top of page
Search

Ask the OT Session Summary 24 Sept 2026

Writer: LinkFairy
LinkFairy
6 days ago
3 min read

You're not losing it, this session was originally scheduled for the 17th and postponed due to pacing requirements. And yes, the first minutes were missed (but included in the summary below).


Presenter: Jo Southall, Independent Occupational Therapist

Host: Hypermobility Syndromes Association (HMSA)

Session Type: Live Q&A (Ask the OT)


🧠 Key Themes Covered

  • Hypermobile joint instability & pain management

  • Mobility aids (crutches, rollators, wheelchairs)

  • Shoulder, SI joint, knee and rib instability

  • Interoception & proprioception in neurodivergent hypermobile people

  • POTS-friendly seating, fidget breaks, circulation support

  • Mattress selection for HSD/hEDS

  • Compression wear, orthotics, bracing

  • Sensory overload, tinnitus, ear pain

  • Paediatric hypermobility support & EHCP routes

  • Advocacy phrases for healthcare barriers

  • Neurodivergence & hypermobility overlap

  • Practical daily-life hacks for joint protection

Detailed Topic Summary

1️⃣ Crutches Causing Shoulder Subluxation

Jo explained that standard crutches often worsen shoulder instability because:

  • They require lifting/carrying between steps

  • They load the shoulder joint unevenly

  • Hypermobile shoulders rely heavily on muscle stability, not ligaments


Recommendations

  • SmartCrutch (forearm-loading, angled handles)

  • Rollators (leaning support, seat, storage, no lifting required)

  • Physiotherapy for shoulder muscle patterning

  • Compression clothing to increase proprioception

  • Shoulder taping or bracing on high-risk days

“My ligaments haven’t improved, but physio changed my shoulder stability dramatically.”

2️⃣ POTS + HSD: Reclining, Pins & Needles, Intercostal Pain

Key Strategies

  • Micro-breaks every 10–30 seconds (linked to adverts, notifications, track changes)

  • Armpit cushions to prevent shoulder droop → reduces compensatory mid-back pain

  • Nesty compression pod (Jo’s new favourite) for upper-body proprioception

  • Weighted blankets for sensory + joint feedback

  • Wedge cushions to adjust pelvic angle

  • Photograph your posture when symptoms start → identify impingement patterns

  • Frequent fidgeting to maintain circulation & reduce POTS symptoms


3️⃣ Mattress Selection for HSD

There is no universal “best mattress” for hypermobility.


Jo’s Advice

  • Spend a full day in a showroom

  • Lie on each mattress for 20 minutes

  • Bring your body pillows and recreate your sleep setup

  • If the store won’t let you lie down: don’t buy from them

  • Adjust later with memory foam toppers or wedges


4️⃣ Neurodivergence + Hypermobile Bodies

Jo covered interoception & proprioception:

Interoception

“Your internal memo system; hunger, thirst, temperature, pain, loo.”

ND people often miss these signals until symptoms escalate.

Proprioception

“Your body-position parking sensors.”

Sketchy proprioception; bumping into doorframes, slouching without noticing.

Activity stacking

Pair body-checks with:

  • Track changes

  • Level completion

  • Notifications

  • Music transitions

5️⃣ Age-related Increased Instability

No formal clinical term.

Jo suggests describing:

  • Hormonal changes (perimenopause, menopause, progesterone, relaxin)

  • Cumulative injury load

  • Deconditioning

  • Ligament laxity progression

“Relaxin should be optional.”

6️⃣ SI Joint Instability & SI Belts

Key Points

  • SI joint should be stable, hypermobile people often struggle

  • SI belts help but ride up when sitting

  • SacroFix solves this by attaching the belt to compression shorts

  • Avoid sleeping in SI belts due to pressure ulcer risk

  • Consider custom compression leggings (DMO, Jobskin)

TENS at night

Jo (as a clinician): “Not recommended.” Jo (as a human): “I do it anyway, but tape the electrodes down.”

7️⃣ Hand Pain, Ring Splints, Proximal Joint Support

Recommendations

  • Hand therapy referral (specialist, not general physio)

  • Smaller ring splints for PIP joints

  • Compression gloves (Chronically Colourful for fun designs)

  • Workspace assessment via Posturite

  • Voice dictation or AI transcription to reduce typing load

8️⃣ Paediatric Hypermobile Pain & EHCP Support

For the 12-year-old with autism, ADHD, hypermobility, haemarthrosis:

Routes to support

  • Pain clinic MDT (physio, OT, psychology, anaesthetics)

  • Orthotics referral

  • Private OT via RCOT directory

  • EHCP-funded private OT (if pain affects learning)

  • Advocacy phrase:

    “Please document your refusal to assess/investigate/treat/refer.”

9️⃣ Knee Buckling & Dislocation

Amazon braces are too flimsy.

Solution

  • NHS orthotist referral

  • Custom carbon-fibre braces (£650 each)

  • Mobility aids (rollator, wheelchair) until stability improves

  • Counter GP objections about “deconditioning” by explaining current injury load

🔊 10️⃣ Tinnitus & Sensory Ear Pain

Suggestions

  • ENT referral (especially unilateral tinnitus)

  • Hearing test → tinnitus often “fills in” missing frequencies

  • Loop / Flare earplugs (soft, small, reduce harsh frequencies)

  • White noise

  • Avoid sensory triggers

  • Consider sensory integration OT

📚 All Links Mentioned (Complete List)

Mobility Aids

Armpit / Mastectomy Pillows

Nesty Compression Pod

SI Joint Support

Orthotics & Compression

Pain Relief

Movement & Exercise

Corsetry

Workstation Ergonomics

Compression Gloves

Jo Southall OT

HMSA Feedback

Zoom Session Link (for replay reference)

Closing Notes

The session was warm, humorous, practical, and deeply validating for attendees. Jo emphasised:

  • Individualised solutions

  • Body-awareness strategies

  • Advocacy in healthcare

  • Neurodivergence-informed coping

  • Practical aids that genuinely help hypermobile bodies

Attendees expressed gratitude, learned a lot, and engaged actively throughout.

 
 
 

Comments

bottom of page