create a vicious cycle of deconditioning, where pain, fatigue, and fear of injury discourage physical activity, leading to muscle atrophy and further deterioration of joint stability. Over time, this cycle can result in significant loss of function and independence, negatively impacting overall quality of life.

For individuals with hEDS, structured strength training—when applied thoughtfully—can be transformative. Powerlifting, in particular, offers a focused and measurable approach to building strength, stability, and resilience. Unlike traditional aerobic exercise, which may exacerbate joint pain or fatigue in hEDS, strength training prioritises controlled, low-impact movements that target stabilising muscles and improve neuromuscular coordination.

Key benefits of strength training for hEDS include:

  • Enhanced Joint Stability: Strengthening the muscles surrounding hypermobile joints reduces reliance on passive structures, such as ligaments and tendons, which are inherently weaker in individuals with EDS.

  • Pain Reduction: By improving movement mechanics and offloading stress from vulnerable joints, strength training can alleviate chronic pain over time.

  • Improved Proprioception and Balance: Training that emphasises motor control and body awareness can help retrain proprioceptive pathways, reducing the risk of falls and enhancing functional mobility.

  • Psychological Benefits: Resistance training fosters a sense of empowerment and accomplishment, helping to combat the mental health challenges that often accompany chronic pain and physical limitations.

By breaking the cycle of deconditioning and providing a structured pathway to improved physical and mental health, strength training offers a lifeline to individuals with hEDS. When guided by an experienced coach and adapted to the individual’s specific needs and capabilities, it has the potential to transform not only physical performance but also overall quality of life.


The Role of Strength Training in EDS Management

Research increasingly highlights the benefits of resistance training for individuals with connective tissue disorders such as Ehlers-Danlos Syndrome (EDS). These benefits extend far beyond physical improvements, encompassing psychological, metabolic, and functional gains that contribute to a better quality of life. Strengthening the muscles surrounding hypermobile joints is a cornerstone of effective management, as it enhances joint stability, reduces pain, and improves functional performance (Engelbert et al., 2017; Scheper et al., 2016). For individuals with EDS, who often contend with chronic pain, fatigue, and joint instability, resistance training offers a tailored solution to address these challenges while building resilience and confidence.

While traditional exercise approaches, such as aerobic conditioning or generalized physical therapy protocols, are often recommended, they can be overly simplistic or even counterproductive for individuals with EDS. Such approaches may fail to adequately address the unique biomechanical and neuromuscular needs of those with connective tissue disorders. Resistance training, however, provides a structured and adaptable method that targets these specific needs. By focusing on muscle strengthening and motor control, it offers a more comprehensive pathway to managing the symptoms of EDS and improving overall functional capacity.

Hypermobile joints are inherently unstable due to a lack of passive support from ligaments and connective tissues, which are compromised by the altered collagen composition characteristic of EDS. This instability places an increased demand on the surrounding musculature to compensate for the lack of structural integrity. As a result, the stabilising muscles—such as the deep core, glutes, and rotator cuff—play a critical role in maintaining joint alignment and reducing the risk of injury. Resistance training programmes tailored for EDS focus on activating and strengthening these stabilisers, enhancing proprioception, and improving joint mechanics. Over time, this leads to a reduction in pain, improved movement quality, and greater confidence in performing daily activities.

A narrative review by Zabriskie et al. (2022) underscores the importance of customised resistance training programmes for individuals with hypermobile EDS (hEDS), highlighting the need for gradual progression, individualised exercise selection, and an emphasis on motor control. Gradual progression is particularly critical, as connective tissues in individuals with EDS adapt more slowly to mechanical loading compared to those without the condition. This means that training intensity must be increased at a pace that allows the body to adapt without exacerbating symptoms or causing injuries.

Individualised exercise selection is another key component, as no two individuals with EDS present the same symptoms or functional limitations. Tailored programmes that incorporate isometric, eccentric, and low-impact exercises can help address specific weaknesses and accommodate joint instability while promoting strength and endurance. For example, exercises such as glute bridges, cable rows, and banded side steps can effectively target stabilising muscle groups without placing excessive strain on vulnerable joints.

