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

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!

Transcript

0:00

Hello everyone and welcome back to TMI talk with Dr. Mary. I'm your host, Dr. Mary. Today I brought on Dr. Jill Stevenson, an orthopedic and pelvic floor physical therapist who also specializes in hypermobility and pots. She is a physical therapist that currently works with me at Brazilian RX in Austin, Texas, and she's a new addition to our team and is. Filled with a wealth of knowledge. And so I brought her on today to talk about pots, Ehlers Danlos, hypermobility, neurodivergence, and how all of these things intersect and the best ways that we can help our patients and clients that are working with these diagnoses. So her and I speak about our experiences with A DHD and history of pots. She also has hypermobility, so she shares a little bit about her story as well. I. We navigate these personal challenges, how it's made us more aware, more, more curious, and more compassionate as clinicians to understand what it's like not just from a clinician standpoint, but also from a patient standpoint. We'll dive into what it means to treat patients with LERs, danlos, and hypermobility disorders, and why the traditional rehab model often misses the mark for this population. Dr. Jill also explains how pot shows up beyond the textbook definition, how it impacts energy, movement, tolerance and recovery, and why nervous system regulation has to be a part of the plan. We explore often overlooked link between hypermobility. Neurodivergence and nervous system dysregulation and how A DHD and autism traits can change the way people experience in their bodies and how they respond differently to treatment. We also talk about how to recognize sensory overwhelming patients and how it's important to have a sensory safe clinic if you are working with this population. So without further ado, I'm really excited for you all to learn more about what we do at Resilient rx, but also if you're listening as a clinician, how you can better help your patients in this population. And if you are somebody listening who is has any of these diagnoses, I believe you'll benefit a lot from this as well. So without further ado, we'll jump into the episode. Welcome back to TMI talk with Dr. Mary where we dive into non-traditional forms of health that were once labeled as taboo or dismissed as Woo. I'm your host, Dr. Mary. I'm an orthopedic and pelvic floor physical therapist who helps health. Movement and rehab professionals integrate whole body healing by blending the nervous system into traditional biomechanics to maximize patient outcomes. I use a non-traditional approach that has helped thousands of people address the deeper roots of health that often get overlooked in conventional western training. And now we are gonna be starting our next episode. Well, welcome to the podcast, Jill. Thank you for having me. I was so excited you're here. I am too. It's finally real. I know. We've, uh, Jill reached out a few 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 you all. And she's got a lot of information, a lot of great things to help us from a PT perspective on how to help patients with hypermobility, LERs, danlos, and pots. And I truly believe our profession, you're uplifting our profession by. It helping us all learn. Oh, I appreciate that. It's nice to be somewhere where it's encouraged and we have the time to really get into so many layers. Yeah. And so much education for patients. Yeah. And other providers. I think that's huge. Totally. Yeah. Well, we'll go ahead and jump right in. Let's do it. All right. So can you explain what POTS is and how it presents clinically? So for people that are unaware, POTS is post orthostatic tachycardic syndrome. Exactly. Yeah. So pots, especially in post COVID is coming up a lot more. So we're gonna see more research on it hopefully in the next five to 10 years. But basically it's a cardiovascular and autonomic nervous system piece, right. That nervous system that's trying to regulate our breath, our blood pressure, heart rate temperature regulation is a huge one here in Texas and it's when the autonomic nervous system. Struggles to react appropriately and can even react in an unhelpful way. Right? So in POTS specifically, it's gonna have that postural component. So a lot of times standing or moving from sitting to standing, like that lightheaded feeling, or the, um, you know, your eyes go black for a minute. If you ever experienced that from moving too quick, blood pressure drops in a healthy, I shouldn't say healthy, in a more normal nervous system, the blood pressure is going to constrict those distal. Um, veins and help you get more heart rate up in an appropriate way. Mm-hmm. That's gonna return your pressure to normal and help you be able to move efficiently in the autonomic nervous system, the vessels can't constrict in an appropriate way. So the heart sweet little thing tries to help out more. She pumps faster. So the clinical, clinical would be like a 30 beats per minute, more increase for like a solid 10 minutes after being laying down. Right. That means the body is really trying hard to get that blood pressure back up, but it basically ends up feeling like anxiety or that racing thoughts feeling, and it can often lead to syncope or fainting. Doesn't happen to everybody, but it's definitely a huge fatigue factor for a lot of my patients. Yeah. I mean, it wasn't until like a couple 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 Epstein Barr virus goes with, with, um, pots. You've got, I have endometriosis. Well, usually there's like these clusters Absolutely. Of people that have different types of autoimmune or undiagnosed, like from a western, generalized western medicine perspective. A lot of these people get missed. And I remember just being told to go on an antidepressant and uh, just to keep pushing myself and I kept flaring up and feeling like I was gonna need to pass out. Yeah. To reset. Yeah, yeah, yeah. I would do that as a kid. It was honestly better to pass out than to avoid it sometimes. Yeah.'cause that fatigue just wouldn't leave. When did you first notice that you had pots? I mean, it wasn't called pots then, right? It was just like, what? Yeah. Syncope, uhhuh. So they were basically like, you know, your, your vaso, your vascular system and your vagus nerve aren't cooperating. So it's an autonomic disautonomia. Right? Mm-hmm. That's gonna be the umbrella term for something like pots. Um, the clinical diagnosis is kind of, you know, hard to find someone who wants to do on you. And I feel like a lot of my people, if you have the symptoms, we can do a quick testing clinic, but you can normally see it. It's normally very based on their report. Yeah. They'll tell you. Yeah. I mean it's pretty, and then they've gone through all of this extensive testing usually and people, but yeah, my first one was at Six Flags. Oh yeah. I scared the shit outta my sister, but we were waiting in line, it was hot and I was watching like one of those big old rides that goes back and forth the ship. Yeah. And I don't know if it was that input or what if I was standing with my legs locked out. I really don't know. I was like. Maybe 13. Yeah. But yeah, it just went black and I was on the ground and my adorable uncle Bear was carrying me 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 why knees locking out would make a difference? Absolutely. Especially if you have an excess in range of motion of your knees. If you lock them out, you're really not allowing the venous system to pump. It only works to get back to the heart through our musculoskeletal system. So when we're standing still or there's been a prolonged stagnancy, your blood is more likely to be pooling. Plus it's a hot day humid up in Dallas, Texas and probably hadn't had enough water or salt that day to help me maintain my water mass. I've been to that Six Flags. Yeah. Even in May. And I was like, they had to shut down half the rides'cause it was so hot. Aw. See, back then it hadn't gotten that terrible, right? Oh, it's 20 years ago. Oh my gosh. Yeah. Yeah, I mean I bet that was scary. Like that's scary when you don't know what's happening. So especially if we run into patients, you know, if for practitioners or movement professionals that are listening, if you are hearing these types of things from your clients, it often happens after a virus as well. Like mine was after Epstein Barr. We're seeing it after