Better Mobility Lab
**Updated Referral Information**
Unfortunately due to wait times exceeding 3 years and lack of physician and allied health personnel support, we are no longer accepting referrals for Hypermobility Spectrum Disorders or hypermobile subtype Ehlers-Danlos Syndrome. We know this is very disappointing for patients and physicians, but more support in the clinic is necessary at this time. This will hopefully be temporary, until we are able to establish a multidisciplinary care team in this clinic. This decision was not made lightly. Thank you for your understanding and patience.
If you would like to participate in any research studies on Hypermobility Spectrum Disorders or hypermobile subtype Ehlers-Danlos Syndrome, please click here.
If you would like to help fund a multidisciplinary clinic for these conditions, please click here.
What is the Connective Tissue Disorders Rehabilitation Clinic?
The Connective Tissue Disorders Rehabilitation Clinic at Foothills Medical Centre was developed to focus on assessment and management of the musculoskeletal consequences of conditions such as the Hypermobility Spectrum Disorders, the Ehlers-Danlos Syndromes, Marfan Syndrome, Loewy-Dietz Syndrome, Down Syndrome, Stickler Syndrome, and Familial Thoracic Aneurysm and Dissection syndromes, amongst others. Clinical and research trainees are active parts of this clinic to advance patient care and awareness of these conditions and their impacts.
The Grand Visions are:
- to develop a multidisciplinary patient-informed centre for the assessment and management of inherited connective tissue disorders in Southern Alberta,
- to build the research evidence for rehabilitating conditions that cause loose large and small joints, and
- to educate clinicians from a variety of disciplines about the nuances of caring for patients with a variety of inherited connective tissue disorders
In order to do this, we need your support. Please click here or contact us if you are able to help with volunteer or financial support.
What Happens in the Clinic?
Dr. Manocha is a physiatrist (specialist doctor in Physical Medicine & Rehabilitation). Dr. Manocha’s role is to assist in the physical rehabilitation of the musculoskeletal (bone and joint) consequences of connective tissue disorders, particularly with regards to exercises, bracing, adaptive equipment, preparing for and recovering from surgery, preparing for pregnancy and the postpartum period, adapting hobbies/work/family life, and educating your other healthcare providers.
For more information on what a physiatrist is, please click here.
Resources for Patients, Doctors, and Researchers: Hypermobility Spectrum & Ehlers-Danlos Syndromes
The following educational websites are provided for general guidance. We do not take responsible for site content. Site content does not constitute medical advice. Please speak to your own healthcare providers for further guidance. To suggest a resource, please email bettermobilitylab@ucalgary.ca.
- Our Hope for Hypermobility Conferences
- These are hybrid (in-person in Calgary and available virtually) conferences run every year to help patients and local clinicians learn more about research and care for people with Hypermobility Spectrum Disorders and hypermobile Ehlers-Danlos Syndrome
- Foundations & Societies:
- EDS Society
- https://www.ehlers-danlos.com/
- Consider downloading this wallet card: Download Your Wallet Card - The Ehlers Danlos Society
- Hypermobility Syndromes Association
- The ILC Foundation
- Ehlers Danlos Society UK
- EDS Society
- Peer Support (for patients):
- Ehlers Danlos Syndrome Canada
- EDS & Patient Engagement in Canadian Research (EDS Canada)
- The Ehlers-Danlos Syndrome Society
- Loose Connections Magazine
- Dysautonomia Support Network
- Books (for patients):
- Bending Without Breaking - Isobel Knight
- Disjointed: Navigating the Diagnosis and Management of Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders - Paldeep Atwal, Myles Koby, Jill Schofield
- Joint Hypermobility Handbook: A Guide for the Issues & Management of Ehlers-Danlos Syndrome Hypermobility Type and the Hypermobility Syndrome - Brad T. Tinkle
- Life Hacks (For Patients):
- Videos by Emily Rich (Arizona Occupational Therapist)
- For Healthcare Providers/Researchers
- To learn more: EDS ECHO Healthcare Professionals - The Ehlers Danlos Society
- Overviews of Classifications and Clinical Presentations:
- Hypermobility Spectrum Disorders & Hypermobile Ehlers-Danlos Syndrome:
- Castori M et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):148-157.
- Castori M et al. Natural history and manifestations of the hypermobility type Ehlers-Danlos syndrome: a pilot study on 21 patients. Am J Med Genet A. 2010 Mar;152A(3):556-64.
- How to diagnose hEDS
- Classical EDS:
- Vascular EDS (vEDS)
- Hypermobility Spectrum Disorders/Hypermobile EDS:
- Physical Activity, Exercise, Physical Therapy:
- For Patients:
- Jeannie di Bon (United Kingdom Physiotherapist - Pilates Videos)
- Libby Hensley (North Carolina Physiotherapist - Yoga Videos)
- Intelligent Exercise - How you can take control with EDS - The Ehlers Danlos Society
- For Researchers/Clinicians:
- Brittain et al. (2024) Physical therapy interventions in generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome: a scoping review. Disability and Rehabilitation, 46:10, 1936-1953.
- Buryk-Iggers S et al. Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl. 2022 Mar 4;4(2):100189. doi: 10.1016/j.arrct.2022.100189.
- Smith TO et al. (2013). Physiotherapy and occupational therapy interventions for people with benign joint hypermobility syndrome: a systematic review of clinical trials. Disability and Rehabilitation, 36(10), 797–803.
