Episode 50: Rethinking Rehab for POTS, EDS & Hypermobility with Jill Stephenson PT, DPT

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I sit down with Dr. Jill Stephenson, an orthopedic and pelvic floor physical therapist, hypermobility/POTS specialist, and the newest member of our ResilientRx team.

We dive into the overlap of hypermobility, Ehlers-Danlos, POTS, neurodivergence and sensory processing issues and how these often misdiagnosed or misunderstood patterns can drastically change how someone experiences pain, movement, fatigue, and even relationships.

You’ll hear both our clinical and personal perspectives navigating these diagnoses, how they shaped our work, and what the traditional rehab model often misses with this population.

We cover:

• Why POTS and hypermobility show up together more often than you'd think and how impaired connective tissue affects blood flow, energy, and exercise tolerance

• How neurodivergence (especially ADHD and autism traits) changes the way people feel their bodies, process pain, and respond to cues

• What "fatigue" actually means in this population and why pushing through can backfire

• Why some patients need sensory-safe environments just as much as they need strength programs

• How to spot when someone is overwhelmed and what about our language might be triggering without even realizing it

Whether you're a patient who's felt dismissed or a provider wanting to better your these clients, this one’s for you.

00:00 Introduction and Guest Introduction

00:40 Personal Experiences with POTS and Hyper-mobility

03:50 Understanding POTS and Its Clinical Presentation

06:07 Challenges and Misdiagnoses in Chronic Illness

08:23 Intersections of Neurodivergence and Hyper-mobility

14:21 Navigating Healthcare and Building Support Systems

29:41 The Importance of Self-Care and Sustainable Growth

38:02 Understanding Neurodivergence and Hyper Mobility

39:16 The Impact of ADHD on Daily Life

39:48 Challenges and Misconceptions in Diagnosing Neurodivergence

41:53 The Importance of Community and Support

42:09 Navigating Hormonal Changes and Neurodivergence

45:09 The Role of Physical Therapy in Managing Symptoms

49:08 Balancing Rest and Activity

01:04:54 Creating a Sensory-Friendly Environment

01:09:10 Final Thoughts and Resources

Dr Jill works at my practice in Austin, TX. You can find more about her there or on IG:

resilient-rx.com

instagram.com/learnwithdrjill

If you are a health or movement professional and want to stay in touch with future episodes, webinars, courses, events and more. Subscribe to my email list here

I’ll see you in a week!

Episode Transcript

(00:00):
Hello everyone and welcome backto TMI talk with Dr.
Mary.
I'm your host, Dr.
Mary.
Today I brought on Dr.
Jill Stevenson, an orthopedicand pelvic floor physical
therapist who also specializesin hypermobility and pots.
She is a physical therapist thatcurrently works with me at
Brazilian RX in Austin, Texas,and she's a new addition to our

(00:21):
team and is.
Filled with a wealth ofknowledge.
And so I brought her on today totalk about pots, Ehlers Danlos,
hypermobility, neurodivergence,and how all of these things
intersect and the best ways thatwe can help our patients and
clients that are working withthese diagnoses.
So her and I speak about ourexperiences with A DHD and

(00:44):
history of pots.
She also has hypermobility, soshe shares a little bit about
her story as well.
I.
We navigate these personalchallenges, how it's made us
more aware, more, more curious,and more compassionate as
clinicians to understand whatit's like not just from a
clinician standpoint, but alsofrom a patient standpoint.

(01:04):
We'll dive into what it means totreat patients with LERs,
danlos, and hypermobilitydisorders, and why the
traditional rehab model oftenmisses the mark for this
population.
Dr.
Jill also explains how pot showsup beyond the textbook
definition, how it impactsenergy, movement, tolerance and
recovery, and why nervous systemregulation has to be a part of

(01:28):
the plan.
We explore often overlooked linkbetween hypermobility.
Neurodivergence and nervoussystem dysregulation and how A
DHD and autism traits can changethe way people experience in
their bodies and how theyrespond differently to
treatment.
We also talk about how torecognize sensory overwhelming
patients and how it's importantto have a sensory safe clinic if

(01:52):
you are working with thispopulation.
So without further ado, I'mreally excited for you all to
learn more about what we do atResilient rx, but also if you're
listening as a clinician, howyou can better help your
patients in this population.
And if you are somebodylistening who is has any of
these diagnoses, I believeyou'll benefit a lot from this

(02:15):
as well.
So without further ado, we'lljump into the episode.
Welcome back to TMI talk withDr.
Mary where we dive intonon-traditional forms of health
that were once labeled as tabooor dismissed as Woo.
I'm your host, Dr.
Mary.
I'm an orthopedic and pelvicfloor physical therapist who
helps health.
Movement and rehab professionalsintegrate whole body healing by

(02:36):
blending the nervous system intotraditional biomechanics to
maximize patient outcomes.
I use a non-traditional approachthat has helped thousands of
people address the deeper rootsof health that often get
overlooked in conventionalwestern training.
And now we are gonna be startingour next episode.
Well, welcome to the podcast,Jill.
Thank you for having me.

(02:57):
I was so excited you're here.
I am too.
It's finally real.
I know.
We've, uh, Jill reached out afew months ago looking for a
job, and I was like, hell yeah.
This, this is, sounds like a,such a perfect fit and I'm
excited to introduce her to youall.
And she's got a lot ofinformation, a lot of great

(03:18):
things to help us from a PTperspective on how to help
patients with hypermobility,LERs, danlos, and pots.
And I truly believe ourprofession, you're uplifting our
profession by.
It helping us all learn.
Oh, I appreciate that.
It's nice to be somewhere whereit's encouraged and we have the
time to really get into so manylayers.

(03:41):
Yeah.
And so much education forpatients.
Yeah.
And other providers.
I think that's huge.
Totally.
Yeah.
Well, we'll go ahead and jumpright in.
Let's do it.
All right.
So can you explain what POTS isand how it presents clinically?
So for people that are unaware,POTS is post orthostatic
tachycardic syndrome.
Exactly.
Yeah.
So pots, especially in postCOVID is coming up a lot more.

(04:04):
So we're gonna see more researchon it hopefully in the next five
to 10 years.
But basically it's acardiovascular and autonomic
nervous system piece, right.
That nervous system that'strying to regulate our breath,
our blood pressure, heart ratetemperature regulation is a huge
one here in Texas and it's whenthe autonomic nervous system.
Struggles to react appropriatelyand can even react in an

(04:28):
unhelpful way.
Right?
So in POTS specifically, it'sgonna have that postural
component.
So a lot of times standing ormoving from sitting to standing,
like that lightheaded feeling,or the, um, you know, your eyes
go black for a minute.
If you ever experienced thatfrom moving too quick, blood
pressure drops in a healthy, Ishouldn't say healthy, in a more
normal nervous system, the bloodpressure is going to constrict

(04:51):
those distal.
Um, veins and help you get moreheart rate up in an appropriate
way.
Mm-hmm.
That's gonna return yourpressure to normal and help you
be able to move efficiently inthe autonomic nervous system,
the vessels can't constrict inan appropriate way.
So the heart sweet little thingtries to help out more.
She pumps faster.
So the clinical, clinical wouldbe like a 30 beats per minute,

(05:14):
more increase for like a solid10 minutes after being laying
down.
Right.
That means the body is reallytrying hard to get that blood
pressure back up, but itbasically ends up feeling like
anxiety or that racing thoughtsfeeling, and it can often lead
to syncope or fainting.
Doesn't happen to everybody, butit's definitely a huge fatigue

(05:35):
factor for a lot of my patients.
Yeah.
I mean, it wasn't until like acouple years ago I realized that
that's what I had.
I got it after.
I know people are probably like,oh, she has so many things.
I'm like, yeah, when you have.
Multiple, like chronic EpsteinBarr virus goes with, with, um,
pots.
You've got, I haveendometriosis.

(05:56):
Well, usually there's like theseclusters Absolutely.
Of people that have differenttypes of autoimmune or
undiagnosed, like from awestern, generalized western
medicine perspective.
A lot of these people getmissed.
And I remember just being toldto go on an antidepressant and
uh, just to keep pushing myselfand I kept flaring up and
feeling like I was gonna need topass out.

(06:17):
Yeah.
To reset.
Yeah, yeah, yeah.
I would do that as a kid.
It was honestly better to passout than to avoid it sometimes.
Yeah.
'cause that fatigue justwouldn't leave.
When did you first notice thatyou had pots?
I mean, it wasn't called potsthen, right?
It was just like, what?
Yeah.
Syncope, uhhuh.
So they were basically like, youknow, your, your vaso, your

(06:38):
vascular system and your vagusnerve aren't cooperating.
So it's an autonomicdisautonomia.
Right?
Mm-hmm.
That's gonna be the umbrellaterm for something like pots.
Um, the clinical diagnosis iskind of, you know, hard to find
someone who wants to do on you.
And I feel like a lot of mypeople, if you have the
symptoms, we can do a quicktesting clinic, but you can
normally see it.
It's normally very based ontheir report.