COVID. Totally. Um, you're seeing it perimenopause. Yes. With hormone changes. Huge. What are some other common times that you're seeing it? I think a lot of times too, like chronic or times of deconditioning, whether or not it was intentional or from an illness, right. Trying to get back into your normal, trying to go right back to your normal level and your body creates that crash or that bust cycle where you go, go, go, you're trying to break through that wall like you were talking about. Like surely it's on the other side of this and it turns out it's just a wall. And then you're splatted, you literally hit a wall. Like it is like cartoon splat. I was like a, like a college athlete 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 to do 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 of protection response. Yeah. Within our central nervous system because it's a central nervous system disorder. Mm-hmm. So of course I'm a little anxious about it. That's keeping me upright. That's gonna help me not have to pass out. Yeah. That's, that's just like functioning day to day. Now add on any other anxiety or stress or things like that. And that's why that spoon theory, I think is important for people dealing with chronic, um, diseases, lifelong, you know, that are ongoing. It's just that, you know, on the days. Like most people generally don't understand how chronic illness works. There's only so much energy. People that have multiple conditions can have in a day. Mm-hmm. Sometimes they have 10 spoons that they can use. Absolutely. Sometimes they have two. So you have to con helping them conserve energy is gonna be super important. Even deciding what you're gonna stress out about, you know, who you surround yourself with. Are people doubting you? Do you have a work environment that's supportive and that's supportive of the nervous system? Or do they constantly stress you out and overwork you? Like there's so many things, even just outside of just the basic day to day or that just living in the body well and all of that requires a huge amount of like introspection and being able to actually tell where I'm at. If your body's always a little anxious and you've been told it's just anxiety, you get really good at just kind of ignoring it. Like that's normal. Yeah. Anxiety's a symptom. It is not a freaking disease. 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 that anxiety as a helper, as like a, hey, a little warning. And if you start to listen to me, I'll warn you gentler five steps ahead of this. Yeah. Or how about we just put you on an antidepressant and ignore it? Well, that could fix it. Yeah. That's, it's just like the way that I look at this, and I've said this before, is like, it's like putting on headphones when there's a fire alarm. Right. And I love that, even like using the term, I used to use the term, I have anxiety. Everybody has anxiety. So then I was starting to identify with it. It's like, no, my body's giving me signals. And so if we have patients that are coming in and they're anxious, you know, teaching them nervous system regulation to help calm their nervous system and even nervous system regulation, but that's. That's not addressing the cause. Right. Either. So, so in order to understand why it's dysregulated, we need to be regulated first and then we can look at, okay, well what in my environment, what did I do? What did I eat? What was my sleep like? Like being able to collect all of this information. Well, I think so many of us are like, 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 can frequently be in like kindergarten. Yeah. And if you've had all of this stuff and you didn't have a label for it and that awful Instagram where it's like you've inherited your mother's nervous system, it's like, how are we supposed to win at this? Yeah. No, but finding those techniques at a younger age or even learning how breath works within the body mm-hmm. Would've been hugely helpful I think to me.'cause I was told to do breath and I was just breathing through the chest. Yes. Well then if you're bracing all the time. You can't actually, I'll get it. Where, when I first started doing breath work, I kept feeling lightheaded and everyone's like, just keep going through. And I'm like, yes, I feel like I'm good. If is somebody gonna call 9 1 1 because I'm gonna pass out? And it's like your fascist chronic fight or flight, your fascist stuck down.'cause the fascia tightens because the body thinks, oh, it knows two things. Yeah. It knows am I running from a bear or am I safe? Got it. And so you're telling people with anxiety to breathe, but we're not giving them that rib expansion to be able to that. And that's even with people that are hypermobile.'cause that fascia's gonna stick. It needs to, yeah. Mm-hmm. Yeah. It's gotta stay aware. Yeah. So it's even more paramount to actually let it stretch safely, but then finish with activation and support. Mm-hmm. To make sure you're not a limp noodle. Yeah, exactly. But no, I agree. And I think all people, but especially those born as female, 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 of like what a belly breath looked like. Yeah. Until yoga got really popular and then it was. Yeah. Yeah, it's interesting. All of it's so interesting'cause it's like, it, it's, it's multifactorial. A lot of this tends to happen more to people born and as women. Um, but in that, there's cultural things on top of this too, right? So there's, so, there's so many things. So the, if we're that first touch point, that validates'em, that explains even just a little bit, they love that information, right? I mean, just to know I'm not crazy. I mean, I'm in healthcare and I've been in the system. I've worked in it, and it wasn't until like three years ago or something like that, that I really 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 for people and helping them navigate the system and know, hey, no, you're not crazy. But then now that we know you're not, and that the symptoms do line up, where can we help direct you? And that's why since you've joined us, you know, I'm reaching out to people in the community being like, Hey, who can be partners with, with us to help you? So cardiology and rheumatology and things like that. Because not every cardiologist is aware of this. Not every rheumatologist is either Correct. And gi I think GI is huge in terms of mm-hmm. That connective tissue and fascia. Yeah. And the bracing and the anxiety piece, like of course and hormone regulation. Mm-hmm. Right. We're learning way too much about gut health and I have. Like less tools in that community. Rheumatology sometimes can be better at looking at that systemic inflammation for the gut. Mm-hmm. So it is, I think, finding your people who are curious that you don't have to convince. Right? Yeah. And similar for patients, they walk in instead of spinning the whole visit, they're armored, right? They come in ready, they're like, I know I have this, well, they have their list of stuff. They're like, here. Well, and they've already triaged. Yeah. They're like, I'm only gonna tell you two things. So you don't think I'm insane? Yeah. But these are the two things I'd like to address. Yeah. And instead of having to spend a visit proving their dysfunction, you get to have a provider that's like, I already believe you. Let's start getting through the weeds. Let's start figuring shit out. But also that's, that's wild for them though, too, right? Because they're like, what? Yeah. I don't need to convince you that is connected. I thought it was, it's like, yes, all of it is correct and I will, and rewarding that. Rewarding the ability to feel those connections. Yes. That's one of my favorites. Like I, I'm just so impressed with people, their intuition when I'm like, yes, keep doing that. I'm like, tell me more. Yes, yes. I'm like, you just, you labeled it all for me and now I get to be a mirror. Like that's when it's really nice. Yeah. But I think most people who have lived in a body that hasn't made sense to other providers, they often know much more than the person in front of them. I a thousand. The amount of times I've been told, I don't know if you've experienced this. Oh, I've never heard that before. Abso, oh, that's not true. That's, that can't happen. Yeah. That's actually not how that works. What do you wanna do? They'll ask me. I'm like, yeah, what did I just pay for? Correct. That's not how hormones work. Do we know? Yeah. Or all of these blood tests were like. 