Ehlers-Danlos Syndromes (EDS) frequently affect the feet and ankles due to connective tissue laxity (loose ligaments), causing instability, pain, and structural changes. Because the body’s connective tissues are more fragile, the feet often cannot support the body properly, leading to structural failures and a high rate of foot-related disabilities.
Common Foot Problems in EDS
- Flat Feet (Pes Planus): An estimated 55% of individuals with EDS experience flat feet, where the arches collapse.
- Ankle Instability: Weak ligaments lead to chronic ankle pain, instability, and frequent sprains or “rolling” of the ankles.
- Plantar Fasciitis: A common source of chronic heel and foot pain, frequently reported by EDS patients.
- Toe Deformities: Issues such as hammer toes, hallux valgus (bunions), or long/slender toes (arachnodactyly) are common, which may be exacerbated by structural changes.
- Skin Fragility/Easy Bruising: The skin on the feet can be fragile, with slow wound healing, and in some, premature aging of the skin.
- Nerve Issues: Small fibre neuropathy can cause a burning sensation or “pins and needles” in the feet.
- Poor Circulation: Some experience Raynaud’s phenomenon, causing toes to turn white or blue due to poor blood flow.
Management and Treatment Strategies
- Podiatry Care: Specialized care is essential for assessment, gait analysis, and tailored treatment.
- Orthotics: Custom-made foot orthotics are recommended to support arches, reduce pain, and improve function.
- Footwear: Stability or motion-control shoes are generally recommended to provide a firm base and support the ankle.
- Physical Therapy: Exercises to strengthen the muscles surrounding the foot and ankle, along with proprioceptive training, can improve stability.
- Management of Skin/Infections: Antifungal sprays may be used for fungal infections (athlete’s foot) that can occur, especially if toes are deformed and difficult to dry, but powders and creams should be used cautiously.
Why EDS Affects Feet
Ligament laxity means that gravity constantly pulls on these loose structures, causing them to collapse, which then triggers compensatory pain in the knees, hips, and lower back.
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