(07:01):
Yeah.
They'll tell you.
Yeah.
I mean it's pretty, and thenthey've gone through all of this
extensive testing usually andpeople, but yeah, my first one
was at Six Flags.
Oh yeah.
I scared the shit outta mysister, but we were waiting in
line, it was hot and I waswatching like one of those big
old rides that goes back andforth the ship.
Yeah.
And I don't know if it was thatinput or what if I was standing

(07:22):
with my legs locked out.
I really don't know.
I was like.
Maybe 13.
Yeah.
But yeah, it just went black andI was on the ground and my
adorable uncle Bear was carryingme to the medical tent for
Cheezits.
His name Bear Barry.
I love that.
Yes.
Oh my gosh.
I love my uncle Bear.
Rest in peace.
So can you explain to them whyknees locking out would make a
difference?
Absolutely.
Especially if you have an excessin range of motion of your

(07:44):
knees.
If you lock them out, you'rereally not allowing the venous
system to pump.
It only works to get back to theheart through our
musculoskeletal system.
So when we're standing still orthere's been a prolonged
stagnancy, your blood is morelikely to be pooling.
Plus it's a hot day humid up inDallas, Texas and probably
hadn't had enough water or saltthat day to help me maintain my

(08:06):
water mass.
I've been to that Six Flags.
Yeah.
Even in May.
And I was like, they had to shutdown half the rides'cause it was
so hot.
Aw.
See, back then it hadn't gottenthat terrible, right?
Oh, it's 20 years ago.
Oh my gosh.
Yeah.
Yeah, I mean I bet that wasscary.
Like that's scary when you don'tknow what's happening.
So especially if we run intopatients, you know, if for

(08:27):
practitioners or movementprofessionals that are
listening, if you are hearingthese types of things from your
clients, it often happens aftera virus as well.
Like mine was after EpsteinBarr.
We're seeing it after COVID.
Totally.
Um, you're seeing itperimenopause.
Yes.
With hormone changes.
Huge.
What are some other common timesthat you're seeing it?

(08:48):
I think a lot of times too, likechronic or times of
deconditioning, whether or notit was intentional or from an
illness, right.
Trying to get back into yournormal, trying to go right back
to your normal level and yourbody creates that crash or that
bust cycle where you go, go, go,you're trying to break through
that wall like you were talkingabout.
Like surely it's on the otherside of this and it turns out

(09:08):
it's just a wall.
And then you're splatted, youliterally hit a wall.
Like it is like cartoon splat.
I was like a, like a collegeathlete and I was like, I can't,
I just had to quit.
I was like, I have to quit.
I can't.
At the time, nobody knew what todo with me.
Right.
They were like, you're just,it's psychosomatic.
And I was like, I'm not crazy.
Yes.
I literally can't function Well,and it has to become some type

(09:32):
of protection response.
Yeah.
Within our central nervoussystem because it's a central
nervous system disorder.
Mm-hmm.
So of course I'm a littleanxious about it.
That's keeping me upright.
That's gonna help me not have topass out.
Yeah.
That's, that's just likefunctioning day to day.
Now add on any other anxiety orstress or things like that.
And that's why that spoontheory, I think is important for

(09:52):
people dealing with chronic, um,diseases, lifelong, you know,
that are ongoing.
It's just that, you know, on thedays.
Like most people generally don'tunderstand how chronic illness
works.
There's only so much energy.
People that have multipleconditions can have in a day.
Mm-hmm.
Sometimes they have 10 spoonsthat they can use.

(10:13):
Absolutely.
Sometimes they have two.
So you have to con helping themconserve energy is gonna be
super important.
Even deciding what you're gonnastress out about, you know, who
you surround yourself with.
Are people doubting you?
Do you have a work environmentthat's supportive and that's
supportive of the nervoussystem?
Or do they constantly stress youout and overwork you?
Like there's so many things,even just outside of just the

(10:35):
basic day to day or that justliving in the body well and all
of that requires a huge amountof like introspection and being
able to actually tell where I'mat.
If your body's always a littleanxious and you've been told
it's just anxiety, you getreally good at just kind of
ignoring it.
Like that's normal.
Yeah.
Anxiety's a symptom.
It is not a freaking disease.

(10:56):
I'm so tired.
And it's a helpful symptom.
Yeah.
In a lot of cases.
That we then vilify.
Yeah.
Instead, it's like, look at thatanxiety as a helper, as like a,
hey, a little warning.
And if you start to listen tome, I'll warn you gentler five
steps ahead of this.
Yeah.
Or how about we just put you onan antidepressant and ignore it?
Well, that could fix it.
Yeah.
That's, it's just like the waythat I look at this, and I've

(11:17):
said this before, is like, it'slike putting on headphones when
there's a fire alarm.
Right.
And I love that, even like usingthe term, I used to use the
term, I have anxiety.
Everybody has anxiety.
So then I was starting toidentify with it.
It's like, no, my body's givingme signals.
And so if we have patients thatare coming in and they're
anxious, you know, teaching themnervous system regulation to

(11:37):
help calm their nervous systemand even nervous system
regulation, but that's.
That's not addressing the cause.
Right.
Either.
So, so in order to understandwhy it's dysregulated, we need
to be regulated first and thenwe can look at, okay, well what
in my environment, what did Ido?
What did I eat?
What was my sleep like?
Like being able to collect allof this information.

(11:59):
Well, I think so many of us arelike, well damn, when's the last
time I was like regulated?
Mm-hmm.
When I was three?
Like I don't know her.
Yeah.
Your first anxiety memory canfrequently be in like
kindergarten.
Yeah.
And if you've had all of thisstuff and you didn't have a
label for it and that awfulInstagram where it's like you've
inherited your mother's nervoussystem, it's like, how are we

(12:19):
supposed to win at this?
Yeah.
No, but finding those techniquesat a younger age or even
learning how breath works withinthe body mm-hmm.
Would've been hugely helpful Ithink to me.
'cause I was told to do breathand I was just breathing through
the chest.
Yes.
Well then if you're bracing allthe time.
You can't actually, I'll get it.
Where, when I first starteddoing breath work, I kept
feeling lightheaded andeveryone's like, just keep going

(12:40):
through.
And I'm like, yes, I feel likeI'm good.
If is somebody gonna call 9 1 1because I'm gonna pass out?
And it's like your fascistchronic fight or flight, your
fascist stuck down.
'cause the fascia tightensbecause the body thinks, oh, it
knows two things.
Yeah.
It knows am I running from abear or am I safe?
Got it.
And so you're telling peoplewith anxiety to breathe, but

(13:01):
we're not giving them that ribexpansion to be able to that.
And that's even with people thatare hypermobile.
'cause that fascia's gonnastick.
It needs to, yeah.
Mm-hmm.
Yeah.
It's gotta stay aware.
Yeah.
So it's even more paramount toactually let it stretch safely,
but then finish with activationand support.
Mm-hmm.
To make sure you're not a limpnoodle.
Yeah, exactly.
But no, I agree.
And I think all people, butespecially those born as female,

(13:23):
we learn it like age eight,boobs up, butt out, never
breathe into your stomach.
No one can know.
Oh God, I can't.
I can't.
Yeah.
There weren't even examples oflike what a belly breath looked
like.
Yeah.
Until yoga got really popularand then it was.
Yeah.
Yeah, it's interesting.
All of it's so interesting'causeit's like, it, it's, it's
multifactorial.
A lot of this tends to happenmore to people born and as

(13:46):
women.
Um, but in that, there'scultural things on top of this
too, right?
So there's, so, there's so manythings.
So the, if we're that firsttouch point, that validates'em,
that explains even just a littlebit, they love that information,
right?
I mean, just to know I'm notcrazy.

(14:06):
I mean, I'm in healthcare andI've been in the system.
I've worked in it, and it wasn'tuntil like three years ago or
something like that, that Ireally started noticing, oh my
God, because that was.
And, and I know the system.
Of course.
Yeah.
So then what?
So we can be huge advocates forpeople and helping them navigate
the system and know, hey, no,you're not crazy.

(14:28):
But then now that we know you'renot, and that the symptoms do
line up, where can we helpdirect you?
And that's why since you'vejoined us, you know, I'm
reaching out to people in thecommunity being like, Hey, who
can be partners with, with us tohelp you?
So cardiology and rheumatologyand things like that.
Because not every cardiologistis aware of this.

(14:49):
Not every rheumatologist iseither Correct.
And gi I think GI is huge interms of mm-hmm.
That connective tissue andfascia.
Yeah.
And the bracing and the anxietypiece, like of course and
hormone regulation.
Mm-hmm.
Right.
We're learning way too muchabout gut health and I have.
Like less tools in thatcommunity.
Rheumatology sometimes can bebetter at looking at that

(15:09):
systemic inflammation for thegut.
Mm-hmm.
So it is, I think, finding yourpeople who are curious that you
don't have to convince.
Right?
Yeah.
And similar for patients, theywalk in instead of spinning the
whole visit, they're armored,right?
They come in ready, they'relike, I know I have this, well,
they have their list of stuff.
They're like, here.
Well, and they've alreadytriaged.
Yeah.
They're like, I'm only gonnatell you two things.
So you don't think I'm insane?

(15:30):
Yeah.
But these are the two things I'dlike to address.
Yeah.
And instead of having to spend avisit proving their dysfunction,
you get to have a providerthat's like, I already believe
you.
Let's start getting through theweeds.
Let's start figuring shit out.
But also that's, that's wild forthem though, too, right?
Because they're like, what?
Yeah.
I don't need to convince youthat is connected.

