Zebra Therapy: Physical Therapy for the Hypermobile

There is a phrase in medical school where students are often taught, "When you hear hooves, think horses, not zebras." This refers to the idea that most of the time, the most common explanation is the correct one; however, there are exceptions, which is how more complex and atypical patients have come to call themselves "Zebras". The Ehlers-Danlos Society has adopted the zebra stripes as part of their logo to acknowledge this aspect of the syndromes. Although many Zebras do have an official Ehlers-Danlos Syndrome (EDS) diagnosis, (most often hypermobile EDS (hEDS)), not everyone who qualifies as hypermobile will, but that does not change my treatment approach.

Due to the nature of hypermobility, a Zebra's joints are inherently less stable and with tendons and ligaments that are more lax than someone who does not have a connective tissue disorder. It is imperative to incorporate strengthening exercises to help those joints be more stable, to reduce subluxation, and to strengthen within the existing range of motion as part of treating hypermobility. Without a good understanding of hypermobile spectrum disorders (HSD), a Zebra can be pushed too far and end up worse off than before because hypermobile bodies do not respond the same way to traditional exercise training as someone without hypermobility. Additionally, connective tissue exists throughout the body, not just joints, so it is important for a Zebra's provider to understand other potential symptoms of EDS (next section).

EDS and HSD rarely exist in a bubble, and often present as The Triad with POTS and MCAS. I live with all of these conditions and understand the complexity of appropriate care for people who deal with them. Unlike more traditional physical therapists, I look at the ENTIRE person, not just the joint that's causing you pain. This means we will cover the usuals like strength, range of motion, pain, and set you up with a Home Exercise Program, but we will also cover body positions at work/school, hobbies with exercises tailored to meet your interests and goals, nutrition, sleep hygiene, stressors, emotional well-being - all the things that affect your physical health. I work with many specialists in the Denver Metro Area who also treat these conditions, and I may be able to help you find additional providers to round out your healthcare team if you are finding gaps.

I provide specialized treatment for specialized conditions. I do not have contracts with any insurance companies or Medicaid/Medicare, and am cash pay only. I work outside the box most of the time as traditional allopathic medicine does not do a good job of treating these conditions; therefore, traditional health insurance does not generally cover the sort of work I do. I am happy to provide you with a Superbill if you'd like to submit for reimbursement independently. 

If you find value in the services I provide but are unable to meet the listed costs, please ask about sliding scale payment. Payment forms include: cash, check, or debit card preferred; Venmo and PayPal with transaction fee.

Initial Hypermobile Evaluation: $300 

90 minutes - 2 hours for full evaluation of condition(s), symptoms, movement patterns, current management, lifestyle, etc. You will leave with a comprehensive plan of care including short term and long term goals, a Home Exercise Program, and scheduled follow up visits.

60-minute Follow Up: $150

After initial evaluation, sessions can include updates to current treatment plan, exercise routine, coping mechanisms, symptom management practices, troubleshooting triggers, and lifestyle techniques. These sessions can vary widely because my goal is to meet your individual needs, not a predetermined checklist.

45-minute Education Session: $120

In addition to traditional physical therapy, I offer medical coaching from how to speak with a new provider, how to advocate for yourself for particular treatments, to educating friends and family on understanding conditions and symptoms that are complex. I can also assist with paperwork such as school forms, requests for workplace accommodation (I cannot sign these, just create appropriate wording), and documentation of levels of function.

Other work outside these specific sessions will be charged at a rate of $150/hour in 15-minute intervals.

In the event you'd like to cross-reference with the Ehlers-Danlos Society Healthcare Professionals Directory, you can find my official affiliation here:

https://www.ehlers-danlos.com/directory/sara-townsend/