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Thoracic and Lumbar Spine Presentation in HSD/EDS

presented by Heather Purdin, MSPT, CMPT and Patricia Stott, PT, DPT, ATC, CHT, CYT

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Financial: Heather Purdin receives compensation from MedBridge for the production of this course. She is also a presenter for EDS Society and Providence Health systems and is a coauthor of Taming the Zebra—It’s Much More than Hypermobility: The Definitive Physical Therapy Guide to Managing HSD/EDS.

Financial: Patricia Stott receives compensation from MedBridge for the production of this course. She is also a presenter for EDS Society and Home CEU and is a coauthor of Taming the Zebra—It’s Much More than Hypermobility: The Definitive Physical Therapy Guide to Managing HSD/EDS.

Nonfinancial: Heather Purdin is the president of the Oregon Area Ehlers-Danlos Society (nonprofit). She has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Nonfinancial: Patricia Stott has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 120 Minutes, Learning Assessments: 48 Minutes

The thoracic cavity typically presents as a stable compartment of standard anatomy. However, patients with HSD/EDS may present with pathologies of the thoracic outlet, thoracic spine, ribs, and diaphragm more commonly than seen in the general population. For a patient with HSD/EDS, this area can be frustrating to treat with continued rib subluxations that become difficult to keep in place. Understanding how the different components of the thoracic cavity work together can improve outcomes with interventional strategies. This, combined with knowledge of how the body with HSD/EDS responds, can lead to improved long-term management goals. The lumbar spine can have peculiar neurological findings in HSD/EDS that should be screened for. Instability, subluxation, and guarding are common, and evaluation and treatment will be covered.

Meet Your Instructors

Heather Purdin, MSPT, CMPT

Heather Purdin has been a practicing PT in an outpatient setting for 26 years and has a special interest in chronic pain, fibromyalgia, and connective tissue disorders. She is president of the Oregon Area Ehlers-Danlos Society. She is also president of Good Health Physical Therapy & Wellness, a private practice specializing in connective tissue disorders…

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Patricia Stott, PT, DPT, ATC, CHT, CYT

Patricia Stott treats primarily those with HSD/EDS and those considered highly sensitive patients at her own practice, Elevation Wellness, outside the Denver metro area in Colorado. Also trained in functional and herbal medicine, she works on health and wellness through holistic strategies with these patients, both in person and through telehealth appointments. With an extensive…

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Chapters & Learning Objectives

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1. Thoracic Spine and Rib Manifestations in HSD/EDS

This chapter will cover the more commonly seen pathologies in the thoracic cavity for those with HSD/EDS. A presentation regarding why these conditions are more prevalent will be provided when appropriate.

2. Thoracic Evaluation of a Patient With HSD/EDS

Within this chapter, we will review some basic observations and investigations to cover in the evaluation of someone with HSD/EDS. Some observations can clue in the provider to additional pathologies or issues that need to be addressed.

3. Intervention Strategies for the Thoracic Spine

Therapeutic strategies will be covered within this chapter for the thoracic spine, with an understanding of the altered presentation and response we may see in a patient with HSD/EDS. Soft-tissue and fascial connections within this cavity are crucial to understanding the impact on the spine itself in someone more affected by their connective tissue.

4. Intervention Strategies for the Ribs

Rib subluxations are a common and frustrating complaint for those with HSD/EDS. In this section, we will review rib relocation interventional and support strategies for the patient with hypermobility.

5. Intervention Strategies for the Diaphragm

The diaphragm is an integral functional structure that coordinates with the thoracic, abdominal, and even pelvic cavity. This chapter will review therapeutic strategies and interventions that can support the more common diaphragmatic dysfunction seen in HSD/EDS.

6. Lumbar Spine Pathologies in HSD/EDS

Specific pathologies common in HSD/EDS but rarely found in the general population will be reviewed, including screening and modifications to therapy approaches.

7. Anatomy of the Lumbar Spine With HSD/EDS

This chapter reviews common presentations in the lumbar spine, including tender points and interventions to reduce guarding, common patterns of guarding and instability, and common subluxations.

8. Rehab Strategies With the Lumbar Spine in HSD/EDS

Interventions to address subluxations while engaging stabilizers will be reviewed. Stabilization interventions with examples of beginner, intermediate, and advanced options will be presented, along with reasoning for where to start with a patient.

9. Bracing and Ergonomic Methods With the Lumbar Spine

Options for bracing, posture cueing, and ergonomic aids will be reviewed. Examples of modifications to position and use of external supports will be shared.

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