170: Hypermobile Ehlers-Danlos, Fascia, and Pain (with Tina Wang) Listener Favorite

🎙 Hypermobile Ehlers-Danlos, Fascia, and Pain (with Tina Wang) Listener Favorite

Why do people with extra-flexible tissues often hurt more, not less? What does fascia actually look like on ultrasound in someone with hypermobility — and why did the findings surprise even the researchers? Dr. Tina Wang — a board-certified physical medicine and rehabilitation physician whose research uses ultrasound to study fascial dysfunction in hypermobile patients — joins Til and Whitney for a wide-ranging conversation about Ehlers-Danlos syndrome, the paradox of mushy tissue that won’t glide, and why the deep fascia may be where most myofascial pain actually lives.

This is one of our most listened-to episodes ever — a listener favorite we’re bringing back for those who missed it and those ready for a second listen. Dr. Wang also offers a 1-hour class on hypermobility in the A-T subscription library (get a free month with code thinking: https://a-t.tv/subscriptions/)

✨ Topics covered in this episode include:

• The hypermobility paradox: why people with EDS have tissue that feels “mushy” and spongy yet lacks fascial glide• The diagnostic framework for hypermobile EDS — Beighton scores, systemic manifestations, body proportions, piezogenic papules, and why 30% of the population is hypermobile without pathology• Dr. Wang’s ultrasound research: sternocleidomastoid fascia that was profoundly thicker in EDS patients than expected, and the surprising elastography findings about stiffness• Why the deep fascia — not muscle alone — appears to be the primary source of myofascial pain in 75% of cases• Ultrasound-guided fascial injections and the role of different tissue layers in pain• The connection between EDS, neurodivergence, autism, and ADHD — and Dr. Wang’s case that hypermobile EDS may be neurodevelopmental• Why some patients respond to treatment with fevers, catatonia, and autonomic dysfunction — and what that tells us about their nervous system• Interoception, exteroception, and why people with EDS often have heightened sensory processing• The fibroblast–nerve–immune cell crosstalk happening at the tissue level• Why “go slow and form the connection” may be the most important clinical advice for working with this population• Dr. Wang’s personal experience as a clinician with EDS and co-occurring autism

✨ Resources:

• Dr. Wang’s 1-hour course: https://advanced-trainings.com/product/hypermobility-for-hands-on-therapists/• Dr. Wang’s clinical practice: https://tupelopointe.com/