The emphasis on motor control is equally important. Many individuals with EDS experience proprioceptive deficits, which can impair their ability to maintain proper joint alignment during movement. Resistance training that prioritises controlled, deliberate movements helps retrain the neuromuscular system, improving proprioception and reducing the risk of injury. Incorporating tempo work, pauses, and balance challenges into training can further enhance these outcomes.

By addressing these biomechanical and neuromuscular factors, resistance training becomes more than just a means of improving strength; it serves as a holistic intervention that enhances physical performance, reduces pain, and fosters a sense of empowerment for individuals with EDS. With appropriate guidance and individualisation, it provides a sustainable, long-term solution to managing the complexities of this condition.


Key Principles of Strength Training for EDS


  1. Individualisation - Each individual’s presentation of EDS varies significantly, from the severity of joint hypermobility to the presence of associated conditions such as chronic pain, fatigue, or autonomic dysfunction (Castori et al., 2013). As a result, no single programme is universally applicable. Individualisation involves assessing an athlete’s specific strengths, weaknesses, and symptoms to create a plan that maximises benefits while minimising risks. For example, someone with significant joint instability may benefit from isometric exercises before progressing to dynamic movements.

  2. Controlled Progression - Gradual overload is essential in resistance training for individuals with EDS. Unlike athletes without connective tissue disorders, whose tissues can generally adapt to increasing stress more readily, those with EDS are more susceptible to injury due to the fragility of their collagenous tissues (Engelbert et al., 2017). Progressing too quickly can result in overuse injuries, exacerbation of symptoms, or even dislocations. Controlled progression ensures tissues adapt at a pace that aligns with their individual capacity for recovery and adaptation.

  3. Exercise Variation - Minimising repetitive stress on joints is another critical principle for managing EDS. Repetitive movements, particularly under load, can lead to cumulative strain on hypermobile joints, increasing the likelihood of subluxations or ligamentous damage. Incorporating a variety of exercises that target the same muscle groups in different ways can distribute stress more evenly across the joints and tissues, reducing the risk of overuse injuries (Scheper et al., 2016). For example, a focus on single-leg work, different planes of motion, and variations in resistance can ensure comprehensive yet joint-friendly strength development.

  4. Motor Control Focus - Reinforcing proper movement patterns is fundamental to improving proprioception and joint stability. Individuals with EDS often have impaired proprioception, making them more vulnerable to poor movement mechanics and injuries (Tinkle et al., 2017). Exercises that emphasise controlled movement, proper alignment, and a full range of motion can help reprogram neuromuscular pathways and improve overall coordination. This might include slow, tempo-focused lifts or movements incorporating balance and stability elements.

  5. Low-Impact Approach - Resistance training for EDS should be designed to minimise high-impact activities that place excessive stress on joints. Instead, low-impact exercises such as resistance band work, machine-based exercises, and water-based resistance training can provide effective stimuli without the added risk of exacerbating symptoms. These approaches also allow individuals to maintain a high training volume without compromising joint integrity.

  6. Focus on Core Stability - A strong and stable core is particularly important for individuals with EDS, as it plays a critical role in protecting the spine and providing a stable base for limb movements. Incorporating exercises that strengthen the deep core musculature, such as planks, anti-rotation movements, and controlled leg raises, can help mitigate back pain and improve functional performance (Rombaut et al., 2011).

  7. Psychological Benefits - Resistance training offers not only physical benefits but also psychological advantages for individuals with EDS. Many experience anxiety or depression due to chronic pain and mobility limitations, and resistance training can improve self-confidence, foster a sense of achievement, and reduce stress through the release of endorphins (Tinkle et al., 2017). This holistic approach to health is essential for long-term adherence and well-being.

These principles align closely with the tenets of the Conjugate Method, which emphasises individualisation, exercise variation, and gradual progression. By adhering to these guidelines, resistance training can become a cornerstone of effective EDS management, offering a sustainable and empowering pathway to improved health and functionality.

