Specialized Physical Therapy Before and After Spinal Surgery in Ehlers-Danlos Syndrome Patients

Introduction

Specialized physical therapy is a cornerstone of care for patients undergoing spinal surgery, especially those diagnosed with Ehlers-Danlos Syndrome (EDS). The connective tissue fragility inherent to EDS presents unique challenges in surgical preparation and recovery. This article provides an in-depth guide to preoperative and postoperative physiotherapy, emphasizing the specific needs of EDS patients and integrating real clinical protocols and professional experience.

Physical therapist wearing purple scrubs placing hands on the lower back of a seated woman in a white shirt, with exercise balls visible in the background

Why EDS Patients Require Specialized Rehabilitation

 

Ehlers-Danlos Syndrome is characterized by connective tissue abnormalities that lead to joint hypermobility, ligamentous laxity, and musculoskeletal instability. These patients often present with chronic pain, joint dislocations, and spinal instability, making standard rehabilitation approaches inadequate or even counterproductive.

Specialized physiotherapy for EDS patients focuses on:

  • Strengthening stabilizing musculature
  • Avoiding hyperextension and overstretching
  • Promoting proprioception and neuromuscular control
  • Managing chronic pain through neuromodulation techniques
 

Working with a physical therapist who specializes in connective tissue disorders is vital. These professionals understand the unique challenges EDS patients face and can design individualized programs that protect fragile structures while still promoting gradual functional recovery.

 

Preoperative Physiotherapy: Building a Safe Foundation

Before the operation, physical therapy focuses on strengthening the muscles that support and stabilize the spine. This enhanced muscular support improves overall spinal stability, which is especially important in EDS patients due to the inherent weakness and laxity of connective tissues.

By increasing core strength and body awareness, preoperative therapy not only helps to reduce the risk of intraoperative and postoperative complications but also prepares the body for the physical stress of surgery. A well-prepared musculoskeletal system can promote a smoother and more effective recovery process.

A typical preoperative session at our clinic includes:

  • Assessment of postural alignment and muscular imbalances
  • Treatment of muscle contractures or pain
  • Breathing techniques and postural hygiene education
  • Initiation of active stabilization exercises for hypermobile joints (shoulders, hips, etc.)
 

This phase also plays a crucial role in educating patients about what to expect in the postoperative period, and which movements or habits to avoid.

 

Postoperative Physiotherapy: Structured Recovery for Lasting Results

After spinal surgery, physical therapy becomes even more crucial, particularly in individuals with Ehlers-Danlos Syndrome. Because patients with EDS have lax connective tissues and often suffer from joint instability and muscle weakness, they are more vulnerable to postoperative complications such as joint dislocations, excessive scar formation, or mechanical failure around the operated area.

Postoperative physical therapy aims to rebuild muscle strength and endurance, especially in the paraspinal and core muscles, to restore stability not only to the spine but also to surrounding joints. This enhanced stabilization helps to prevent movements that might endanger the surgical repair or contribute to re-injury.

The postoperative phase involves:

  • Anti-inflammatory and pain-relieving techniques
  • Fascia relaxation without mobilizing the operated area
  • Progressive stabilization work on upper and lower limb joints
  • Neuromodulation techniques for pain control
 

Moreover, physical therapy facilitates blood circulation and promotes joint mobility, both of which are essential for reducing inflammation, preventing scar tissue adhesion, and accelerating tissue healing. Exercises are also tailored to improve flexibility and restore the full range of motion in a controlled and safe manner, helping to prevent postoperative stiffness or joint contractures.

 

Online Follow-Up: Continuity of Care Beyond Hospital Walls

Continuing care after discharge is vital to ensure safe and optimal recovery. Our protocol includes eight online physiotherapy sessions with structured frequency:

  • Two sessions during the first two weeks (one per week)
  • Two sessions over the following month (one every 15 days)
  • Three sessions over the next three months (one every 30 days)
 

These sessions allow for:

  • Ongoing evaluation and adaptation of exercises
  • Monitoring of local physiotherapy progress at patient’s residence
  • Timely intervention in case of complications or regressions
 

This follow-up model is essential for international patients returning home after surgery in Barcelona, maintaining professional oversight and support throughout the recovery process.

 

Long-Term Benefits and Quality of Life

Beyond the physical recovery, specialized physical therapy supports the patient’s long-term well-being and quality of life. By reducing neuropathic pain and improving motor control, it can significantly enhance day-to-day function. It also helps prevent secondary complications such as joint subluxations, persistent hypermobility, paresthesia, or chronic muscle tension.

Furthermore, physical therapy has a positive psychological impact. As patients with Ehlers-Danlos begin to regain strength, mobility, and confidence, they often feel more in control of their recovery process. This empowerment can reduce the anxiety commonly associated with chronic pain and complex surgical recoveries. A proactive role in rehabilitation helps promote emotional resilience and fosters a more positive adaptation to the postoperative experience.

 

Conclusion: A Cornerstone of Surgical Success

In summary, specialized physical therapy before and after spinal surgery is essential for achieving safe and sustainable outcomes in patients with Ehlers-Danlos Syndrome. It prepares the body for the physical demands of surgery, protects the surgical repair during recovery, and promotes both biomechanical and emotional healing.

At Dr. Gilete’s clinic in Barcelona, the rehabilitation program is not just an adjunct, but a strategic pillar of our comprehensive care. Our multidisciplinary team integrates physiotherapists, neurosurgeons, internal medicine specialists and rehabilitation experts to design personalized, evidence-based treatment protocols that truly respect the complexity of connective tissue disorders.

To request an evaluation or begin your preoperative assessment:  Schedule your consultation with Dr. Gilete

 

FAQs

 

What makes physical therapy for EDS patients different?

EDS patients have fragile connective tissues. A standard exercise program might lead to overstretching or injury. Specialized therapy emphasizes joint protection and neuromuscular re-education.

How soon after spinal surgery can physical therapy begin?

Typically within the first week post-op, beginning with non-invasive techniques and progressing according to the patient’s condition.

Can I do the therapy from home if I live outside Spain?

Yes. Our online follow-up program ensures continuity of care with remote sessions, exercise review, and clinical supervision.

Is preoperative therapy really necessary?

Yes. It prepares the body, educates the patient, reduces surgical risks, and often results in faster recovery.

Can physical therapy reduce my chronic pain?

Absolutely. Through neuromodulation, posture correction, and muscle strengthening, pain can often be significantly reduced.

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