(15:53):
I thought it was, it's like,yes, all of it is correct and I
will, and rewarding that.
Rewarding the ability to feelthose connections.
Yes.
That's one of my favorites.
Like I, I'm just so impressedwith people, their intuition
when I'm like, yes, keep doingthat.
I'm like, tell me more.
Yes, yes.
I'm like, you just, you labeledit all for me and now I get to
be a mirror.
Like that's when it's reallynice.
Yeah.

(16:14):
But I think most people who havelived in a body that hasn't made
sense to other providers, theyoften know much more than the
person in front of them.
I a thousand.
The amount of times I've beentold, I don't know if you've
experienced this.
Oh, I've never heard thatbefore.
Abso, oh, that's not true.
That's, that can't happen.
Yeah.
That's actually not how thatworks.
What do you wanna do?
They'll ask me.
I'm like, yeah, what did I justpay for?

(16:34):
Correct.
That's not how hormones work.
Do we know?
Yeah.
Or all of these blood tests werelike.
Built around men, but Correct.
And the range is massive.
Can we look at mild blood work?
Mm-hmm.
And see if it's similar.
I mean, it's 2025 and we stilldon't have menopause figured
out.
We really don't.
We're trying finally, hopefullyit continues.

(16:56):
Yes.
And I am so thankful and I thinkwe are gonna continue because
there are enough women likeready to invest and we have more
women with more money than ever.
So Absolutely.
The tables are, and hey, it'snot, it's, it's, it's half the
population is literally goingthrough, going to go through
this.
Crazy.
I'm excited y'all are gonna haveit all figured out by the time

(17:17):
I'm there.
I know, I know.
I'm like I told you I'm inperimenopause.
I'm, I'm, I'll give you all mytips.
Do the work for me.
Yeah.
Thank you.
why would you say, so for peoplelistening, can you explain why
POTS is common with people withhypermobility or L or Danlos?
Absolutely.
So POTS itself is relying on thevenous system and the connective
tissue in it to respondappropriately.

(17:38):
If you have a change inconnective tissue, you could
have a change in how your vesselvessels contract.
There are certain types of EDS,right?
There's like 18 types that canbe within that.
Cardiovascular based EDS isdefinitely one I would send for
genetic testing if I had.
Any inkling that it could be athing, right?
Because then we're talking aboutmitral valve prolapse or aortic

(18:01):
dissections and a lot of otherconnective tissues that I would
wanna have a very close acarotid too.
Exactly.
In terms of in like uppercervical instability, my God.
Like being armored with that,going into other places and
being able to say, I have this.
Please don't pull on my necksharply.
Like it could literally resultin something bad.

(18:22):
It gives you the ability to setyour boundaries, but no, for
POTS in general, they're gonnabe so closely linked.
I think from that standpoint ofjust the tissues and the
introspection part, and honestlyfor me, the A DHD neurodivergent
side, I never know when I'mthirsty until I am drinking
water because I'm supposed to,or my husband has informed me

(18:43):
that I haven't had water thatday.
Right?
Yeah.
Like I don't know when I'mhungry, I think.
We grew.
I grew up in the nineties.
There was a lot of that, likelow calorie, zero salt.
It turns out we need a goodamount of salt.
We need, so if you're a littlepsy, we need So salt.
Yeah.
Like all of those.
And it's not just water.
The electrolyte.
Yeah.
Like we treat it in higher levelathletics.

(19:03):
It should just be a basic for alot of individuals like, Hey,
you actually do need that.
Don't listen to that.
No salt, none of this.
Some people do need to avoid it,but a lot of us aren't getting
enough, especially if we're in aplace that's sweaty.
Mm-hmm.
Constantly sweating here.
Yeah.
Can you explain to them how, whyelectrolytes would help?
Absolutely.
So just plain water, it canincrease our volume, but it

(19:26):
doesn't have the beneficialelectrolytes to actually keep us
moving.
So it's not the dramatic term.
Right.
It would be you can drown inyour own water because I can't
absorb it well.
Mm-hmm.
The salt helps bind to it andhelps you stay actually hydrated
in your cells.
Right.
You're not just voidingconstantly.
Although I do think for ourpelvic floor side, urine output

(19:48):
is a great metric of, Hey, areyou actually getting enough
water?
Or is your body kinda holdingonto it and never letting you
void?
'cause it's recognizing it's ina deficit.
So like if they're not payingenough.
Yeah.
Yeah.
Or if they're like, I neverreally have to pee.
It's like, that surely can't betrue.
Let's delve into that.
Yeah.
Yeah.
And it can just be like anotherbeneficial external marker.

(20:10):
I am always looking for myexternal markers.
Yeah.
Well, what are some otherexternal markers you're looking
at?
Um, I mean, so silly, butstanding up and feeling that
woozy feeling, it's like, Ithink that's silly.
Ooh.
You know, a little Phoebe momentfrom friends and then you drink
some water with electrolytes.
Mm-hmm.
There are a bunch of littleones.
For me, having people be theexternal has been the biggest

(20:33):
help.
Right.
My mom trained me at a young agelike baby girl, when I tell you
to eat something, it is notbecause I'm being mean to you.
It's not because you're beingannoying, it's'cause I can tell
you're fading.
And I give a lot of close familyand friends that same allowance.
Like, Hey, if I'm irritable or alittle bitchy, remind me, maybe
I haven't eaten and I need somewater'cause my moods changes

(20:54):
like that.
Oh yeah.
I'm just more prone to thatcrash cycle.
But how much of that though,like,'cause hangry to me is a
lot of blood sugar dysregulationas well.
Absolutely.
And that's what I'm excited tolearn about.
More so from your side with thehormone and blood sugar part.
Yeah.
Because I do think that's apiece of it, but now I'm
recognizing what snack do Iactually crave a salty one?

(21:15):
Mm Right.
Like finding out which piecesI'm actually needing craving.
Exactly.
Well, and I think that's what'simportant too, is we've really
bypassed our intuition inhealthcare and understanding
like what our body's messagesare.
And so.
You know, I first learned thisfrom some of my, um, colleagues
like years ago where I was justlike, Hey, I'm just craving

(21:38):
sweets all the time.
I'm constantly feeling depleted.
And they're like, oh, you mighthave insulin resistance.
And then my doctor had said thattoo, and I was like, oh my gosh,
well what's that?
And I went down this wholerabbit hole and basically your
body is just constantly goinginto this glucose if you don't
have any protein or fat to helpstabilize.
And then it's basically, theinsulin is just not responding.

(21:58):
It's just not as, our body's notsensitive to it.
Right?
So, so then we have more glucosein our bloodstream.
Um, but typically like if youhave, um, walking after meals
are gonna help with that.
It's gonna help use the glucosemuscle.
Muscle mass is gonna be superimportant.
This is why we see this inperimenopause.

(22:19):
Yes.
Um, so gaining muscle,'causemuscle uses that glucose.
Mm-hmm.
So that's why people that aremore muscular, not all the time,
but if they have more musclemass, they're more apt to be
more sensitive to insulin.
So we need insulin to beworking.
But I think it's important tonote too, from like a pot

(22:41):
standpoint as well.
'cause if your blood, if yourblood sugars spiking and then
crashing mm-hmm.
Your autonomic nervous system'sgonna go into fight or flight as
well.
And a lot of times I can't eat abig meal.
Mm-hmm.
'cause then all of my blood isworking there.
I'm more prone to feeling potsyafter.
Mm.
Right.
Yeah.
Like if you ever eat and thenyou feel like crap.
There's a lot of reasons itcould be.

(23:01):
But if it's like, I need to laydown with my legs up.
And I think that's been abarrier in learning like.
It's kind of a full-time jobeating.
I have to plan my day aroundthose little meal breaks in
order to keep that.
Well also too is like thedensity of the food.
Mm-hmm.
You know, if we're like carbheavy, it's gonna be more dense.
If it's gonna be a lighter food,chewing food to apple sauce.

(23:22):
Consistency as well to make iteasier on the digestive process.
So there's so many like littlethings that we can do even
before medication.
And I'm not anti-medication.
I'm just like, Hey, let's, let'ssee what our body can do first
and then add on any medicationsthat we need from that.
So then you're not on a milliondifferent types of medications,

(23:42):
you're just on the ones that arespecific to, to you.
You.
Um, but yeah, so blood sugar'sgonna be a big one.
That one also happens a lot inperimenopause as well.
But I think that was a gamechanger for me with my fatigue
was the blood sugar regulation.
And I, I found that out throughthe blood glucose monitor you

(24:03):
might get a lot, I think peopleget a lot of information from
that, trying not to obsess aboutit, like doing it a few weeks
and seeing, hey, what is causingmy blood sugar to spike and stay
spiked?
'cause for me, it wasn't what Iwas eating.
It was actually like my, uh,cortisone inhaler.
No way.
Uhhuh.
Yeah.
Oh, that's unfortunate.
Yeah.

(24:23):
So I just switched to justanother type that was non
cortisone and it was fine.
Cool.
Um, the other one is if I hadmore than one cup of coffee in
one sitting.
If I did two, it was spiked therest of the day.
So technically I wasn't eatingsweets.
Right.
And so then that was causing meto crash and feel like kinda
shit at the end of the day.