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 still don't have menopause figured out. We really don't. We're trying finally, hopefully it continues. Yes. And I am so thankful and I think we are gonna continue because there are enough women like ready to invest and we have more women with more money than ever. So Absolutely. The tables are, and hey, it's not, it's, it's, it's half the population is literally going through, going to go through this. Crazy. I'm excited y'all are gonna have it all figured out by the time I'm there. I know, I know. I'm like I told you I'm in perimenopause. I'm, I'm, I'll give you all my tips. Do the work for me. Yeah. Thank you. why would you say, so for people listening, can you explain why POTS is common with people with hypermobility or L or Danlos? Absolutely. So POTS itself is relying on the venous system and the connective tissue in it to respond appropriately. If you have a change in connective tissue, you could have a change in how your vessel vessels contract. There are certain types of EDS, right? There's like 18 types that can be within that. Cardiovascular based EDS is definitely one I would send for genetic testing if I had. Any inkling that it could be a thing, right? Because then we're talking about mitral valve prolapse or aortic dissections and a lot of other connective tissues that I would wanna have a very close a carotid too. Exactly. In terms of in like upper cervical 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 neck sharply. Like it could literally result in something bad. It gives you the ability to set your boundaries, but no, for POTS in general, they're gonna be so closely linked. I think from that standpoint of just the tissues and the introspection part, and honestly for me, the A DHD neurodivergent side, I never know when I'm thirsty until I am drinking water because I'm supposed to, or my husband has informed me that I haven't had water that day. Right? Yeah. Like I don't know when I'm hungry, I think. We grew. I grew up in the nineties. There was a lot of that, like low calorie, zero salt. It turns out we need a good amount of salt. We need, so if you're a little psy, we need So salt. Yeah. Like all of those. And it's not just water. The electrolyte. Yeah. Like we treat it in higher level athletics. It should just be a basic for a lot 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 a place that's sweaty. Mm-hmm. Constantly sweating here. Yeah. Can you explain to them how, why electrolytes would help? Absolutely. So just plain water, it can increase our volume, but it doesn't have the beneficial electrolytes to actually keep us moving. So it's not the dramatic term. Right. It would be you can drown in your own water because I can't absorb it well. Mm-hmm. The salt helps bind to it and helps you stay actually hydrated in your cells. Right. You're not just voiding constantly. Although I do think for our pelvic floor side, urine output is a great metric of, Hey, are you actually getting enough water? Or is your body kinda holding onto it and never letting you void?'cause it's recognizing it's in a deficit. So like if they're not paying enough. Yeah. Yeah. Or if they're like, I never really have to pee. It's like, that surely can't be true. Let's delve into that. Yeah. Yeah. And it can just be like another beneficial external marker. I am always looking for my external markers. Yeah. Well, what are some other external markers you're looking at? Um, I mean, so silly, but standing up and feeling that woozy feeling, it's like, I think that's silly. Ooh. You know, a little Phoebe moment from friends and then you drink some water with electrolytes. Mm-hmm. There are a bunch of little ones. For me, having people be the external has been the biggest help. Right. My mom trained me at a young age like baby girl, when I tell you to eat something, it is not because I'm being mean to you. It's not because you're being annoying, it's'cause I can tell you're fading. And I give a lot of close family and friends that same allowance. Like, Hey, if I'm irritable or a little bitchy, remind me, maybe I haven't eaten and I need some water'cause my moods changes like that. Oh yeah. I'm just more prone to that crash cycle. But how much of that though, like,'cause hangry to me is a lot of blood sugar dysregulation as well. Absolutely. And that's what I'm excited to learn about. More so from your side with the hormone and blood sugar part. Yeah. Because I do think that's a piece of it, but now I'm recognizing what snack do I actually crave a salty one? Mm Right. Like finding out which pieces I'm actually needing craving. Exactly. Well, and I think that's what's important too, is we've really bypassed our intuition in healthcare and understanding like what our body's messages are. And so. You know, I first learned this from some of my, um, colleagues like years ago where I was just like, Hey, I'm just craving sweets all the time. I'm constantly feeling depleted. And they're like, oh, you might have insulin resistance. And then my doctor had said that too, and I was like, oh my gosh, well what's that? And I went down this whole rabbit hole and basically your body is just constantly going into this glucose if you don't have any protein or fat to help stabilize. And then it's basically, the insulin is just not responding. It's just not as, our body's not sensitive to it. Right? So, so then we have more glucose in our bloodstream. Um, but typically like if you have, um, walking after meals are gonna help with that. It's gonna help use the glucose muscle. Muscle mass is gonna be super important. This is why we see this in perimenopause. Yes. Um, so gaining muscle,'cause muscle uses that glucose. Mm-hmm. So that's why people that are more muscular, not all the time, but if they have more muscle mass, they're more apt to be more sensitive to insulin. So we need insulin to be working. But I think it's important to note too, from like a pot standpoint as well.'cause if your blood, if your blood sugars spiking and then crashing mm-hmm. Your autonomic nervous system's gonna go into fight or flight as well. And a lot of times I can't eat a big meal. Mm-hmm.'cause then all of my blood is working there. I'm more prone to feeling potsy after. Mm. Right. Yeah. Like if you ever eat and then you feel like crap. There's a lot of reasons it could be. But if it's like, I need to lay down with my legs up. And I think that's been a barrier in learning like. It's kind of a full-time job eating. I have to plan my day around those little meal breaks in order to keep that. Well also too is like the density of the food. Mm-hmm. You know, if we're like carb heavy, it's gonna be more dense. If it's gonna be a lighter food, chewing food to apple sauce. Consistency as well to make it easier on the digestive process. So there's so many like little things that we can do even before medication. And I'm not anti-medication. I'm just like, Hey, let's, let's see what our body can do first and then add on any medications that we need from that. So then you're not on a million different types of medications, you're just on the ones that are specific to, to you. You. Um, but yeah, so blood sugar's gonna be a big one. That one also happens a lot in perimenopause as well. But I think that was a game changer for me with my fatigue was the blood sugar regulation. And I, I found that out through the blood glucose monitor you might get a lot, I think people get a lot of information from that, trying not to obsess about it, like doing it a few weeks and seeing, hey, what is causing my blood sugar to spike and stay spiked?'cause for me, it wasn't what I was eating. It was actually like my, uh, cortisone inhaler. No way. Uhhuh. Yeah. Oh, that's unfortunate. Yeah. So I just switched to just another type that was non cortisone and it was fine. Cool. Um, the other one is if I had more than one cup of coffee in one sitting. If I did two, it was spiked the rest of the day. So technically I wasn't eating sweets. Right. And so then that was causing me to crash and feel like kinda shit at the end of the day. Mm-hmm. Then you feel like pulling in your feet. Yeah. And things like that. So it's really interesting. And that might have even been some perimenopause, like, I'm so exhausted, I need this extra cup of coffee. Mm-hmm. And then it comes at a greater cost. Well, it's your, like my buddy was just telling us the other day, just how you're stealing from your future with the caffeine. It's like if I, I get the energy