The Conjugate Method: An Overview

The Conjugate Method, popularised by Louie Simmons and Westside Barbell, is a system designed to develop multiple strength qualities simultaneously. Unlike linear periodisation, which focuses on a single quality for an extended period, the Conjugate Method rotates exercises and training stimuli weekly (Simmons, 2007). This approach includes:

  • Maximal Effort (ME) Training: Heavy, low-rep work to build absolute strength.

  • Dynamic Effort (DE) Training: Lighter, fast-paced work to develop explosive power.

  • Repetition Effort (RE) Training: Higher-rep accessory work to build muscle and address weaknesses.

  • Exercise Rotation: Frequent variation in main and supplemental lifts to reduce overuse and target different muscle groups (Simmons, 2007).

This variability is particularly beneficial for individuals with EDS, as it minimises repetitive stress on hypermobile joints and allows for training adaptations without exacerbating joint instability or pain. This is a very vague overview and much can be found here: THE CONJUGATE METHOD FOR DUMMIES

Applying the Conjugate Method to EDS Management

1. Maximal Effort Work for Joint Stability - 

Maximal effort training builds absolute strength, which is essential for stabilising hypermobile joints. For individuals with EDS, this means carefully selecting exercises that challenge the musculature around vulnerable joints without placing undue stress on connective tissues. Examples include:

  • Box squats with accommodating resistance (bands or chains)

  • Trap bar deadlifts to reduce lumbar strain

  • Safety bar squats to minimise shoulder stress (Simmons, 2007)

These variations allow individuals to safely work near maximal loads while reinforcing proper movement patterns. Research supports that resistance training improves joint stability and reduces pain in hypermobile individuals (Barton & Bird, 1996; Kerr et al., 2000).

2. Dynamic Effort Work for Neuromuscular Control - 

Dynamic effort training focuses on bar speed and explosive power, improving neuromuscular coordination. For individuals with EDS, this can enhance proprioception and reaction time, reducing the risk of injury. Bands and chains are particularly useful here, as they provide accommodating resistance that challenges stability throughout the range of motion (Simmons, 2007).

Exercises might include:

  • Speed bench press with bands

  • Banded box squats

  • Dynamic effort deadlifts with chains

However these can be daunting to a new trainee so there are many regressions available that an individual can start with. 

3. Repetition Effort Work for Muscle Hypertrophy - 

Building muscle mass around hypermobile joints is crucial for providing additional stability. The repetition effort method allows for targeted hypertrophy while keeping joint stress low. Accessories should be chosen based on individual weaknesses and vulnerabilities, such as:

  • Suitable regressions of Bulgarian split squats for single-leg stability

  • Reverse hypers for spinal support

  • Band pull-aparts for shoulder stability (Engelbert et al., 2017)

4. Exercise Rotation to Prevent Overuse - 

The frequent rotation of main and supplemental lifts is a cornerstone of the Conjugate Method. For individuals with EDS, this variability prevents the repetitive stress that can exacerbate joint pain and instability. Rotating specialty bars, such as the safety squat bar or the cambered bar, further reduces strain on vulnerable joints while maintaining training efficacy (Simmons, 2007).


Addressing Coexisting Conditions: Lipoedema and Neurodivergence


Lipoedema - 

Lipoedema, a chronic condition characterised by the abnormal accumulation of subcutaneous fat tissue, typically in the lower body, often coexists with Ehlers-Danlos Syndrome (EDS) and is more prevalent among individuals who are neurodivergent (Forner-Cordero et al., 2018). This condition can cause pain, heaviness, and mobility challenges, significantly impacting the quality of life. Resistance training has emerged as a particularly beneficial intervention for managing lipoedema due to its multifaceted impact on the lymphatic system, body composition, and overall functional capacity.

One of the key benefits of resistance training for individuals with lipoedema is its ability to improve lymphatic flow and circulation. Lipoedema is often accompanied by lymphatic dysfunction, leading to swelling and discomfort. The repetitive muscle contractions involved in strength exercises act as a mechanical pump, stimulating lymphatic drainage and reducing fluid retention in the affected areas. This process can alleviate the characteristic heaviness and swelling associated with lipoedema, enhancing overall comfort and mobility.