(24:44):
Mm-hmm.
Then you feel like pulling inyour feet.
Yeah.
And things like that.
So it's really interesting.
And that might have even beensome perimenopause, like, I'm so
exhausted, I need this extra cupof coffee.
Mm-hmm.
And then it comes at a greatercost.
Well, it's your, like my buddywas just telling us the other
day, just how you're stealingfrom your future with the
caffeine.
It's like if I, I get the energynow, but then I'm stealing it

(25:06):
from my sleep later.
Yeah.
But then it's like, well, I'mtired.
How do I get through the day?
Okay, well you get to decidelike, is there some days I still
like, you know, I'm trying towean from caffeine, but Yeah.
Well sometimes we'll use it, butalso it's like why is our body
depleted?
Right?
Is it hormonal?
Is it electrolytes, is it water?
Is it blood pooling like orimpaired lymphatic drainage and.

(25:29):
And these different messages.
So it's like what you weresaying is like, what are my
messages?
And that's that interceptionwhich gets impaired with people
with hypermobility.
Absolutely.
And you wanna explain that?
I mean, explain what Well,interception is basically the
internal messages Yeah.
That we have.
I'm hungry, I'm tired.
I'm not, I'm cold.
Yeah.
Yeah, go ahead.
I mean, I think that's probablythe hardest relationship if

(25:53):
you've always had blood testsand it's like, well, you're
normal.
It's like, but my body istelling me I'm not.
Do I need to ignore that?
Or like coming out of a nervoussystem that's heightened, you're
gonna go back and forth.
Right.
But your body and nervous systemkind of think same.
Good, better.
No thank you.
Worse.
Nah.
Right?
I'd rather stay exactly where Iam.

(26:13):
This is safe.
Mm-hmm.
Even if it's not our optimalzone.
So a lot of us turn to livingthere, which means, hey, I'm
less likely to get injured androll my ankle'cause I'm so
hypervigilant.
Right?
Mm-hmm.
But I have to be like, there'sso many things, a lot of
hypermobile people have to.
Constantly be aware of thatdrains them and they don't even
know they're doing it.

(26:33):
Or that normal people don't haveto,'cause you've never had a
different body.
Mm-hmm.
Right.
So I think a, a lot of ourintrospection could get tied up
in literally just trying toexist without spraining
something.
Right.
Well, even that, and thenenvironments too, like nothing,
everything's set up forable-bodied people.
Like my bro, I have two brothersand the one that just passed, I

(26:55):
mean, I've scanning environmentsjust for, oh my God, he would
never be able to get throughthat door or.
You know, you're just, andthat's that I'm not even the
person.
Exactly.
You know, and it's like that's,that people have that, that are
not, that don't fit in theseboxes that healthcare has just
set us in, even if we're not ina wheelchair.

(27:17):
I mean, the disabilities likewalking further, you know?
Yeah.
Um, being able to maneuver inawkward, like cars, I'm sure
people having children gettingin their car and like taking the
kiddo out.
Like these are like littledetails.
Everything is so made for likethis one particular like person

(27:37):
who doesn't have any of thesethings.
And yeah.
It's the constant environment.
Not, and then add on.
It's overwhelming the, thestress of canceling because
you're tired, right?
Having people looking flaky.
Mm-hmm.
Yes.
I think.
Yeah.
Two, like there is a reward forlearning better introspection
and getting to that place, butit takes way too damn long for

(27:59):
that reward to come along.
Mm-hmm.
There's a ton of grief in themeantime.
Yeah.
Of being like, I can't actuallywork 40 hours a week.
Like what a failure.
That feels like.
Mm-hmm.
There's a lot of dismantlingthat has to happen that comes at
a cost of productivity,financial gain, and sometimes
like, not friendships entirely,but some social costs.
Right.
Like, God, you're alwayscanceling.

(28:20):
Yeah.
It's like, yeah.
I've been trying to give my bodypermission to let me know when
it doesn't feel up to it.
I've had, yeah, I've had to likejust.
N like the people that don'tlike it, I'm like, sorry.
Yeah.
I just, I can't, I'm not, Iagree.
And if you can't and if yougimme shit, I'm like, we're not,
I can't keep doing this.
Like Correct.
Just add it to my list of corks.

(28:41):
I am, yeah.
I am a list of corks that I atleast now can label and name.
Yeah.
But starting to like unmask ismore of a neurodivergent term,
but I do think there's a lot ofthat in hypermobility, right?
Like, oh, I have another ribout.
Like I have to go get itadjusted for my pt or somebody
else.
Like, yeah, I need to leave workagain.

(29:02):
Like there's a lot of judgmentsthat you can feel even if
they're not spoken.
Mm-hmm.
Especially if you've alreadybeen feeling that guilt shame
cycle.
Mm-hmm.
You're gonna be looking for it.
You're more sensitive to it.
Mm-hmm.
It's a very hard thing to belike honest and vulnerable
about.
Mm-hmm.
But at least for a lot of us, Ican't speak for everyone, but
the more you are honest andvulnerable, the deeper

(29:25):
connections get the softer youare with yourself.
And I feel like when we'resofter to ourselves, other
people begin to be softer aswell.
Or at least I perceive it asmore softness.
No, I've seen it.
Yeah, I've seen it.
'cause I, I remember just tryingto plow through and just go, go,
go and try to run this business.
Like running around with my headcut off and then I got cancer
and I was like, yeah, not doingthis.

(29:46):
You're like, message receipts.
I didn't survive cancer to likemarket every morning Saturday
morning at 8:00 AM like notdoing that.
I will grow slow and steady andhonor my body.
And that, it's just funny'causeit's like I'm just now meeting
other business owners that feelthis way of like growing with
integrity, growing at a pacethat feels good for the nervous

(30:07):
system.
'cause I thought I was kind of.
Isolated for a long time.
'cause I was like this, none ofthis stuff resonates with me.
Right.
You know, in a way, in the wrongbusiness is this.
Yeah.
Surely somebody else is doing itthis way.
And I was like, I guess I'm justgonna do it and see what
happens.
And I just kept trusting my gutand it's just cool to kind of
see it all.
Like you just randomly calledme, you know?
And Aris it randomly called meand yeah.

(30:30):
I'm like, I mean, I did have anad out, but I don't even think
you saw the ad.
I didn't.
No.
Yeah.
So it's just, it's sointeresting because the universe
does honor you when you honoryourself and it can feel scary
at first to be like, oh my God,I'm gonna lose these things.
You might, yeah.
Right.
And that's okay because thoseweren't meant to be in your next
chapter.
Well, and hopefully it's even alittle more humorous.

(30:52):
Right?
Yeah.
Like looking back, there were somany things, my job before this
allowed me a little moreflexibility and less than 40
hours a week.
Mm-hmm.
I was like, okay, I am onlydoing three nines in an eight
and now I'm like, I would liketo do less.
Right?
Like, what does my nervoussystem need after that?
But I remember feeling so guiltyto myself and my partner that

(31:14):
like, oh, I'm not gonna make themoney.
I should because I can't workthe 40 hours.
Right.
And I would like run my salaryor pay based off 40 to try and
make myself feel better.
Like, and now looking back, I'mmaking more money than I was
when I was running around like achicken with my head cut off.
Like the lies that are so deeplyingrained in my nervous system,
looking back and being able tobe like, man, that was some

(31:36):
bullshit.
Mm-hmm.
Like, that's delightful.
How was I training as much as Iwas training, I mean, I was
training 50 to 80 people a week.
Yeah.
And then I was teaching on theweekends, and then I'd have to
take off that Monday to rest.
But everybody else kept goingand they were like, why?
Why do you need to slow down?
Why do you need Monday?
I'm like, how are you doingthis?

(31:56):
When are you doing laundry?
How do you see your friends?
When do you see your partner?
You know, and it's just like,God, we've really lost it.
I think I always go back and Isay this over and over again.
I always go back to the momentof the first day I was getting
chemo.
I look out the window and I go,why the fuck was I doing living
for everybody else?
Yeah.
You know?

(32:16):
And, and that's a whole notherlayer when you have chronic,
like autoimmune things going onand then you have to go through
chemo'cause that takes extralong to recover.
Yeah.
From like the average person.
And so it's like, but that's awhole nother podcast.
But I guess the point is that itdoesn't have to get to cancer to
change us, but it did for me.

(32:37):
And I am just so hugely anadvocate for getting people to
understand this before they getsick.
You know, people are gettingthere as a whole, I think
everyone's looking around a lotmore and saying like, I don't
think this works for me.
Yeah.
It's the millennials or no.
Are you a millennial?
I am technically, I'm ageriatric millennial.
Are you?
I think you look great Jerry.

(33:01):
No, I agree.
I think as a whole, as likecapitalistic culture isn't
working for these generations,it's not, we're like, okay, what
else needs to be changed?
Like apparently a lot you'resaying we're just like, I, I've,
I've said before as just we'rein this massive split'cause
capitalism's not working,patriarchy's not working.
And that doesn't mean men arebad.

