​What is EDS?
Ehlers-Danlos Syndrome (EDS) is a group of 13 inherited connective tissue disorders that affects the connective tissue in the body (Ehlers-Danlos, 2024). Connective tissues are important to provide strength, elasticity, support, and protection in our body’s skin, joints, blood vessels, and other organs. Each type of EDS presents with its own diagnostic criteria, but common characteristics include joint hypermobility, skin hyperextensibility, and tissue fragility. Consequently, people with EDS often present with hypermobility, skin that bruises, tears or scars easily, chronic pain, fatigue, and issues with their blood vessels and organ functioning. It is difficult to know how many people have EDS, but estimates suggest that it affects 1 in 5000 to 1 in 20,000 people worldwide. Hypermobile EDS is the most common type and accounts for approximately 90% of EDS cases.
Pain is unfortunately common with EDS from the overload of musculoskeletal structures and abnormal movement patterns due to joint instability. Central sensitisation can occur too resulting in people with EDS being hypersensitive to painful stimuli (Ehlers-Danlos Society 2022). Fatigue is also extremely common and can be due to a dysregulation of the autonomic nervous system, for example low blood pressure with a fast heart rate, and gastrointestinal problems. This can all lead to a decreased exercise tolerance and difficulty performing daily tasks. Psychological symptoms such as depression, and anxiety are also common co-morbidities (Ehlers-Danlos Society 2022). 

​Osteoarthritis is an inflammatory process that occurs within the body which usually results in the pain, swelling and stiffness in a joint.
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It is one of the most common joint problems with 595 million people being affected by it as of 2020.[1] Within Australia, 1 in 5 over the age of 45 have osteoarthritis.[2] Those with this condition may talk about pain that is gradual in onset and worsens with activity, feels stiff (reduced range of motion), increased swelling, and pain after prolonged sitting or resting.
 
Research shows many factors can contribute to Osteoarthritis including injury to the joint, pre-existing joint diseases, obesity, thoughts and even gut health.
 
The latest research demonstrates a new approach can bring hope that pain can be reduced, function can be improved, and the progression of Osteoarthritis be slowed down by specific rehabilitation and input. It is estimated that approximately 344 million are experiencing severity levels of moderate or severe levels of Osteoarthritis who could benefit from this type of specific rehabilitation.[3] This could be to avoid or delay joint surgery or pre-habilitation prior to joint replacement surgery being considered or undertaken.

​There are 3 inter-related areas that have been described in 'The Knee Osteoarthritis Handbook' by Mosely, Butler & Stanton (2023), as being key to assisting in the management of this condition including:

• Increasing physical activity - build strength and mobility in the affected area to be able to feel stronger and fitter, reduce inflammation and lose weight
• Decreasing inflammation within the body - improve capacity for movement, improve the healthiness of your joints and body
• Increasing knowledge within the area (if you’ve read up to this point, you’re already starting this process!) - enhance your capacity to problem-solve and plan for the ways to achieve you functional goals and aspirations, as well as reduce your body’s stress and inflammatory response.

​Whether you're a sufferer or a carer of someone with severe chronic fatigue syndrome (ME/CFS), long COVID or another debilitating chronic illness, you know how it robs quality of life. 😞
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With 25% of chronic fatigue syndrome sufferers being so sick they are housebound or bed ridden, it means that many people are limited in their ability to implement self-care strategies that others may take for granted. Things such as going for a walk or having coffee with a friend. To complicate things further, symptoms such as light sensitivity, noise sensitivity, food intolerances, brain fog, pain and mobility issues can make it hard to engage in some activities.
 