Additionally, strength training can reduce pain and improve physical function. Studies have highlighted that regular resistance exercise can lower inflammatory markers, which are often elevated in individuals with lipoedema. By promoting muscular strength and endurance, resistance training also helps stabilise the joints and improve movement mechanics, reducing the risk of pain and injury. This is especially important for individuals with EDS, who frequently experience joint hypermobility and instability alongside lipoedema.

Another significant advantage of resistance training is its role in enhancing metabolic health and supporting fat metabolism. While the fat deposits characteristic of lipoedema are resistant to diet and traditional weight-loss methods, increased muscle mass through resistance training can enhance metabolic activity, improving energy expenditure at rest. Moreover, strength training can aid in reshaping the body and improving functional mobility, making daily activities easier and less painful.

The psychological benefits of resistance training should not be overlooked. Lipoedema often carries a significant psychosocial burden due to its aesthetic and functional impacts. Engaging in a structured exercise programme can foster a sense of control, improve self-confidence, and combat the mental health challenges that frequently accompany lipoedema, such as anxiety and depression.

Resistance training’s low-impact nature makes it particularly well-suited for individuals managing both lipoedema and EDS. When properly programmed, it minimises stress on vulnerable joints while still providing the necessary stimulus for muscle growth and lymphatic activation. Exercises such as bodyweight movements, resistance band work, and machine-based training can be tailored to accommodate individual abilities, ensuring accessibility and long-term adherence.

By addressing the physical, metabolic, and psychological challenges of lipoedema, resistance training offers a holistic and effective approach to improving quality of life for those living with this condition. With appropriate guidance and modifications, it can empower individuals to take control of their health, reducing the impact of lipoedema on daily life.


Neurodivergence - 

Many individuals with Ehlers-Danlos Syndrome (EDS) also experience neurodivergence (or whatever way you prefer to articulate that phrase like don’t @ me), such as Attention Deficit Hyperactivity Disorder (ADHD) or autism. These neurodevelopmental conditions can significantly influence motivation, focus, and adherence to training programmes, often necessitating a tailored approach to ensure long-term consistency and success. For example, individuals with ADHD may struggle with the monotony of repetitive training cycles or the sustained focus required by traditional linear periodisation models. Similarly, autistic athletes may find comfort in structure and predictability but also benefit from a degree of variability to prevent overstimulation or frustration when encountering plateaus.

The Conjugate Method offers a unique advantage in this context due to its structured yet flexible nature. The method’s frequent rotation of exercises, which involves max effort and dynamic effort variations across different movement patterns, helps prevent boredom while maintaining a high level of engagement. Short, intense sessions align well with the attentional capacities of neurodivergent athletes, particularly those who thrive on high-energy activities with clear, concise objectives. This variability not only enhances focus but also allows for creative problem-solving in addressing individual weaknesses, which can be particularly beneficial for athletes managing both EDS and neurodivergent traits.

Research suggests that neurodivergent individuals often excel when their environment accommodates their specific needs, promoting a sense of agency and control over their training process (Hurst et al., 2017). The Conjugate Method’s emphasis on individualisation—through exercise selection, accommodating volume adjustments, and regular performance feedback—can help create an athlete-centred programme that reduces anxiety and fosters intrinsic motivation. For example, an athlete with autism might benefit from pre-planned but varied training cycles, while an athlete with ADHD might thrive when given autonomy to choose accessory work from a curated list.

Another critical consideration is the impact of sensory processing differences common in neurodivergent populations. These differences may influence an athlete’s tolerance for environmental stimuli, such as the noise and activity levels in a busy gym. The Conjugate Method can accommodate these needs by enabling home training setups with specialty bars, accommodating resistance bands, or chains to mimic dynamic effort and max effort work seen in larger facilities. This adaptability empowers athletes to train in environments where they feel most comfortable and focused.

Ultimately, the Conjugate Method is uniquely suited to address the multifaceted challenges faced by individuals managing both EDS and neurodivergence. Its balance of structure and flexibility offers a practical framework for improving strength while fostering an engaging, supportive training environment tailored to the athlete’s needs. By integrating neurodivergence-friendly principles with the method’s established efficacy, it is possible to optimise both performance and quality of life.