(33:23):
It doesn't mean money's bad.
It just means that ourrelationships, it's, it's, it
means that we're not on thisearth to make money.
Like consistently to eventuallythen pay the person that's
highest at the highest, at thehighest.
Right.
It's like, how can we coexistwith a good amount of money?
How can we create lives aroundmaybe these illnesses that we

(33:47):
have?
Mm-hmm.
Or, um, the chronic fatigue orsupporting our nervous system.
'cause now there's more at like,there's more ways than ever with
ai.
Absolutely.
You have like a business coachfrom ai, you can set up all
these things that help your bodywhile you're making money and
doing these things in theinterim.
Yeah.
There's gonna be times wherethere's like, you know, you and

(34:09):
I were talking about this'causelike you're starting into a cash
practice when mm-hmm.
Before you were in an in-networkpractice where you're
in-network, you're gonnaimmediately have a full
caseload.
Yeah.
And here it's like a slow build,but it's like in that.
You know, and we're seeing, it'sactually not as much of a slow
build as we thought becauseyou're such a niche.
But we know that there's, thereis a little bit of a risk when

(34:32):
you switch that and it's scary.
And we have to work with ournervous system because it's an
investment for long term.
'cause the short term is, yeah,I guess I, I could go and work
for a corporation and just makemoney and definitely at, at the
expense of me working how manyhours, you know?
Absolutely.
And so.
There's, there's a lot to unpackwith that.

(34:53):
And it is, it's such a stretchand that feeling isn't fun or
comfortable.
Mm-hmm.
I think that is another lie.
I was told that at some point Iwould enjoy that feeling.
No, growth always sucks and Ifeel like we can market it on
the opposite side once you'rethrough it, but when you're in
the middle of all of thesechanges and unveiling all of
this stuff, it is a lot.

(35:14):
It's overwhelming.
Mm-hmm.
And I do think it's a hugeprivilege that I have.
I have fallbacks if I need them.
I have family that can supportme.
Like I truly don't know if mycurrent nervous system would be
this bold to try something thisdifferent if I didn't have
those.
Well, even if people don't havethose too, it's like there's
aspects of understanding how toapply for loans, right.

(35:38):
How to, like, there's grants,there's, um, use, if you have
good credit, you can lean oncredit cards like.
For like 0% interest for 15months sometimes to help people
get started or whatever theyneed to do.
I think we just don't look at itin this way.
We just think, oh my gosh, it'sso scary.
I don't have that.
And it's like, well, if you'vesaved up anything in your 401k,

(36:01):
you can take a loan out againstit.
Like, there's so many differentways that I've had to navigate
too.
Like, yes, I've had family helpsupport with, um, investing, and
then I will pay them back.
As you know, the businesscontinues to make money, but
it's not, it, it's not enough tokeep it, it, it was enough to
just like kind of keep thelights on at the beginning and

(36:21):
like as we would grow, but itwas never like it was, I had to
live off of other things.
So for me it was credit cards.
It was, um, you know, I didn'thave a par, I don't have a
partner.
I, um, thankfully I bought ahome and I had equity.
I could live off of that, butthen you still have to pay that
back.
Right.
But, so there's, even if youdon't maybe have the family

(36:44):
aspect, you know, there's,there's other ways to think too
about like, can you live with afriend that maybe can give you a
discount on rent and you helpwith other ways or do a trick?
You know, there's just so manythings outside the box that
we're not looking at.
We just think, oh my gosh, nomoney.
And, and that only benefitscapitalistic society.

(37:06):
I really Well, and it keeps metired enough to not wonder what
else there is.
Exactly.
Exactly.
Yeah.
And, and then, yeah.
And then when you speak up incorporate settings, it's like,
eh, you can leave.
Bye.
He's like, I shall.
Thank you.
Bye.
Um, okay, so let's go into whatways do neuro, in what ways can

(37:29):
you explain in what waysneurodivergent, such as a DH,
ADHD and autism intersect withhypermobility and how that
influences pain and sensoryprocessing and motor planning?
Absolutely.
I don't know the realpercentage, but it is something
crazy, like 50 50 if you happento have hyper-mobility or A DHD
or some type of a divergence.
Right.
A lot of women have been missed.

(37:49):
We're finding them better now.
Mm-hmm.
Same with hyper-mobility.
Men can have it too.
We just typically, I think whenmen present with symptoms, they
are more likely to be diagnosedfour times faster.
Mm-hmm.
Right.
Which can be four years fasterthan women because of our
hormones.
Because it could be this,because you are just anxious.
Right.
There's a lot more layers to it.

(38:11):
But no, for me, diNeurodivergence helped me get
towards my hyper mobility andthe science is kind of cool.
There is like.
In utero, when we're creatingour connective tissue, we're
creating our nervous system, theautonomic nervous system.
So they're happening cocurrently.
So if there is an extra stretchin one, there's an extra stretch
in the other.
And I think that is just crazyto kind of know, like, okay, it

(38:34):
can be a genetic code that wejust have.
We're not sure why theprevalence has increased.
Are we just better atdiagnosing?
I think we're better atdiagnosing.
I agree.
And we're less likely to put upwith, you know, the side effects
of living in a world that's notmade for us.
Totally.
We're all like, actually I'm,I'm looking for something else.

(38:54):
I think we're trailblazers, tobe honest.
And I do like thinking aboutwhen insurance, they could deny
you.
Mm-hmm.
Right.
Having a DHD could have been adenial thing.
So I think a lot of our oldergenerations are like, if that's
on your permanent record, I'mlike, that's really a valid.
Fear, fear for you guys.
'cause that could have kept youfrom healthcare.
Hopefully that's not thedystopian future we have.

(39:15):
Yeah.
I'm thankful for my A DH ADHDsometimes because I'm like, I, I
I, it, it pushes me, I think, inso many different levels.
Yeah.
That when people don't have it,I'm just like, oh, you don't
think that way?
Mm-hmm.
Okay.
I mean, it has its pros and itscons.
Like, of course I have clustersof like, you, like when you

(39:36):
moved in, I was like, uh, we'rejust gonna put this in the
drawer.
Correct.
I don't know where that goes,Kelly.
I put it in here if I ask later.
Thank you.
Yeah.
Kelly's our assistant, she's ourfront desk.
I'm like, uh, can you help mewith this?
And I can't look at it.
Yeah.
You know, there's pros and consto both, but I think it's so
interesting how in society withpeople that are A DHD or
autistic, like, we don't knowwhat to do.

(39:57):
Oh my God.
They're neurodivergent.
I even hate the wordneurodivergent, who?
You, I kinda like it hate aboutit because it's, it's like.
It's like a labeling that yourbrain is different than the
norm.
Right?
But what if our brains are thenorm?
I feel like we're going toovertake it at some point
because the world.
But who determines who's thenorm?
That's the thing.

(40:18):
No.
So that's why I don't, someonefrom like a hundred years ago,
so that's why I don't like theterm, because it's like it's
setting this, this thing oflike, oh, well this is the norm
and you're outside of it.
Right?
If we treated everybody asthough they were neurodivergent,
we'd have way more fun, way morecolor.
Oh my God.
And way more avenues andpathways, right?
That wouldn't feel so crazy orbold to do.

(40:40):
It would just be kind of normal.
My favorite sometimes withpeople that I'm friends with
that are autistic, I'm like, oh,you just like have this freedom
and this play of a child and Imean, not every person with
autism, I'm just saying like a,a theme I've seen is like, wow,
there's like this freedom oflike, whatever, like with

(41:00):
self-expression and just evencommunication.
It's so honest.
Yeah.
And to think that honesty is thenon norm, you're just like,
damn, that's unfortunate.
I, my brother, he is undiagnosedon the spectrum, but he, I mean,
he just like went up to like, Ithink it was like in high
school, he, this is when I firstrealized it.

(41:21):
He, he just went up to the mostpopular girl in school that he
like didn't even know when,asked her to prom.
And I was like, oh my God, youlike my anxiety for it?
Everybody was like, oh my god,Michael, like, and she said yes.
And we were like, what?
Oh my God.
It was so, that's impressive.
That was my first moment of.
Wow, what a gift.
That's awesome.
To just embrace life and just,you know, and don't have that

(41:47):
gift.
I'm working to undo those, thoselayers, those barriers of
worrying about what people thinkand all that stuff.
I think partially because, youknow, going through so many
health issues.
Yeah.
And you know, I think I'm what,seven years older than you or
something?
Something like that.
Something, yeah.
And then, and then on top ofthat, having the hormone

(42:08):
fluctuations, you don't haveenergy.
Like, especially if people arelistening or they have clients
that are perimenopause, likethere's no, there's no more
masking.
Well, and a lot of women willstart to get diagnosed around
this time.
Yeah.
Because the hormone deficit kindof undoes the, the.
Guards or the guardrails thatyou had, the co, it was coping
mechanisms, correct?
It wasn't.

(42:28):
It's not, I don't think, and I'mnot a specialist in diagnosing A
DHD, but in my experience whatit's been is like, oh, the
coping strategies don't workanymore.
Yes.
Something undoes them and I'm, Igo back and forth.
It would've been interesting tobe diagnosed younger.
Right?
Like, I think that'll be cool aswe learn more like, Hey, we're
diagnosing your kid with A DHD.

(42:50):
We're also gonna run a quickhypermobility screen.
I want you to know this iscomorbid.
Here are some signs to look outfor.
Like it will just help us beable to catch people more.
Yeah.
Sooner.
And then that helps yourself-esteem.
Right?
But like half of us, greatInstagram diagnosed us during
COVID TikTok, but like all ofthose random bumps and bruises,

(43:12):
that's introspection.
Um.
You know, sort of looking awayand dropping a thing or running
into door jams.
Yeah.
Like a bunch of our cute quirksend up being connectors to
something that can help usunderstand better of why
friendships haven't worked, whycertain job places haven't
worked.
It makes sense why these peopleare called to me and I honestly
think the hyper-mobilitypopulation because they are

(43:35):
weird by nature.
Yeah.
They love curiosity.
Yeah.
And they like fun language.
I can give muscles,personalities without judgment.
Yeah.
Personification.
And you can watch them followyour like Yeah.
Your brain pathway.
Yeah.
And you're like, thank you.
I feel they don't find it weird.
And then they feel like they canunmask, oh, it's so great.
And they create community.

