Ehlers-Danlos Syndrome: What Athletes Need to Know (& Why Nutrition Matters)
If you’re an athlete living with Ehlers-Danlos Syndrome (EDS), chances are you’ve been met with a mix of curiosity, confusion, and maybe even a little skepticism, especially when it comes to your training. While EDS does bring some unique challenges, that doesn’t mean high-level movement or performance is off the table. With the right team, supportive strategies, and a clear understanding of how your body works, you can pursue your goals on your terms.
So, What Is Ehlers-Danlos Syndrome?
EDS isn’t just one thing—it’s actually a group of genetic connective tissue disorders that affect how your body produces collagen. Since collagen is a key building block for joints, skin, blood vessels, and other connective tissues, having “floppy” or weakened collagen can show up in a lot of ways.
There are 13 recognized subtypes of EDS, but hypermobile EDS (hEDS) is the one you’re most likely to hear about in athletic spaces. It’s the form that involves significant joint hypermobility—sometimes helpful in flexibility-based sports, but often problematic when training gets intense.
How EDS Shows Up in Athletes
EDS doesn’t look the same for everyone, but here are some common ways it can impact athletes:
Elevated injury rates, particularly affecting joints under repetitive stress
Difficulty maintaining stable positions during high-intensity movements
Tendency to hyperextend joints during explosive or dynamic activities
Reduced endurance capacity during extended training sessions
Prolonged recovery requirements between intense training days
Inconsistent performance due to varying joint stability
GI issues and symptoms related to the autonomic nervous system (like dizziness or irregular heart rate)
It’s a lot to manage—and that’s where a smart, thoughtful approach comes in.
The Performance Paradox
Hypermobile athletes can often move into shapes others can’t—deep squats, wild shoulder angles, extreme backbends. But this extra mobility doesn’t always translate to performance gains. In fact, it can increase the risk of injury, especially if joints aren’t adequately supported or movement patterns aren’t dialed in.
You might notice:
A higher rate of sprains, strains, and overuse injuries
Trouble with joint control under load
Difficulty building endurance
Fatigue that lingers longer than expected
Fluctuations in performance based on how “together” your body feels day to day
It’s not about pushing harder—it’s about working smarter with the body you’ve got.
Where Nutrition Comes In
It is common for individuals with EDS to experience some additional challenges in their nutrition, including acid reflux, food aversions, or food sensitivities. If this is you and affects your quality of life, getting support for your nutrition and eating habits may help you understand how to work with your body, not against it.
While no diet can “fix” EDS, targeted nutrition can support tissue health, reduce inflammation, and help you recover more efficiently.
Here are some key strategies:
🥩 Collagen Support
Your body builds collagen using amino acids from protein, plus cofactors like vitamin C and zinc. Think: protein-rich meals, citrus, berries, leafy greens. Collagen supplements may be worth considering, but the basics matter just as much.
🥑 Anti-Inflammatory Foods
EDS often brings low-grade inflammation. Omega-3s (from fatty fish, flaxseeds, or walnuts), plus colorful fruits and vegetables, can help cool things down internally.
🍚 Stable Blood Sugar = Stable Energy
Autonomic dysfunction can impact blood sugar regulation in EDS. Balanced meals—think protein, complex carbs, healthy fats—can help maintain steady energy and reduce “crash and burn” fatigue.
💧 Hydration + Electrolytes
Some folks with EDS also experience dysautonomia or POTS. In these cases, fluids and electrolytes (like sodium, potassium, and magnesium) are extra important—especially around workouts.
🥣 Digestive Support
GI issues are common. A focus on gut-friendly meals, gentle fiber, and personalized support (possibly with a CNS or dietitian familiar with EDS) can go a long way.
🌞 Micronutrients Matter
Vitamin D, magnesium, zinc, and B vitamins are particularly important in connective tissue health. Testing and supplementation may be helpful depending on your symptoms.
Rehab with EDS: Meet Evan Ingerson, DPT
If you’re trying to train or climb with EDS (especially if you're navigating injuries), working with a knowledgeable physical therapist is essential. I often refer my clients to Evan Ingerson, DPT, based in Santa Fe.
Evan brings a rare combo of clinical expertise and lived climbing experience—he’s been climbing for over 25 years and has spent the past 9 treating climbers specifically. He doesn’t just treat injuries; he helps athletes develop smarter movement patterns, improve proprioception, and build strength that sticks, especially important when joints are a little too mobile for their own good.
Whether you’re dealing with a cranky shoulder, chronic instability, or trying to figure out how to train sustainably, Evan designs rehab that fits your sport and your body. And yes, he tests his own protocols on the rock all the time.
Movement Strategies That Respect Your Body
Physical therapy and strength training for athletes with EDS need to go beyond “standard” protocols. Some of the core strategies Evan (and other EDS-aware clinicians) might use include:
Joint protection and education: Learning how to move safely without triggering instability
Proprioceptive training: Building better joint awareness and body control
Low-load, high-rep strength work: Especially important around unstable joints
Technique refinement: Adapting sport-specific movement patterns to protect vulnerable areas
Load management: Planning training that builds capacity without overwhelming the system
It’s all about working with your unique physiology, not trying to override it.
Long-Term Health Comes First
The goal isn’t to train despite EDS—it’s to train with it, using informed, flexible strategies that support your long-term health and performance. That might mean:
Prioritizing recovery just as much as training
Tracking symptoms and fatigue patterns
Working with providers who actually get it
Letting go of rigid protocols in favor of sustainable ones
Perfectionism and EDS
Perfectionism around nutrition in athletes with EDS can manifest in unique and complex ways, especially given your chronic pain, fatigue, GI issues, and hypermobility challenges. Perfectionism might show up as “all-or-nothing” thinking about foods, guilt or shame when deviating from a “perfect” nutrition plan, overidentification with food rules to feel in control of an unpredictable body, and fear of food “causing” flares. You may feel like you need to follow a strict elimination diet, micromanage your macronutrients, or fear weight fluctuations due to joint load.
If this is you, your striving for better health is a great goal! However, it’s possible to feel your best in your body without the limiting and restrictive diets or rigid meal plans. Even if you do have a flare-up of symptoms, you can’t place blame on yourself or your diet. Nutrition is a wonderful tool to support your body, but it can’t fix the underlying condition. Embracing a broad management plan is one way to tackle your unique situation and regain a sense of power in your body.
Final Thoughts
EDS doesn’t have to be the end of your athletic story—it’s just a different chapter. With the right blend of education, support, and personalization, you can continue doing what you love (without constantly bracing for injury or burnout).
If you're looking for collaborative care that includes nutrition and PT, I'm happy to connect you with colleagues like Evan or walk with you through the nutrition side of your training.
Let’s connect!
Looking for nutrition support? Send me an email (nutrition@caitlinholmes.com)! I’d love to chat about your unique situation.
Need advanced physical therapy and training support? Contact Evan here! Or, send him an email (evan@rockrehab.co).