- Zabriskie HA. Rationale and Feasibility of Resistance Training in hEDS/HSD: A Narrative Review. J Funct Morphol Kinesiol. 2022 Aug 20;7(3):61. doi: 10.3390/jfmk7030061.
- For Patients:
- Pain Management:
- Castori et al. (2011) Management of pain and fatigue in the joint hypermobility syndrome (aka Ehlers-Danlos Syndrome, Hypermobility Type): Principles and proposal for a multidisciplinary approach. Am J Med Genet Part A 158A:2055-2070.
- Jeong H-J et al. (2023) Pain Characteristics and Symptom Management in Children with Hypermobile Ehlers–Danlos Syndrome and Hypermobility Spectrum Disorder. Phys Occ Ther Ped 43(5):630-643.
- Sleep
- Gaisl T, Giunta C, Bratton DJ, et al. Obstructive sleep apnoea and quality of life in Ehlers-Danlos syndrome: a parallel cohort study. Thorax 2017;72:729-735.
- Sedky K, Gaisl T, Bennett DS. Prevalence of obstructive sleep apnea in joint hypermobility syndrome: a systematic review and meta-analysis. J Clin Sleep Med. 2019;15(2):293–299.
- Physical Activity, Exercise, Physical Therapy:
- Diet & Hypermobility Spectrum Disorders/all types of Ehlers-Danlos Syndrome
- Mast Cell Dysfunction
- For Patients:
- The Mastocytosis Society of Canada
- For Healthcare Providers/Researchers:
- For Patients:
- Respiratory Complications
- Bascom R et al. Respiratory manifestations in the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2021 Dec;187(4):533-548.
- Chohan K, Mittal N, McGillis L, et al. A review of respiratory manifestations and their management in Ehlers-Danlos syndromes and hypermobility spectrum disorders. Chronic Respiratory Disease. 2021;18.
- Speech, Ear, Nose, and Throat Issuess:
Local Healthcare Providers (HSD/hEDS)
These individuals have been recommended by other patients, but have not been personally vetted by Dr. Manocha.
- Kinesiologists:
- Kalindra Walls
- Massage Therapists:
- Christa Powers, Health Tree Wellness Centre
- Physical Therapists:
- Mercedes Eustergerling, Vida Health and Wellness
- Shilpa Kumar, Naturally Balanced
- Christine MacSween, Vida Health and Wellness
- Rebecca Margel, Fix Physio
- Prolotherapy:
- Dr. Martin Breton, Infini Health
- Eric Lavoie, Nurse Practitioner, Evidence Sport and Spinal Therapy
- You may wish to also look at this link, for healthcare providers who self-declare expertise in working with hypermobile individuals: Healthcare Professional Directory Archive - The Ehlers Danlos Society
Resources for Patients, Doctors, and Researchers: Other Conditions
Marfan, Loeys-Dietz, Familial Aortic Aneurysm, and Stickler Syndromes
The following educational websites are provided for general guidance. We do not take responsible for site content. Site content does not constitute medical advice. Please speak to your own healthcare providers for further guidance. To suggest a resource, please email bettermobilitylab@ucalgary.ca.
- General:
- Marfan Syndrome
- The Marfan Foundation
- For Healthcare Providers & Researchers:
- Diagnosis, Presentation, Management:
- How to diagnose Marfan Syndrome
- Bitterman AD et al. Marfan Syndrome: A Clinical Update. J Am Acad Orthop Surg. 2017 Sep;25(9):603-609.
- Dean JC. Marfan syndrome: clinical diagnosis and management. Eur J Hum Genet. 2007 Jul;15(7):724-33.
- Verstraeten A et al. Marfan Syndrome and Related Disorders: 25 Years of Gene Discovery. Hum Mutat. 2016 Jun;37(6):524-31.
- Cardiovascular complications:
- Bone Health:
- Diagnosis, Presentation, Management:
- Loeys-Dietz Syndromes
- Loeys-Dietz Syndrome Foundation Canada
- For Healthcare Providers:
- General:
- MacCarrick G et al. Loeys-Dietz syndrome: a primer for diagnosis and management. Genet Med. 2014 Aug;16(8):576-87.
- Williams JA et al. Early surgical experience with Loeys-Dietz: a new syndrome of aggressive thoracic aortic aneurysm disease. Ann Thorac Surg. 2007 Feb;83(2):S757-63; discussion S785-90.
- Bone Health:
- General:
General Patient Resources
- Getting stuck in the negatives (and how to get unstuck) - Alison Ledgerwood
- How to have effective doctor appointments - Shani Weber
- Free Classes Through Alberta Healthy Living:
- Better Choices, Better Health – Chronic Pain
- Conserving your Energy
- Eating Well and Managing Irritable Bowel Syndrome
- Living Well with Stress
- Moving Matters to Your Health
- Pacing for people with chronic pain
- Try a little self-kindness – motivating with self-compassion
- Waking up to healthy sleep
- Supervised Exercise Program (requires referral from MD)
- Nutrition Program (requires referral from MD)
- Make sure your walking aids are fit properly and that you are using them correctly
- Adaptive devices
- Proprioceptive devices
- BodyBraid for body proprioception
- GiveMohr sling for shoulder stability
- Solidea are compression garments recommended by many patients. They are available at KenronPharmacy or through Canadian Orthopedic Supply.