(43:56):
I think autism.
In particular, right?
That diagnostic criteria is veryhard for adult women and adults
in general.
They are very accepting of selfdiagnoses.
Hypermobility can be diagnosed,but it is a financial burden and
a lot of hoops to go through.
That community's also reallyaccepting of self diagnoses.

(44:16):
Like, they're just like, you'rehere, you're a part of this.
Well, also, where do you evengo?
Right?
You know?
And like, okay, even the peoplethat treat this, like I know,
like I said, I know yourschedule's gonna fill up pretty
quick.
And I know that otherpractitioners that treat these
populations, they stay full.
And so sometimes people are onwait list, you know?

(44:36):
So at that point it's like,yeah, self-diagnosis is gonna be
important.
'cause none of my stuff has everbeen official.
Right.
I haven't done my, my, um,hypermobility.
I honestly'cause hypermobile,EDS even Yeah.
Doesn't have a.
Genetic marker.
Mm-hmm.
Right.
It has a criterion based on somehypermobility movements and a

(44:58):
history.
The brighten scale.
Yeah.
Yeah.
And some history, which cancancel out a lot of adults.
Right.
So I'll be like, Hey, what aboutas a kid, could you do that?
Great.
That helps.
But I think in general, knowinghypermobility spectrum disorder,
just HSD, can be a hugeconnector in a way for people to
get more information.

(45:19):
Well, I, you know, I, I justthink about patients that I've
treated in the past, and when Itell them, I'm like, Hey,
they're like, we have to becareful with our cues sometimes
too.
Yes.
I have to catch myself.
The classics don't work.
Yeah.
Like when people say, like, yourglutes not firing, please stop
saying that to people that arehypermobile because just keep
your core engaged.
They don't, they're because theinterception is impaired.

(45:43):
Mm-hmm.
There's this inability to knowhow to activate.
So then there can almost bethis, I don't know.
I don't know.
And then they can get moreanxious and just shut down.
Especially with classicmovements.
Yeah.
Like a squat is like, pleasedon't make me do a squat.
Yeah.
I don't know where I'm supposedto feel it.
This is how other people do it.
I've been told to do it thisway.
And you're like, where do youfeel it?
And they're like, I don't know.

(46:03):
Yeah.
And I'll catch myself, you know?
Of course.
And sometimes'cause people don'tknow that they are.
Yeah.
And so even in clinic, like, soif we're listening, if you're
listening as a movement orhealthcare professional, like
keep that in mind.
If somebody's not answering cuesor going with cues, sometimes
that can be overwhelming fortheir nervous system.
Like I, I remember, um, for, forme the first time was when.

(46:26):
I was doing planks at, at workone day and they were like, what
are you doing?
Oh no.
And I was like, what do you meanI look great?
You're doing a plank.
They're like, no, look in themirror.
And I was like, so dislike,connected.
And then, um, and then I did PTwith a, um, for my neck a while,
a couple years after.
And like the PT that was workingwith me was very like shameful.

(46:47):
Like, how do you not know this?
You're a pt.
Yeah.
And I was like, bitch, like getThat was hard in school.
Yeah.
Like, yeah.
That didn't feel good.
Mm-hmm.
And then you just shy away fromit.
You're like, forget it.
I'll just, but, or if I can't doa plank, I shouldn't be lifting
heavy then.
Yeah.
That's a poor correlation.
Lifting heavy actually gives youmore proprioception feedback.

(47:09):
Yeah.
It can actually be a veryhelpful avenue.
Yeah.
But if I can't move Right.
I'm not going into a commercialgem and looking like, you know,
the town idiot.
And there's reminds a barrierreminds, was it the friends
episode where Phoebe's runningor?
Yes.
Phoebe and Rachel go out forruns and Phoebe's doing it like
a mad woman.
I bet Phoebe was hypermobile.
Um, Phoebe had all thedivergences.

(47:30):
Yes, totally.
Yes.
Yeah, yeah, yeah.
She nailed it.
Yeah.
She gave us all the permissionto be weird.
Yes.
And to maybe even like findstrength in that.
Yeah.
And connection and realize thatyou can still have all these
friends and people still loveyou, like smelly cat ly.
Well, in some of my neurotypicalfriends, it's great'cause
they'll watch me do somethingand they'll be like, ha.

(47:52):
They're like, I'm gonna waittill you jiggle that door handle
three times and then you'regonna turn around and you're
gonna check it one more time.
I'm like, yes, I am.
Thank you for staying with me.
Like, that's community.
Yeah.
Well, it's also, it's notjudgment.
It's also important as partners.
Like I've dated people.
They're like, I've never datedsomebody that needed this much
rest.
And I was like.
Ew.
You can, or another one was, uh,another one was like, why?

(48:15):
Like why can't you just, it'sjust kind of getting old.
Can you just not, you know, or,and there's a balance, right?
Because I'm in a phase where I,I think I've realized a lot of
mine was low progesterone.
Yeah.
Because of Endo having a DHDand, um, chronic EBV and history

(48:35):
of pots.
Yes.
Which all, they all kind ofkinda intertwine together.
Um, not as much as thehypermobility, but it's.
Interesting.
Because it's like you have tohave that support do around you.
And we talk so much in healthabout, oh, this, this the way we
eat like this, or this movementand this.

(48:55):
But like the people around you,if you have a partner or a
friend that's like, please restYeah.
Call me.
Or I can just come over.
Oh my God.
For the nervous system.
Yeah.
That is such a gift.
Your zero battery friends.
That's true.
Or like a I'm so proud of you.
Yeah.
Like, I'll do that on my donothing days.
Like I take Wednesdays off formy brain.

(49:17):
Mm-hmm.
So I can have two days a day ofrest and then be Right.
I'm bushy tailed.
Right.
But some Wednesdays, Andrew willcome home from work and I'm
like, I did nothing.
And he's like, good job.
You know, like, I need to bepumped up.
But you need to hear thatsometimes.
Yeah.
Like, it's, it's this weirdpermission.
It is.
Um, it really is.
But then there's also a balancetoo, where I feel like my
parents, they're just, they're,they're great.

(49:39):
It's fine, but they would almostbe like, you need to rest.
You need to rest.
Right.
You need to rest.
So it was like this oppositething.
So I was like, so when Iwouldn't rest, I'd start getting
anxiety.
'cause they had like put it inmy head that I always need to
rest.
Like I was like this delicate,but then I'd be the athlete.
Yeah.
That was like going, go going.
And then it was, you need torest.
So it was almost like, what isthat?
They didn't know what to do withme.
They were like, you were alwayslike a sickly kid and we didn't

(50:00):
know why.
Um, and it's funny'cause I, youknow, in retrospect this all
starts to make sense.
But it, it is, it's funny'causeyou can over, there's also a
balance too, right?
Because it's like over restingcan almost be worse.
Hard to move again.
Yes.
What is rest?
Right?
Yeah.
For me, rest often looks likenot having to see people or talk

(50:23):
to people.
Yeah.
Doesn't mean I'm sitting in onespot robotically reaching,
charging.
I'm not like on my bed.
Yeah.
But like having my craft timeset aside.
Love it.
Like you have tinker time builtinto your life.
Mm-hmm.
If you wait for it to happen, itwon't.
Right.
Like there are so many differentforms of rest.
They're not always cute orInstagram worthy.

(50:44):
A lot of times it is rewatchingparks and rec 80 different
times.
A lot of times it is finding thethings that don't drain me.
Mm-hmm.
And allowing my body to say, oh,I would love to do that today.
Totally.
Or for me it was just like, uh,not even having like a booked
lunchtime.
Yes.
Like I realized I was getting,uh, dysregulated when I was not

(51:05):
having a set time to eat.
'cause I was like, oh, it willjust kind of naturally show up
and No, no, like lunchtime needsto be in there.
Correct.
Or I will get to that crashpoint and then you can't fix it.
Yeah.
You need a whole night of actualbrain rest Exactly.
To come back.
Yeah.
But finding those parameters andknowing that they're going to
change is a huge part of thateducation and introspection

(51:26):
piece.
Yeah.
And to just know like you'renever, it's honestly, a lot of
times I'll zoom out and be like,I have so many things on scales
balancing.
Mm-hmm.
It's overwhelming.
Mm-hmm.
But everything's in a balance.
Mm-hmm.
Nothing's ever just gonna stayperfect.
Mm-hmm.
There's always this constant ebband flow, but once your brain
and nervous system can acceptthat a little easier, it gets a

(51:47):
lot.
Softer and simpler to react tothat.
Yeah.
I think it's hard though, likefrom my experience, I don't
wanna identify with something,but I need to respect it.
Does that make sense?
I love that.
Yeah.
So it's like,'cause we can godown this rabbit hole of, oh, I
can't do that'cause I, I havechronic fatigue, or I can't do

(52:07):
this and it's right.
My alphabet soup gets in theway.
Yeah.
And it's like, okay, well howmuch of that is your
identification versus respectingthe symptoms?
Mm-hmm.
Like I am a huge advocate fornot identifying with the
illness, but respecting thesymptoms.
Exactly.
Because then if your symptomsstart getting better and you
start improving, you havenothing to identify with

(52:29):
anymore.
Like, as my fatigue startedimproving, I'm like.
What do I do with this time?
Thankfully, I didn't necessarilyidentify with it.
Yeah, but if you identify withit, if it's like your label on
Instagram and like this is whoyou are as, this is me, and it's
like how much, what are yourthoughts on that?
I think it can vary.