now, but then I'm stealing it from my sleep later. Yeah. But then it's like, well, I'm tired. How do I get through the day? Okay, well you get to decide like, is there some days I still like, you know, I'm trying to wean from caffeine, but Yeah. Well sometimes we'll use it, but also it's like why is our body depleted? Right? Is it hormonal? Is it electrolytes, is it water? Is it blood pooling like or impaired lymphatic drainage and. And these different messages. So it's like what you were saying is like, what are my messages? And that's that interception which 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 probably the hardest relationship if you've always had blood tests and it's like, well, you're normal. It's like, but my body is telling me I'm not. Do I need to ignore that? Or like coming out of a nervous system that's heightened, you're gonna go back and forth. Right. But your body and nervous system kind of think same. Good, better. No thank you. Worse. Nah. Right? I'd rather stay exactly where I am. This is safe. Mm-hmm. Even if it's not our optimal zone. So a lot of us turn to living there, which means, hey, I'm less likely to get injured and roll my ankle'cause I'm so hypervigilant. Right? Mm-hmm. But I have to be like, there's so many things, a lot of hypermobile people have to. Constantly be aware of that drains them and they don't even know they're doing it. Or that normal people don't have to,'cause you've never had a different body. Mm-hmm. Right. So I think a, a lot of our introspection could get tied up in literally just trying to exist without spraining something. Right. Well, even that, and then environments too, like nothing, everything's set up for able-bodied people. Like my bro, I have two brothers and the one that just passed, I mean, I've scanning environments just for, oh my God, he would never be able to get through that door or. You know, you're just, and that'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 these boxes that healthcare has just set us in, even if we're not in a wheelchair. I mean, the disabilities like walking further, you know? Yeah. Um, being able to maneuver in awkward, like cars, I'm sure people having children getting in their car and like taking the kiddo out. Like these are like little details. Everything is so made for like this one particular like person who doesn't have any of these things. And yeah. It's the constant environment. Not, and then add on. It's overwhelming the, the stress of canceling because you're tired, right? Having people looking flaky. Mm-hmm. Yes. I think. Yeah. Two, like there is a reward for learning better introspection and getting to that place, but it takes way too damn long for that reward to come along. Mm-hmm. There's a ton of grief in the meantime. Yeah. Of being like, I can't actually work 40 hours a week. Like what a failure. That feels like. Mm-hmm. There's a lot of dismantling that 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 always canceling. Yeah. It's like, yeah. I've been trying to give my body permission to let me know when it doesn't feel up to it. I've had, yeah, I've had to like just. N like the people that don't like it, I'm like, sorry. Yeah. I just, I can't, I'm not, I agree. And if you can't and if you gimme shit, I'm like, we're not, I can't keep doing this. Like Correct. Just add it to my list of corks. I am, yeah. I am a list of corks that I at least now can label and name. Yeah. But starting to like unmask is more of a neurodivergent term, but I do think there's a lot of that in hypermobility, right? Like, oh, I have another rib out. Like I have to go get it adjusted for my pt or somebody else. Like, yeah, I need to leave work again. Like there's a lot of judgments that you can feel even if they're not spoken. Mm-hmm. Especially if you've already been 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 be like honest and vulnerable about. Mm-hmm. But at least for a lot of us, I can't speak for everyone, but the more you are honest and vulnerable, the deeper connections get the softer you are with yourself. And I feel like when we're softer to ourselves, other people begin to be softer as well. Or at least I perceive it as more softness. No, I've seen it. Yeah, I've seen it.'cause I, I remember just trying to plow through and just go, go, go and try to run this business. Like running around with my head cut off and then I got cancer and I was like, yeah, not doing this. You're like, message receipts. I didn't survive cancer to like market every morning Saturday morning at 8:00 AM like not doing that. I will grow slow and steady and honor my body. And that, it's just funny'cause it's like I'm just now meeting other business owners that feel this way of like growing with integrity, growing at a pace that feels good for the nervous system.'cause I thought I was kind of. Isolated for a long time.'cause I was like this, none of this stuff resonates with me. Right. You know, in a way, in the wrong business is this. Yeah. Surely somebody else is doing it this way. And I was like, I guess I'm just gonna do it and see what happens. And I just kept trusting my gut and it's just cool to kind of see it all. Like you just randomly called me, you know? And Aris it randomly called me and yeah. I'm like, I mean, I did have an ad out, but I don't even think you saw the ad. I didn't. No. Yeah. So it's just, it's so interesting because the universe does honor you when you honor yourself 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 those weren't meant to be in your next chapter. Well, and hopefully it's even a little more humorous. Right? Yeah. Like looking back, there were so many things, my job before this allowed me a little more flexibility and less than 40 hours a week. Mm-hmm. I was like, okay, I am only doing three nines in an eight and now I'm like, I would like to do less. Right? Like, what does my nervous system need after that? But I remember feeling so guilty to myself and my partner that like, oh, I'm not gonna make the money. I should because I can't work the 40 hours. Right. And I would like run my salary or pay based off 40 to try and make myself feel better. Like, and now looking back, I'm making more money than I was when I was running around like a chicken with my head cut off. Like the lies that are so deeply ingrained in my nervous system, looking back and being able to be like, man, that was some bullshit. Mm-hmm. Like, that's delightful. How was I training as much as I was training, I mean, I was training 50 to 80 people a week. Yeah. And then I was teaching on the weekends, and then I'd have to take off that Monday to rest. But everybody else kept going and they were like, why? Why do you need to slow down? Why do you need Monday? I'm like, how are you doing this? 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 I say this over and over again. I always go back to the moment of 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? And, and that's a whole nother layer when you have chronic, like autoimmune things going on and then you have to go through chemo'cause that takes extra long to recover. Yeah. From like the average person. And so it's like, but that's a whole nother podcast. But I guess the point is that it doesn't have to get to cancer to change us, but it did for me. And I am just so hugely an advocate for getting people to understand this before they get sick. You know, people are getting there as a whole, I think everyone's looking around a lot more 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 a geriatric millennial. Are you? I think you look great Jerry. No, I agree. I think as a whole, as like capitalistic 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're saying we're just like, I, I've, I've said before as just we're in this massive split'cause capitalism's not working, patriarchy's not working. And that doesn't mean men are bad. It doesn't mean money's bad. It just means that our relationships, it's, it's, it means that we're not on this earth to make money. Like consistently to eventually then pay the person that's highest at the highest, at the highest. Right. It's like, how can we coexist with a good amount of money? How can we create lives around maybe these illnesses that we have? Mm-hmm. Or, um, the chronic fatigue or supporting our nervous system.'cause now there's more at like, there's more ways than ever with ai. Absolutely. You have like a business coach from ai, you can set up all these things that help your body while