Practical Considerations for EDS Powerlifting 

When implementing a powerlifting programme for individuals with Ehlers-Danlos Syndrome (EDS), several considerations are paramount to ensure safety, progress, and long-term adherence. Due to the unique challenges presented by EDS, it is essential to approach training with a focus on individualisation, gradual progression, and proactive management of symptoms. Below are key guidelines to consider:

  1. Collaborate with Medical Professionals - Consultation with physiotherapists, doctors, or other healthcare professionals familiar with EDS is crucial. These experts can provide valuable insights into an individual’s specific needs, limitations, and comorbidities, such as autonomic dysfunction or chronic pain syndromes. A collaborative approach ensures that the programme aligns with the trainee’s medical care plan and minimises the risk of exacerbating symptoms.

  2. Start Conservatively - 

Powerlifting programmes for individuals with EDS should begin with lighter loads, prioritising movement quality and technique over intensity. This allows the individual to develop neuromuscular control, improve proprioception, and build confidence in their movements. Starting conservatively also reduces the likelihood of injuries, which can occur more easily due to joint instability and tissue fragility (Engelbert et al., 2017). Gradual progression, rather than abrupt increases in intensity or volume, is essential.

  1. Monitor Symptoms Closely - 

Individuals with EDS must pay close attention to their body’s signals, including pain, fatigue, and joint stability. Pain that persists or worsens during or after training may indicate that adjustments are necessary, such as reducing intensity, modifying exercise selection, or incorporating additional recovery time. Keeping a training journal to track symptoms alongside workout details can provide valuable data for adjusting the programme.

  1. Prioritise Recovery - 

Recovery is paramount for individuals with EDS, as their connective tissues take longer to repair and adapt to physical stress. This includes incorporating adequate rest days, quality sleep, and connective tissue-supportive nutrition, such as ensuring sufficient intake of protein, vitamin C, and collagen precursors (Scheper et al., 2016). Mobility work, such as gentle stretches and foam rolling, can also help reduce muscle tension and improve circulation, aiding recovery.

  1. Use Specialty Equipment - 

Specialty equipment can make powerlifting safer and more effective for individuals with EDS. Tools like safety squat bars, reverse hypers, and resistance bands can reduce strain on vulnerable areas, provide additional stability, and allow for controlled progression. For example, a safety squat bar shifts the centre of gravity, minimising shoulder strain and promoting a more upright posture, while bands can add accommodating resistance that matches the lifter’s strength curve.

  1. Embrace Flexibility in Programming - 

Individuals with EDS should feel empowered to modify traditional powerlifting programmes to meet their specific needs. They need not feel confined to rigid linear periodisation models or formal training schedules. Additional rest days, the inclusion of rehab or prehab exercises, and adjustments for symptoms on any given day are not only acceptable but often necessary. This flexible approach allows the trainee to prioritise their health and recovery while still making meaningful progress (Zabriskie et al., 2022). The emphasis should be on consistency over perfection, with adaptability as a guiding principle.

  1. Focus on Joint-Friendly Exercises - 

Exercise selection should prioritise joint-friendly movements that minimise the risk of strain or hyperextension. Isometric holds, unilateral exercises, and machine-based movements are particularly useful for individuals with EDS, as they provide stability and control while targeting specific muscle groups. For example, single-leg presses or isometric wall sits can strengthen the lower body without placing undue stress on the knees or hips.This can also mean only working initially in ranges of movement that are comfortable.

  1. Incorporate Motor Control and Proprioception Training - 

Motor control and proprioception training are critical components of a powerlifting programme for individuals with EDS. Exercises that emphasise slow, controlled movements, pauses, and balance challenges can improve joint stability and body awareness. For example, tempo squats or deadlifts with a focus on maintaining proper alignment throughout the lift can help retrain neuromuscular pathways and reduce the risk of injury (Tinkle et al., 2017).