(52:51):
I think there's a lot of powerin the labels.
I think when I'm looking formyself.
Yeah, the labels aren't ashelpful when I'm trying to
explain myself to medicalproviders or to people.
If it's gotten to that pointwhere it's like, well, why are
you having that?
You're like, well, I had this inmy past.
Right.
Yeah.
EVV, I've had chronic fatigue inthe past.

(53:12):
I might be prone to it.
Mm-hmm.
Right?
Like you have that history thathelps explain how you got to
where you are.
Mm-hmm.
But also that feeling of, Ithink initially when we get a
label, it's like, oh, thank GodI have a label.
There's a ton of empowerment.
Hold onto it.
Yes.
Be empowered.
Yes.
And then it starts to soften andyou're like, now I am a person.
But especially later in life.

(53:32):
Yeah.
If you grow up with a label,like I was diagnosed dyslexic as
a kid, that was a shame label.
Like I never told anybody.
Yeah.
And I've seen that in my friendswith A DHD.
From childhood diagnoses,they're like, yeah, I'm not like
proud of that.
It's weird to have all you guyslike hyped to be diagnosed.
I'm like, that is a reallyinteresting perspective.
Like, yeah, I am more than thisdiagnosis, but it's like finding

(53:53):
out about a piece of my heritageor history.
It's a balance.
Yeah.
Yeah.
Yeah.
I get, yeah, yeah, yeah.
I, I like that.
I, I have answers, but I don'twant it to be my identity.
Like, I don't wanna be like, Iam a cancer survivor.
It's more of, I had cancer and Ilearned and grew from it.
Right.
I have endometriosis, but I amnot, I am not endometriosis.

(54:16):
Right.
Or like, if I cancel anappointment late, I'm not gonna
be like, I have a DH adhd.
I'm so sorry.
You know what I mean?
Like, yeah.
It's not an excuse.
It's not an excuse.
Right.
And that's a big thing.
'cause then when we make it anexcuse, then it, and then it
disqualifies or it disempowersother people who actually need.
The extra help in theirsituations.

(54:38):
Right.
It's like, well, and then itdisempowers you.
'cause then like you said, now Idon't have as much fatigue.
Am I allowed to do more?
Are people gonna be like, Ithought you were fatigued.
Yeah, but for me it's like, howmuch was mine?
Hormone dysregulation the wholetime.
I know which, being onprogesterone, I'm like bright
eye, bushy tail.
I'm like, oh hey, all of that.
Like PMDD, all of the new labelsthat we're getting.

(54:58):
Oh yeah.
It's huge.
Yeah.
Because yeah, it's, it's wild.
'cause it's like, yeah, there,there, I think there is a
balance.
'cause it's, there's a grief init too.
There's a grief in it and thenthere's an acceptance.
But then that acceptance, it'sknowing what it is to be able to
articulate it, but notnecessarily like letting it
control your life.
I agree.
How can you make it coexist inthis world with it while still

(55:22):
honoring the symptoms?
But, does that make sense whatI'm saying?
Yeah, absolutely.
And I think,'cause I've gonedown that road and it was very
disempowering.
Yeah.
And I think a lot of women wouldrelate to that.
Yeah.
As well as men, but especiallywomen who typically get labeled
with something so that they'llleave a medical office.
Yeah.
Right.
Like, here's a word for it, gobe.

(55:43):
Mm-hmm.
It is, it's definitely a thing,but we don't have a ton of
examples of how to live withthat balance.
Yeah.
No, I, I think that the socialmedia is helping, I almost think
sometimes too, like there's,there is a balance of
oversharing.
Mm-hmm.
And having your pain be yourbrand.

(56:05):
Absolutely.
Um, but.
Yeah, I think people just haveto figure out what works for
them.
That's it.
And I share my step just to beopen about it, to let other
people know, Hey, you can run abusiness.
Right?
Hey, guess what?
Like you can be like, live ahappy life.
Like you can do all thesethings, but in order to get to
that side, we have tounderstand, well what are the

(56:26):
things that you're like evenfrom a nervous system that
you're masking?
Yes.
Who is around you?
All those things.
Then also like understandingfrom the medical side, okay,
well what are the things that weneed?
What medications do we need tobe on?
What are supplements that peoplemight be helpful?
And I'm not a huge advocate forbeing on a million supplements,
just like the specific ones,like, um, like DIM for a lot of,

(56:47):
oh, I'm on DIM right now.
Yeah, DIM ISS gonna help peoplebreak down estrogen more so you
don't have as many of the PMM DDsymptoms and help with, um,
perimenopause.
So, um, I have an episode onestrogen dominance to listen to
on that, but DIM and vitamin Dfor me, yeah, are big ones.
Vitamin D in women too.
Mm-hmm.
Like that's a metric that hasn'tbeen adjusted appropriately.

(57:10):
No.
I mean mine's still like normal,but it's low end.
And then you need vitamin K tohelp it absorb.
Yes.
And we've known that for a longtime.
Yeah.
But it's not something that hasbeen prescribed or educated on
Well, I think as PTs Yeah.
Like we need to know this stuff.
I know.
And I think it's not that we'represcribing it per se, it's

(57:30):
like, hey, this is something tobe aware of.
Consult with your doctor.
'cause you don't wanna be givingpeople vitamin K if they're
already on.
Right.
Any blood.
Any blood thinners.
So it's more of having,'causeyou know this existed this Yes.
To do those people, we get totell them.
Yeah.
Yeah.
We have so much time one-on-oneto get into weird random stuff.
Well, it depends what settingyou're in.
True.

(57:51):
In our setting, yes.
We built our clinic in order tohave a bunch of that time.
Yeah alright, so how doesphysical therapy, like what are
some things that you've seenhelpful for addressing the needs
of hypermobility pots andneurodivergence?
I think a huge chunk of it isbeing able to interconnect those

(58:12):
different alphabets that theymight have.
Right?
Being able to connect, Hey, thisis why those two go together.
What types of scales do theytend to mention?
Right.
Pain can be one I find moreoften.
It's like fatigue.
Or that delayed onset musclesoreness, right?
Mm-hmm.
After two days, very common inthe hypermobile community where
it's like, I worked out, I feltfine.

(58:33):
Two days later I've hit a wall.
Yeah.
Why post exertional malaise?
You've got it.
Oh yeah.
And then it's like, okay, howcan we measure that?
How can we come up with scalesthat make you feel empowered to
find patterns not to feel shame?
Right, and to go, okay, this isa low energy day.
What types of exercises can I doon a super low energy day?

(58:54):
That'll look different for everyhuman, especially pots, right?
Sometimes it's a ton of lyingdown exercises.
I know I need to move, but Iknow if I do too much, it'll
come at a cost.
So let me try this simplermobility and activation and go
from there, right?
A lot of it is finding out whatcan I do safely?
What can I replicate at home?

(59:14):
And what tends to make like acertain pain or rib feeling go
away.
Being able to have like thattoolbox of, okay, you feel that
you do this, that flow chartidea of when you're in pain,
your body just sort of goes, donothing.
Then it will start to connect.
Hey, when I'm in pain, Iactually do feel better if I do
blank.
And then a lot of tools in thetoolbox, a ton of proprioceptive

(59:36):
input.
Um, a greater understanding ofyou need that midday rest break.
That's not laziness, that'sactually going to help your
energy level.
Um, but I think overall.
A huge chunk of it is explainingwhy those traditional patterns
may have not worked out, or whya workout routine works one day
and then is brutal the nextweek.

(59:57):
And just having that ability togo, oh, I can be softer with
myself.
It's nothing I'm doing wrong.
Yeah.
But then it's a lot of likeweird exercises.
I'll tell a lot of my people, ifan exercise isn't working, it's
not you, it's the exercise.
Make it weirder.
Make it harder.
Yeah.
A lot of us are under loaded interms of hypermobility or this

(01:00:18):
other chronic stuff.
Right.
We're like, I'm fragile.
I'm a I'm an orchid.
It's like, no.
Well that's, that's kind of whatI was saying before about the
identifying is like, you'restill strong.
You're still like a human.
Yeah.
You're not, you know, like it's,it's not being fragile.
It's more about how to balanceyour strength and what works for
you.
Exactly.
Yeah.
But especially for runners, Ithink that's a huge one.

(01:00:39):
'cause it can, especially in thehypermobile community.
They can have such a reboundeffect.
But if it's their passion andit's how they mentally feel
great, it's like, okay, how canwe work with that in the
construct?
What type of rest or recovery doyou need to be able to do that?
But that would also be for potstoo.
Absolutely.
Yeah.
Because that's something I'venoticed is like with running,
like some days I can do it andthen if you push beyond your

(01:01:02):
like toast for a few days.
Yeah.
I thought having like migraineor headache after a run was that
wall everyone kept talking aboutis not, it's just not for my
body.
Yeah, it's, it also just doesn'tload through my joints.
Well, it's never a muscularsore.
Well, I think it's importantfrom like a movement rehab
perspective because.
What, so we're not gaslightingthem.

