'Ask the OT' with Jo Southall [August 2026]

LinkFairy
2 hours ago
2 min read

Catch up, 20/08/26

🌿 HMSA Q&A Summary -Jo Southall (Independent OT)

Jo Southall, an independent OT living with hEDS and PoTS, led a Q&A on joint instability, pain, sleep positioning, pacing, exercise, perimenopause, compression garments, SI joint instability and safe movement.

🦴 Shoulder Subluxations & Washing Up

Shoulders are inherently unstable; repeated subluxations worsen laxity. Compression vests or custom Lycra tops improve proprioception and comfort (better than braces, especially for people with breasts). NHS orthotics can provide DM Orthotics, Jobskin or Allard UK garments.

Washing‑up adaptations: tabletop dishwasher, wheeled saddle stool, pre‑soaking, rubber gloves, raising the bowl, micro‑breaks and proactive pacing.

😴 Sleep Positioning

Helpful strategies: wedge cushions (e.g., Dunelm), semi‑reclined back sleeping, 45° side‑sleeping with pillows, armpit pillows, mastectomy cushions (Etsy), compression vests (hot in summer), magnetic insect screens for cooler nights, taped TENS electrodes.

🏃‍♀️ Restarting Exercise (PoTS + Hypermobility)

Begin with gentle “prehab”: wobble cushion during calls, sit‑to‑stands while brushing teeth, posture resets, dancing during chores. Best tolerated: recumbent cycling, reformer Pilates, swimming/water aerobics. Compression options: class 2 thigh‑high stockings, abdominal‑support tights, custom leggings.

🧦 Compression Garments

Leggings/tights: DM Orthotics, Jobskin, Allard UK HIMO; Spanx can help hip stability. Stockings: Medi (durable, Velcro‑proof, open‑toe). NHS prescriptions exist but colours are limited.

🌸 Perimenopause & Hypermobility

Oestrogen drop increases laxity; some clinicians use low‑dose testosterone for muscle support. Creatine may help muscle maintenance and cognition during sleep debt. ADHD symptoms often intensify. The Zebra Club (Jeannie Di Bon) offers perimenopause‑specific movement support.

🦵 SI Joint Instability

SacroFix stabilises SI belts and prevents riding up. Use proactively before flares and during aggravating activities. Available via NHS orthotics.

📦 Moving House & Back Bracing

Back braces must be fitted. Timeless Trends corset extender (via Lucy’s Corsetry) can help. Best advice: hire movers or bribe friends with pizza to avoid injury.

👧 Supporting an 8‑year‑old With Hypermobility

Hypermobility is an observation, not a diagnosis. Focus on pacing, recognising useful vs useless pain, avoiding boom‑and‑bust, and building rest around activities. Blood tests may be needed to rule out inflammatory conditions.