you're making money and doing these things in the interim. Yeah. There's gonna be times where there's like, you know, you and I were talking about this'cause like you're starting into a cash practice when mm-hmm. Before you were in an in-network practice where you're in-network, you're gonna immediately 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's actually not as much of a slow build as we thought because you're such a niche. But we know that there's, there is a little bit of a risk when you switch that and it's scary. And we have to work with our nervous 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 make money and definitely at, at the expense of me working how many hours, you know? Absolutely. And so. There's, there's a lot to unpack with that. And it is, it's such a stretch and that feeling isn't fun or comfortable. Mm-hmm. I think that is another lie. I was told that at some point I would enjoy that feeling. No, growth always sucks and I feel like we can market it on the opposite side once you're through it, but when you're in the middle of all of these changes and unveiling all of this stuff, it is a lot. It's overwhelming. Mm-hmm. And I do think it's a huge privilege that I have. I have fallbacks if I need them. I have family that can support me. Like I truly don't know if my current nervous system would be this bold to try something this different if I didn't have those. Well, even if people don't have those too, it's like there's aspects of understanding how to apply for loans, right. How to, like, there's grants, there's, um, use, if you have good credit, you can lean on credit cards like. For like 0% interest for 15 months sometimes to help people get started or whatever they need to do. I think we just don't look at it in this way. We just think, oh my gosh, it's so scary. I don't have that. And it's like, well, if you've saved up anything in your 401k, you can take a loan out against it. Like, there's so many different ways that I've had to navigate too. Like, yes, I've had family help support with, um, investing, and then I will pay them back. As you know, the business continues to make money, but it's not, it, it's not enough to keep it, it, it was enough to just like kind of keep the lights on at the beginning and like as we would grow, but it was 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't have a par, I don't have a partner. I, um, thankfully I bought a home and I had equity. I could live off of that, but then you still have to pay that back. Right. But, so there's, even if you don't maybe have the family aspect, you know, there's, there's other ways to think too about like, can you live with a friend that maybe can give you a discount on rent and you help with other ways or do a trick? You know, there's just so many things outside the box that we're not looking at. We just think, oh my gosh, no money. And, and that only benefits capitalistic society. I really Well, and it keeps me tired enough to not wonder what else there is. Exactly. Exactly. Yeah. And, and then, yeah. And then when you speak up in corporate settings, it's like, eh, you can leave. Bye. He's like, I shall. Thank you. Bye. Um, okay, so let's go into what ways do neuro, in what ways can you explain in what ways neurodivergent, such as a DH, ADHD and autism intersect with hypermobility and how that influences pain and sensory processing and motor planning? Absolutely. I don't know the real percentage, but it is something crazy, like 50 50 if you happen to have hyper-mobility or A DHD or some type of a divergence. Right. A lot of women have been missed. We're finding them better now. Mm-hmm. Same with hyper-mobility. Men can have it too. We just typically, I think when men present with symptoms, they are more likely to be diagnosed four times faster. Mm-hmm. Right. Which can be four years faster than women because of our hormones. Because it could be this, because you are just anxious. Right. There's a lot more layers to it. But no, for me, di Neurodivergence helped me get towards my hyper mobility and the science is kind of cool. There is like. In utero, when we're creating our connective tissue, we're creating our nervous system, the autonomic nervous system. So they're happening co currently. So if there is an extra stretch in one, there's an extra stretch in the other. And I think that is just crazy to kind of know, like, okay, it can be a genetic code that we just have. We're not sure why the prevalence has increased. Are we just better at diagnosing? I think we're better at diagnosing. I agree. And we're less likely to put up with, you know, the side effects of living in a world that's not made for us. Totally. We're all like, actually I'm, I'm looking for something else. I think we're trailblazers, to be honest. And I do like thinking about when insurance, they could deny you. Mm-hmm. Right. Having a DHD could have been a denial thing. So I think a lot of our older generations are like, if that's on your permanent record, I'm like, that's really a valid. Fear, fear for you guys.'cause that could have kept you from healthcare. Hopefully that's not the dystopian future we have. Yeah. I'm thankful for my A DH ADHD sometimes because I'm like, I, I I, it, it pushes me, I think, in so 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 its cons. Like, of course I have clusters of like, you, like when you moved in, I was like, uh, we're just 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 our front desk. I'm like, uh, can you help me with this? And I can't look at it. Yeah. You know, there's pros and cons to both, but I think it's so interesting how in society with people that are A DHD or autistic, like, we don't know what to do. Oh my God. They're neurodivergent. I even hate the word neurodivergent, who? You, I kinda like it hate about it because it's, it's like. It's like a labeling that your brain is different than the norm. Right? But what if our brains are the norm? I feel like we're going to overtake it at some point because the world. But who determines who's the norm? That's the thing. No. So that's why I don't, someone from like a hundred years ago, so that's why I don't like the term, because it's like it's setting this, this thing of like, oh, well this is the norm and you're outside of it. Right? If we treated everybody as though they were neurodivergent, we'd have way more fun, way more color. Oh my God. And way more avenues and pathways, right? That wouldn't feel so crazy or bold to do. It would just be kind of normal. My favorite sometimes with people 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 I mean, not every person with autism, I'm just saying like a, a theme I've seen is like, wow, there's like this freedom of like, whatever, like with self-expression and just even communication. It's so honest. Yeah. And to think that honesty is the non norm, you're just like, damn, that's unfortunate. I, my brother, he is undiagnosed on the spectrum, but he, I mean, he just like went up to like, I think it was like in high school, he, this is when I first realized it. He, he just went up to the most popular girl in school that he like didn't even know when, asked her to prom. And I was like, oh my God, you like 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 gift. I'm working to undo those, those layers, those barriers of worrying about what people think and all that stuff. I think partially because, you know, 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 of that, having the hormone fluctuations, you don't have energy. Like, especially if people are listening or they have clients that are perimenopause, like there's no, there's no more masking. Well, and a lot of women will start to get diagnosed around this time. Yeah. Because the hormone deficit kind of undoes the, the. Guards or the guardrails that you had, the co, it was coping mechanisms, correct? It wasn't. It's not, I don't think, and I'm not a specialist in diagnosing A DHD, but in my experience what it's been is like, oh, the coping strategies don't work anymore. Yes. Something undoes them and I'm, I go back and forth. It would've been interesting to be diagnosed younger. Right? Like, I think that'll be cool as we learn more like, Hey, we're diagnosing your kid with A DHD. We're also gonna run a quick hypermobility screen. I want you to know this is comorbid. Here are some signs to look out for. Like it will just help us be able to catch people more. Yeah. Sooner. And then that helps your