  1. Encourage Regular Reassessments and Adjustments - 

EDS symptoms can fluctuate, and the demands of a powerlifting programme may need to be adjusted over time. Regular reassessments of strength, mobility, and symptom patterns are essential to ensure that the programme remains safe and effective. Periodic collaboration with medical and coaching professionals can help refine the approach and identify new strategies for managing symptoms or addressing emerging challenges.

By implementing these principles, powerlifting can be a transformative tool for individuals with EDS, promoting physical strength, joint stability, and overall well-being. Thoughtful programming that prioritises safety, individualisation, and flexibility empowers individuals to achieve meaningful progress while respecting their body’s unique needs.


Conclusion

A sensible powerlifting approach, underpinned by the principles of the Conjugate Method, offers a powerful framework for managing and improving facets of Ehlers-Danlos Syndrome. By emphasising exercise variation, gradual progression, and neuromuscular control, this method addresses the unique challenges posed by hypermobility, chronic pain, and joint instability.

Furthermore, the adaptability of the Conjugate Method makes it well-suited for addressing coexisting conditions like lipoedema and neurodivergence, providing a holistic and individualised pathway to strength and resilience. However, it is important to note that this article is intended as an overview based on professional opinion and experience, not as medical advice. I am not a medical doctor, and individuals should consult with healthcare professionals before embarking on any new training programme. Start slowly, prioritise safety, and approach training with patience and caution. With proper guidance and a commitment to personalised programming, powerlifting can empower individuals with EDS to achieve improved stability, strength, and quality of life.

By implementing these principles, powerlifting can be a transformative tool for individuals with EDS, promoting physical strength, joint stability, and overall well-being. Thoughtful programming that prioritises safety, individualisation, and flexibility empowers individuals to achieve meaningful progress while respecting their body’s unique needs.

If you’re interested in learning more, stay connected for future instalments, where we’ll delve deeper into specific aspects of training for EDS. We invite readers to reflect on these initial considerations and explore how strength training can be thoughtfully adapted to enhance quality of life for those with connective tissue disorders. For personalised guidance, I also offer online coaching tailored to the needs of strength athletes, including those managing EDS.








References

Barton, P. M., & Bird, H. A. (1996). Improving pain and joint stability in patients with joint hypermobility syndrome. Rheumatology, 35(10), 986–989.

Castori, M., et al. (2012). Joint hypermobility syndrome and Ehlers-Danlos syndrome hypermobility type: The need for a correct diagnosis. Rheumatology International, 32(5), 1299–1306.

Castori, M., et al. (2013). Clinical and molecular insights into Ehlers-Danlos syndrome and joint hypermobility syndrome: Two sides of the same coin. Clinical Genetics, 84(3), 210–220.

Engelbert, R. H. H., et al. (2017). The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers-Danlos syndrome. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 168–178.

Forner-Cordero, I., Szolnoky, G., Forner-Cordero, A., & Kemeny, L. (2018). Lipedema: An overview of its clinical manifestations, diagnosis, and treatment. Clinical, Cosmetic and Investigational Dermatology, 11, 663–671.

Fonder, M. A., et al. (2007). Lipedema: A frequently misdiagnosed and misunderstood fatty deposition syndrome. Advances in Skin & Wound Care, 20(6), 304–312.

Hurst, D., et al. (2017). Physical activity engagement and barriers for individuals with neurodevelopmental disorders: A narrative review. Journal of Autism and Developmental Disorders, 47(3), 2595–2604.

Kerr, A., et al. (2000). A study of the management of joint hypermobility syndrome in children. Rheumatology, 39(7), 741–743.

Mast, K., et al. (2009). An updated nosology for the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 139(4), 231–236.

Scheper, M. C., et al. (2016). Neuromuscular proprioceptive deficits in children with generalized hypermobility: A systematic review. Journal of Pediatrics, 169, 289–294.

Simmons, L. (2007). Westside Barbell Book of Methods. Westside Barbell.

Tinkle, B., et al. (2017). Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 48–69.

Zabriskie, et al. (2022). The value of tailored resistance training for individuals with hypermobility disorders. Journal of Rehabilitation and Strength Training. (In press).



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