DON’T DESPISE THE SMALL THINGS
Finding small things you can do to bring some joy and calm into your day is essential. Think of these activities as tiny top ups to fill your cup.
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Below are some ideas that can really help people get through a day. Obviously, everyone is different and depending on your symptoms and severity some of these may even seem like too much. It’s important to give things a go (perhaps with the help of a carer) and find what works for you. 💙

​Pacing is the term given to the strategy of managing fatigue and other symptoms in chronic conditions including post-viral fatigue, Long Covid, fibromyalgia, chronic fatigue syndrome (ME/CFS) and many others.
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What this looks like can be slightly different for everyone, but it essentially means being strategic about how you coordinate your life scheduling rest around activities and listening to your body, stopping before your body reaches tipping point. This requires understanding your baseline (which can unfortunately fluctuate), recognising your triggers and structuring your day, week and even month accordingly.

The idea with pacing is to be one step ahead of your body to avoid flares and reduce the severity of post-exertional malaise otherwise known as PEM. PEM is a delayed exacerbation of symptoms (especially fatigue) that occurs in response to mental or physical exertion. For example, having to go out to a doctor’s appointment and doing a load of washing in one day could lead to a significant worsening of symptoms in the days following before returning to baseline. Some of you will know this pattern all too well! 

So, how can you get the most out of pacing?
Here are my 3 top tips for effective pacing.

​While we would love for the government to invest more in Australian’s musculoskeletal health, currently the only way to see a Physiotherapist using Medicare is if your GP has referred you under a Chronic Disease Management Plan – formally and still commonly called an Enhanced Primary Care Plan or EPC for short.
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​What’s an EPC?
An EPC (or Chronic Disease Management Plan) is a plan created by your GP for their patients who suffer from a chronic or terminal medical condition to see other medical providers – such as physiotherapists!

Am I eligible to get an EPC?
A chronic medical condition is one that has been (or is likely to be) present for six months or longer, for example, asthma, cancer, cardiovascular disease, diabetes, musculoskeletal conditions, and stroke. There is no list of eligible conditions, so it is up to the clinical judgement of your GP and the general guidelines set out in the Medicare Benefits Schedule. 

Winter’s here and now more than ever we’re all scrambling to find ways of improving our immunity and warding off the myriad of viruses that are waiting in the wings for a viable host.

​​Using food as medicine is a tool that we all have in our toolkit. We all eat right? So why not make your diet work for you and throw in some foods that have been scientifically demonstrated to reduce the frequency and severity of the winter bugs.
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Here are my top 5 flu flighting foods to add to your diet ASAP….

You may have seen the headlines recently about a new trial giving hope to millions suffering from back pain. This research was assessing to see if there were different outcomes between participants who received ‘Cognitive Functional Therapy’ (CFT) and those who received ‘usual care’.

(if you are interested you can read the abstract of the article on this link https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext)

Low back pain costs the Australian health system 4.8 billion annually (1) with the overuse of medicines, spinal surgery and passive treatments that focus on short term relief.

Historically our treatment options for persistent low back pain haven’t been very good…

Pain medications, bed rest and surgery are now recognised to have a limited role in helping most cases of low back pain. In fact, in some cases, these options can delay recovery and sometimes lead to further loss of capacity.
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However, there is hope and management is getting better…

Dysautonomia is the inability of the autonomic nervous system to regulate itself and is a common feature of Chronic Fatigue Syndrome (MECFS), Postural Orthostatic Tachycardia (POTS), Fibromyalgia and Long COVID.
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The autonomic nervous system consists of the parasympathetic (relaxation) and sympathetic nervous system and controls involuntary actions in the body including heart rate, blood pressure, digestive and bladder function. When the autonomic nervous system is constantly out of balance it can leave people with some debility symptoms which severely impact quality of life.

Chocolate, chocolate, chocolate! Easter is just around the corner and chocolate is everywhere.
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Celebrating and showing affection using chocolates and sugar filled treats has become an important and unavoidable part of our culture. It can be a difficult time for some of us who have health concerns around consuming so much sugary and processed foods. Maintaining moderation can be a huge challenge but there's no need to restrict yourself from this tasty treat altogether (unless you're allergic...please don't eat it!). You can however use the following tips and tricks to help reduce the impact of its many negative side effects!