self-esteem. Right? But like half of us, great Instagram diagnosed us during COVID TikTok, but like all of those random bumps and bruises, that's introspection. Um. You know, sort of looking away and dropping a thing or running into door jams. Yeah. Like a bunch of our cute quirks end up being connectors to something that can help us understand better of why friendships haven't worked, why certain job places haven't worked. It makes sense why these people are called to me and I honestly think the hyper-mobility population because they are 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 follow your 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 can unmask, oh, it's so great. And they create community. I think autism. In particular, right? That diagnostic criteria is very hard for adult women and adults in general. They are very accepting of self diagnoses. Hypermobility can be diagnosed, but it is a financial burden and a lot of hoops to go through. That community's also really accepting of self diagnoses. Like, they're just like, you're here, you're a part of this. Well, also, where do you even go? Right? You know? And like, okay, even the people that treat this, like I know, like I said, I know your schedule's gonna fill up pretty quick. And I know that other practitioners that treat these populations, they stay full. And so sometimes people are on wait list, you know? So at that point it's like, yeah, self-diagnosis is gonna be important.'cause none of my stuff has ever been 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 some hypermobility movements and a history. The brighten scale. Yeah. Yeah. And some history, which can cancel out a lot of adults. Right. So I'll be like, Hey, what about as a kid, could you do that? Great. That helps. But I think in general, knowing hypermobility spectrum disorder, just HSD, can be a huge connector in a way for people to get more information. Well, I, you know, I, I just think about patients that I've treated in the past, and when I tell them, I'm like, Hey, they're like, we have to be careful with our cues sometimes too. Yes. I have to catch myself. The classics don't work. Yeah. Like when people say, like, your glutes not firing, please stop saying that to people that are hypermobile because just keep your core engaged. They don't, they're because the interception is impaired. Mm-hmm. There's this inability to know how to activate. So then there can almost be this, I don't know. I don't know. And then they can get more anxious and just shut down. Especially with classic movements. Yeah. Like a squat is like, please don't make me do a squat. Yeah. I don't know where I'm supposed to feel it. This is how other people do it. I've been told to do it this way. And you're like, where do you feel it? And they're like, I don't know. Yeah. And I'll catch myself, you know? Of course. And sometimes'cause people don't know that they are. Yeah. And so even in clinic, like, so if we're listening, if you're listening as a movement or healthcare professional, like keep that in mind. If somebody's not answering cues or going with cues, sometimes that can be overwhelming for their nervous system. Like I, I remember, um, for, for me the first time was when. I was doing planks at, at work one day and they were like, what are you doing? Oh no. And I was like, what do you mean I look great? You're doing a plank. They're like, no, look in the mirror. And I was like, so dislike, connected. And then, um, and then I did PT with a, um, for my neck a while, a couple years after. And like the PT that was working with me was very like shameful. Like, how do you not know this? You're a pt. Yeah. And I was like, bitch, like get That was hard in school. Yeah. Like, yeah. That didn't feel good. Mm-hmm. And then you just shy away from it. You're like, forget it. I'll just, but, or if I can't do a plank, I shouldn't be lifting heavy then. Yeah. That's a poor correlation. Lifting heavy actually gives you more proprioception feedback. Yeah. It can actually be a very helpful avenue. Yeah. But if I can't move Right. I'm not going into a commercial gem and looking like, you know, the town idiot. And there's reminds a barrier reminds, was it the friends episode where Phoebe's running or? Yes. Phoebe and Rachel go out for runs and Phoebe's doing it like a mad woman. I bet Phoebe was hypermobile. Um, Phoebe had all the divergences. Yes, totally. Yes. Yeah, yeah, yeah. She nailed it. Yeah. She gave us all the permission to be weird. Yes. And to maybe even like find strength in that. Yeah. And connection and realize that you can still have all these friends and people still love you, like smelly cat ly. Well, in some of my neurotypical friends, it's great'cause they'll watch me do something and they'll be like, ha. They're like, I'm gonna wait till you jiggle that door handle three times and then you're gonna 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 not judgment. It's also important as partners. Like I've dated people. They're like, I've never dated somebody that needed this much rest. And I was like. Ew. You can, or another one was, uh, another one was like, why? Like why can't you just, it's just 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 DHD and, um, chronic EBV and history of pots. Yes. Which all, they all kind of kinda intertwine together. Um, not as much as the hypermobility, but it's. Interesting. Because it's like you have to have that support do around you. And we talk so much in health about, oh, this, this the way we eat like this, or this movement and this. But like the people around you, if you have a partner or a friend that's like, please rest Yeah. 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 do nothing days. Like I take Wednesdays off for my brain. Mm-hmm. So I can have two days a day of rest and then be Right. I'm bushy tailed. Right. But some Wednesdays, Andrew will come home from work and I'm like, I did nothing. And he's like, good job. You know, like, I need to be pumped up. But you need to hear that sometimes. Yeah. Like, it's, it's this weird permission. It is. Um, it really is. But then there's also a balance too, where I feel like my parents, they're just, they're, they're great. It's fine, but they would almost be like, you need to rest. You need to rest. Right. You need to rest. So it was like this opposite thing. So I was like, so when I wouldn't rest, I'd start getting anxiety.'cause they had like put it in my 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 to rest. So it was almost like, what is that? They didn't know what to do with me. They were like, you were always like a sickly kid and we didn't know why. Um, and it's funny'cause I, you know, in retrospect this all starts to make sense. But it, it is, it's funny'cause you can over, there's also a balance too, right? Because it's like over resting can almost be worse. Hard to move again. Yes. What is rest? Right? Yeah. For me, rest often looks like not having to see people or talk to people. Yeah. Doesn't mean I'm sitting in one spot robotically reaching, charging. I'm not like on my bed. Yeah. But like having my craft time set aside. Love it. Like you have tinker time built into your life. Mm-hmm. If you wait for it to happen, it won't. Right. Like there are so many different forms of rest. They're not always cute or Instagram worthy. A lot of times it is rewatching parks and rec 80 different times. A lot of times it is finding the things 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 having a set time to eat.'cause I was like, oh, it will just kind of naturally show up and No, no, like lunchtime needs to be in there. Correct. Or I will get to that crash point and then you can't fix it. Yeah. You need a whole night of actual brain rest Exactly. To come back. Yeah. But finding those parameters and knowing that they're going to change is a huge part of that education and introspection piece. Yeah. And to just know like you're never, 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 stay perfect. Mm-hmm. There's always this constant ebb and flow, but once your brain and nervous system can accept that a little easier, it gets a lot. Softer and simpler to react to that. Yeah. I think it's hard though, like from 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 go down this rabbit hole of, oh, I can't do that'cause I, I have chronic fatigue, or I can't do this and it's right. My alphabet soup gets in the way. Yeah. And it's like, okay, well how much of that is your