(01:01:23):
Yeah.
Because that post exertionalmalaise is so real.
And I have, you can haveterrible consequences.
I would have loved to be able toexercise and max out, like, not
even max out, but just like goto the gym every day and lift
heavy weights.
Like when people do that, I'mlike, oh, what a, that would be
so cool.

(01:01:43):
It would, but it's just not forme Post post mono.
It was like, no.
Well, and we're finding,especially for women, it's not
that beneficial for you to dofour days a week.
You can get more benefit withtwo.
I know we're seeing that, butthat's just the way my brain
works.
When I see people like that workout every day like, this sounds
great, but I'm also like, howmuch are they pushing past their

(01:02:04):
limits?
Right.
And how much, how are theirhormones doing too?
Because gentle movement, evenjust walking, get that live
flow, right.
Get your blood sugar regulatedlike walking is so underrated.
It is.
It really is.
For numerous reasons.
It's honestly.
It too simple.
I think in a lot of our brainslike it can't do all that.

(01:02:24):
It can't.
It's magic.
Yes.
Especially at walking for 10minutes after you eat and like
our culture's not set up for it.
Yeah.
So then we don't know it.
But that's what most Europe.
Europe does it.
I mean, that's how they'rebuilt.
Yeah.
It's pretty awesome to think.
How much easier, like at thelast time?
I'll see that a lot.
The last time we all had awalkable community was probably

(01:02:45):
college.
Yeah.
You have a campus, you walk tothe mess hall, you walk to your
classes In dorm, like that isour American grade.
We weren't skinnier in collegeor like more fit because um, of
any, like, it's just like wewere walking more.
Absolutely.
And absolutely not promotingskinny by any means, but more of
like if we're all of a suddengaining weight after college.
I think it's more about,especially for athletes.

(01:03:08):
Yeah.
Oh, athletes.
Oh yeah.
Yeah.
That you're, you're, yourcaloric intake is not matching
your exercise, so you see thatas well, like a massive increase
of weight gain.
That's huge with that.
I definitely have seen that forsure.
And then just finding out thetricks, right?
For me, using bands is huge.
It has to be a strong enoughband, right?

(01:03:28):
Mm-hmm.
Like we need stronger bands thathave that.
Nice.
And I also am a sensory child.
Like, I don't like the rubberones.
I need the cloth ones with thenice gel on the inside.
'cause I'll use them.
Mm-hmm.
Like my body will avoid ickysensory feelings.
Yeah.
I won't do that.
Exercise.
Like the tags on your shirtstoo.
Yeah.
Oh my God.
I can't.
Well, and I think a lot ofpeople will be like, well, I, I

(01:03:49):
don't like the way that feels.
They can be honest.
Like, I literally won't do thatbecause it requires one inch of
setup.
Yeah.
Or my foam roller is hiddenaway.
It's like, great.
Put it in a corner.
Mine moves in the house so thatit's always new.
Yeah, I see it in a new spot.
And I think to use it, if Ileave it in the same spot, my
brain will ignore it.
Well, that's working with the ADH adhd, like there's a lot of

(01:04:09):
trips.
I think when people think a DHADHD only medication, medication
doesn't really work for me.
It just makes me extra anxious.
I can't think as clearly.
Um, but you know, other people,it might work great.
It works great for my body.
Yeah.
But for me, I just have neverbeen able to really tolerate
something consistent.
Mm-hmm.
But for me, it's making thingsfun.
Like my, my drink, my water isfun.

(01:04:31):
I You keep laughing about our Ohyeah.
Your, your spiky water.
That's the best.
Um, making things fun.
Like even in the clinic, we'regetting all these sensory
things, like the overheadspinning.
We we're gonna get some overheadspinning, um, kinetic art, adult
mobiles and adult mobiles.
Yeah.
They're mobiles.
Right, right.
Yeah.
Yeah.
I, I wanna make sure I alwayssay these things wrong, but.

(01:04:54):
We we're providing a sensoryexperience.
Like we want people when theycome in, the lights are a
certain way.
Like you're not overstimulated.
It's quiet when I need that.
Yeah.
I need it too.
That's why I made this, thisclinic.
I was like, I wanna, this is thebrightest room we have.
This is a bright room because ofrecording.
Yes.
Um, but,'cause if we turned thisdown, we wouldn't, we'd be at

(01:05:15):
the dark.
Right.
It would be a little too weird.
Yeah.
But this is the dark, like thisroom.
And we have a lot of naturalsunlight because I was like,
what do I need?
Because if I need this, I canguarantee you our patients need
it.
Well, and like that feeling ofyour nervous system, when
someone's anxious and I'mbuilding off of it, like you can
feel that clash and it helpsnobody.
But if I'm in an environmentwhere I can stay a lot more

(01:05:36):
regulated, it ends uptransferring to the patient.
It does.
And they'll, they'll mention it,which I love.
Yeah.
But no, I think for anyindividual that comes in our
door, it's all aboutpersonalizing it to them.
Finding what works and then.
Knowing that it's not alwaysgonna work.
Mm-hmm.
What tweaks do we need to addin?
We're in your back pocket.
If something goes awry, playwith this.

(01:05:57):
And when the next layer revealsitself, we have more time that
we can focus on that.
Mm-hmm.
Yeah.
And unwinding.
Yeah.
Well, I love that.
I do too.
I'm excited you're with us.
And I, I'm so thankful.
Every day I'm like, oh my gosh,this is real.
Like, you're here, Arista's.
Here, Kelly's here.
Cameron's on maternity leave,but she'll be coming back to
help with nutrition and it'sjust, it's uh, it's really cool

(01:06:20):
because I just thought, likenever, I would've thought seven
years ago I'd be making like asensory kind of.
Um, a sensory experience in theclinic and people may not be
able to notice it right away,but the whole, the feeling I
want people to feel when theycome in is this, I'm okay,
right?
I want to be here.

(01:06:40):
Yeah.
I'm welcome here.
Yes, because I've, I've yet tofind a healthcare space that has
been decorated and, and has thewarm, inviting.
Feel that we have, and maybe I'mjust tooting my own horn, but I
just, I worked really hard totoot away toot toots.
Oh, toots another way.
It's too, it's healthy, butit's, it's real.

(01:07:02):
And so anything from, if you'relistening, and these are
populations that you treat,being aware of your
environments, sounds, smells,colors, like bright colors are
not, they're not for these typesof settings.
And being aware, like if it'snot working for you as a
provider Yeah, it's not workingfor your patients.
Yeah.
Yeah.
I mean, look on Pinterest, findsome colors.

(01:07:23):
Look at like light colors,greens, we have light pinks,
we've got browns.
Like those are calming colors.
And, and, and just thinkingabout how that feels, like
having really, like things likeart that looks really sharp,
that can look scary for peopletoo, and more rounded things are
gonna be helpful.
And just like these littledetails of how to have a sensory

(01:07:43):
clinic is super important.
I feel like I could do a wholenother episode on that.
Yeah, that would be fun.
Oh my gosh.
We could do a tour, a sensorytour.
I love it.
Oh my gosh.
We should totally do that.
But I just, I love like decortoo, so it just blends.
So I'm like, wait, I get to dothis for the clinic too.
Ugh.
It's so cool.
Helps when you follow yourintuition and you just trust

(01:08:06):
your gut and yeah, there havebeen plenty of times I've fallen
into fear and.
Made business decisions Ishouldn't have made, opened up a
second clinic I shouldn't have.
You know, there's so manydifferent things that I've
learned and now I'm like nevernot listening to that little
voice again.
Right.
So, and that voice getsstronger.
It does.
When you start listening more.
It's real limited though.

(01:08:27):
Hmm?
The voice feels a lot like othervoices initially.
Well, yeah, it's sitting, well,you have to be regulated first
and it's more of like, what isthe little voice that keeps
coming up over and over, notlike it came up today.
It's more of how many times am Ihearing this over and over?
And then the decision's gonna,it's a little, can I gut kinda

(01:08:49):
leaning for me?
It's how it feels in the gutthough.
'cause a lot of stuff happensright there.
Yeah.
For me, I feel like it's a senseof lightness.
Yeah.
It's a sense of would my futureself be proud?
Even though this is really hardright now.
Would she be proud?
And if it's the hell yeah, thenit's a, we're doing it, we're
gonna deal with the pain of itand push through.

(01:09:09):
I love that.
So thank you again.
Thank you for having me.
And if you all wanna find her,you can find her on our rep
website.
Website website, uh resilientrx.com.
And her and our Instagram isResilient rx.
And then your Instagram is Learnwith Dr.
Jill.
You got it.
So cool.
Thank you so much.

(01:09:30):
Yeah, thank you.
Thank you so much for listeningto my podcast.
It would be a huge help if youcould subscribe and rate the
podcast.
It helps us reach more peopleand make a bigger impact.
I would also love it if youcould join my email list, which
is LinkedIn, the caption forpodcast updates, upcoming offers
and events.
You can also find me on TikTok,YouTube and Instagram at Dr.

(01:09:53):
Mary pt.
Thanks again.