identification versus respecting the symptoms? Mm-hmm. Like I am a huge advocate for not identifying with the illness, but respecting the symptoms. Exactly. Because then if your symptoms start getting better and you start improving, you have nothing to identify with anymore. Like, as my fatigue started improving, I'm like. What do I do with this time? Thankfully, I didn't necessarily identify with it. Yeah, but if you identify with it, if it's like your label on Instagram and like this is who you are as, this is me, and it's like how much, what are your thoughts on that? I think it can vary. I think there's a lot of power in the labels. I think when I'm looking for myself. Yeah, the labels aren't as helpful when I'm trying to explain myself to medical providers or to people. If it's gotten to that point where it's like, well, why are you having that? You're like, well, I had this in my past. Right. Yeah. EVV, I've had chronic fatigue in the past. I might be prone to it. Mm-hmm. Right? Like you have that history that helps explain how you got to where you are. Mm-hmm. But also that feeling of, I think initially when we get a label, it's like, oh, thank God I have a label. There's a ton of empowerment. Hold onto it. Yes. Be empowered. Yes. And then it starts to soften and you're like, now I am a person. But especially later in life. 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 friends with A DHD. From childhood diagnoses, they're like, yeah, I'm not like proud of that. It's weird to have all you guys like hyped to be diagnosed. I'm like, that is a really interesting perspective. Like, yeah, I am more than this diagnosis, but it's like finding out about a piece of my heritage or history. It's a balance. Yeah. Yeah. Yeah. I get, yeah, yeah, yeah. I, I like that. I, I have answers, but I don't want it to be my identity. Like, I don't wanna be like, I am a cancer survivor. It's more of, I had cancer and I learned and grew from it. Right. I have endometriosis, but I am not, I am not endometriosis. Right. Or like, if I cancel an appointment 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 an excuse, then it, and then it disqualifies or it disempowers other people who actually need. The extra help in their situations. Right. It's like, well, and then it disempowers you.'cause then like you said, now I don't have as much fatigue. Am I allowed to do more? Are people gonna be like, I thought you were fatigued. Yeah, but for me it's like, how much was mine? Hormone dysregulation the whole time. I know which, being on progesterone, I'm like bright eye, bushy tail. I'm like, oh hey, all of that. Like PMDD, all of the new labels that we're getting. 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 in it too. There's a grief in it and then there's an acceptance. But then that acceptance, it's knowing what it is to be able to articulate it, but not necessarily like letting it control your life. I agree. How can you make it coexist in this world with it while still honoring the symptoms? But, does that make sense what I'm saying? Yeah, absolutely. And I think,'cause I've gone down that road and it was very disempowering. Yeah. And I think a lot of women would relate to that. Yeah. As well as men, but especially women who typically get labeled with something so that they'll leave a medical office. Yeah. Right. Like, here's a word for it, go be. Mm-hmm. It is, it's definitely a thing, but we don't have a ton of examples of how to live with that balance. Yeah. No, I, I think that the social media is helping, I almost think sometimes too, like there's, there is a balance of oversharing. Mm-hmm. And having your pain be your brand. Absolutely. Um, but. Yeah, I think people just have to figure out what works for them. That's it. And I share my step just to be open about it, to let other people know, Hey, you can run a business. Right? Hey, guess what? Like you can be like, live a happy life. Like you can do all these things, but in order to get to that side, we have to understand, well what are the things that you're like even from a nervous system that you're masking? Yes. Who is around you? All those things. Then also like understanding from the medical side, okay, well what are the things that we need? What medications do we need to be on? What are supplements that people might be helpful? And I'm not a huge advocate for being on a million supplements, just like the specific ones, like, um, like DIM for a lot of, oh, I'm on DIM right now. Yeah, DIM ISS gonna help people break down estrogen more so you don't have as many of the PMM DD symptoms and help with, um, perimenopause. So, um, I have an episode on estrogen dominance to listen to on that, but DIM and vitamin D for me, yeah, are big ones. Vitamin D in women too. Mm-hmm. Like that's a metric that hasn't been adjusted appropriately. No. I mean mine's still like normal, but it's low end. And then you need vitamin K to help it absorb. Yes. And we've known that for a long time. Yeah. But it's not something that has been 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're prescribing it per se, it's like, hey, this is something to be aware of. Consult with your doctor.'cause you don't wanna be giving people vitamin K if they're already on. Right. Any blood. Any blood thinners. So it's more of having,'cause you know this existed this Yes. To do those people, we get to tell them. Yeah. Yeah. We have so much time one-on-one to get into weird random stuff. Well, it depends what setting you're in. True. In our setting, yes. We built our clinic in order to have a bunch of that time. Yeah alright, so how does physical therapy, like what are some things that you've seen helpful for addressing the needs of hypermobility pots and neurodivergence? I think a huge chunk of it is being able to interconnect those different alphabets that they might have. Right? Being able to connect, Hey, this is why those two go together. What types of scales do they tend to mention? Right. Pain can be one I find more often. It's like fatigue. Or that delayed onset muscle soreness, right? Mm-hmm. After two days, very common in the hypermobile community where it's like, I worked out, I felt fine. 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, how can we measure that? How can we come up with scales that make you feel empowered to find patterns not to feel shame? Right, and to go, okay, this is a low energy day. What types of exercises can I do on a super low energy day? That'll look different for every human, especially pots, right? Sometimes it's a ton of lying down exercises. I know I need to move, but I know if I do too much, it'll come at a cost. So let me try this simpler mobility and activation and go from there, right? A lot of it is finding out what can I do safely? What can I replicate at home? And what tends to make like a certain pain or rib feeling go away. Being able to have like that toolbox of, okay, you feel that you do this, that flow chart idea of when you're in pain, your body just sort of goes, do nothing. Then it will start to connect. Hey, when I'm in pain, I actually do feel better if I do blank. And then a lot of tools in the toolbox, a ton of proprioceptive input. Um, a greater understanding of you need that midday rest break. That's not laziness, that's actually going to help your energy level. Um, but I think overall. A huge chunk of it is explaining why those traditional patterns may have not worked out, or why a workout routine works one day and then is brutal the next week. And just having that ability to go, oh, I can be softer with myself. It's nothing I'm doing wrong. Yeah. But then it's a lot of like weird exercises. I'll tell a lot of my people, if an 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 in terms of hypermobility or this 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 what I was saying before about the identifying is like, you're still 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 balance your strength and what works for you. Exactly. Yeah. But especially for runners, I think that's a huge one.'cause it can, especially in the hypermobile community. They can have such a rebound effect. But if it's their passion and it's how they mentally feel great, it's like, okay, how can we work with that in the construct? What type of rest or recovery do you need to be able to do that? But that would also be for pots too. Absolutely. Yeah. Because that's something I've noticed is like with running, like some days I can do it and then if you push beyond your like toast for a few days. Yeah. I thought having like migraine or headache after a run was that wall everyone kept talking about is not, it's just not for my body. Yeah, it's, it also just doesn't load through my joints. Well, it's never a muscular sore. Well, I think it's important from like a movement rehab perspective because. What, so we're not gaslighting them. Yeah. Because that post exertional malaise is so real. And I have, you can have terrible consequences. I would have loved to be able to exercise and max out, like, not even max out, but just like go to the gym every day and lift heavy weights. Like when people do that, I'm like, oh, what a, that would be so cool. It would, but it's just not for me Post post mono. It was like, no. Well, and we're finding, especially for women, it's not that beneficial for you to do four days a week. You can get more benefit with two. I know we're seeing that, but that's just the way my brain works. When I see people like that work out every day like, this sounds great, but I'm also like, how much are they pushing past their limits? Right. And how much, how are their hormones doing too? Because gentle movement, even just walking, get that live flow, right. Get your blood sugar regulated like 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 brains like it can't do all that. It can't. It's magic. Yes. Especially at walking for 10 minutes 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're built. Yeah. It's pretty awesome to think. How much easier, like at the last time? I'll see that a lot. The last time we all had a walkable community was probably college. Yeah. You have a campus, you walk to the mess hall, you walk to your classes In dorm, like that is our American grade. We weren't skinnier in college or like more fit because um, of any, like, it's just like we were walking more. Absolutely. And absolutely not promoting skinny by any means, but more of like if we're all of a sudden gaining weight after college. I think it's more about, especially for athletes. Yeah. Oh, athletes. Oh yeah. Yeah. That you're, you're, your caloric intake is not matching your exercise, so you see that as well, like a massive increase of weight gain. That's huge with that. I definitely have seen that for sure. And then just finding out the tricks, right? For me, using bands is huge. It has to be a strong enough band, right? Mm-hmm. Like we need stronger bands that have that. Nice. And I also am a sensory child. Like, I don't like the rubber ones. I need the cloth ones with the nice gel on the inside.'cause I'll use them. Mm-hmm. Like my body will avoid icky sensory feelings. Yeah. I won't do that. Exercise. Like the tags on your shirts too. Yeah. Oh my God. I can't. Well, and I think a lot of people will be like, well, I, I don't like the way that feels. They can be honest. Like, I literally won't do that because it requires one inch of setup. Yeah. Or my foam roller is hidden away. It's like, great. Put it in a corner. Mine moves in the house so that it's always new. Yeah, I see it in a new spot. And I think to use it, if I leave it in the same spot, my brain will ignore it. Well, that's working with the A DH adhd, like there's a lot of trips. I think when people think a DH ADHD 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 never been able to really tolerate something consistent. Mm-hmm. But for me, it's making things fun. Like my, my drink, my water is fun. I You keep laughing about our Oh yeah. Your, your spiky water. That's the best. Um, making things fun. Like even in the clinic, we're getting all these sensory things, like the overhead spinning. We we're gonna get some overhead spinning, um, kinetic art, adult mobiles and adult mobiles. Yeah. They're mobiles. Right, right. Yeah. Yeah. I, I wanna make sure I always say these things wrong, but. We we're providing a sensory experience. Like we want people when they come 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, this clinic. I was like, I wanna, this is the brightest room we have. This is a bright room because of recording. Yes. Um, but,'cause if we turned this down, we wouldn't, we'd be at the dark. Right. It would be a little too weird. Yeah. But this is the dark, like this room. And we have a lot of natural sunlight because I was like, what do I need? Because if I need this, I can guarantee you our patients need it. Well, and like that feeling of your nervous system, when someone's anxious and I'm building off of it, like you can feel that clash and it helps nobody. But if I'm in an environment where I can stay a lot more regulated, it ends up transferring to the patient. It does. And they'll, they'll mention it, which I love. Yeah. But no, I think for any individual that comes in our door, it's all about personalizing it to them. Finding what works and then. Knowing that it's not always gonna work. Mm-hmm. What tweaks do we need to add in? We're in your back pocket. If something goes awry, play with this. And when the next layer reveals itself, 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's just, it's uh, it's really cool because I just thought, like never, I would've thought seven years ago I'd be making like a sensory kind of. Um, a sensory experience in the clinic and people may not be able to notice it right away, but the whole, the feeling I want people to feel when they come in is this, I'm okay, right? I want to be here. Yeah. I'm welcome here. Yes, because I've, I've yet to find a healthcare space that has been decorated and, and has the warm, inviting. Feel that we have, and maybe I'm just tooting my own horn, but I just, I worked really hard to toot away toot toots. Oh, toots another way. It's too, it's healthy, but it's, it's real. And so anything from, if you're listening, 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 types of settings. And being aware, like if it's not working for you as a provider Yeah, it's not working for your patients. Yeah. Yeah. I mean, look on Pinterest, find some colors. Look at like light colors, greens, we have light pinks, we've got browns. Like those are calming colors. And, and, and just thinking about how that feels, like having really, like things like art that looks really sharp, that can look scary for people too, and more rounded things are gonna be helpful. And just like these little details of how to have a sensory clinic is super important. I feel like I could do a whole nother episode on that. Yeah, that would be fun. Oh my gosh. We could do a tour, a sensory tour. I love it. Oh my gosh. We should totally do that. But I just, I love like decor too, so it just blends. So I'm like, wait, I get to do this for the clinic too. Ugh. It's so cool. Helps when you follow your intuition and you just trust your gut and yeah, there have been plenty of times I've fallen into fear and. Made business decisions I shouldn't have made, opened up a second clinic I shouldn't have. You know, there's so many different things that I've learned and now I'm like never not listening to that little voice again. Right. So, and that voice gets stronger. It does. When you start listening more. It's real limited though. Hmm? The voice feels a lot like other voices initially. Well, yeah, it's sitting, well, you have to be regulated first and it's more of like, what is the little voice that keeps coming up over and over, not like it came up today. It's more of how many times am I hearing this over and over? And then the decision's gonna, it's a little, can I gut kinda leaning for me? It's how it feels in the gut though.'cause a lot of stuff happens right there. Yeah. For me, I feel like it's a sense of lightness. Yeah. It's a sense of would my future self be proud? Even though this is really hard right now. Would she be proud? And if it's the hell yeah, then it's a, we're doing it, we're gonna deal with the pain of it and push through. 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 resilient rx.com. And her and our Instagram is Resilient rx. And then your Instagram is Learn with Dr. Jill. You got it. So cool. Thank you so much. Yeah, thank you. Thank you so much for listening to my podcast. It would be a huge help if you could subscribe and rate the podcast. It helps us reach more people and make a bigger impact. I would also love it if you could join my email list, which is LinkedIn, the caption for podcast updates, upcoming offers and events. You can also find me on TikTok, YouTube and Instagram at Dr. Mary pt. Thanks again.