Hypermobility and musculoskeletal conditions during and after pregnancy

Project Summary

Background

Maternity services in England are undergoing a period of change as part of the maternity transformation program. We know that people with hypermobility can experience new or worsening musculoskeletal problems with their joints and muscles during and after pregnancy. However, there is currently no existing research asking people with hypermobility about their experiences and for their views on this topic. This research will gather valuable insights into the experiences of both patients and treating physiotherapists for this population group, which is significantly under-researched despite their risks of complications and difficulties throughout the maternal journey.

A systematic scoping review of musculoskeletal physiotherapy throughout pregnancy and up to one-year postpartum found no existing research for women with hypermobility (Minns Lowe et al, under review). The need for further research and improved care within this area led to the development of this PhD project.

Project Outline

The aim of the research is to explore the views and experiences on physiotherapy-related musculoskeletal health of people living with either HSD or hEDS (or previous version of these diagnoses) throughout the perinatal period. The plan is to do 3 stages of research:

Stage 1 – recruitment now live! Click here for more information/how to participate

To explore the views and experiences of people living with hypermobility and physiotherapy-related musculoskeletal (joint / muscle) conditions during and after pregnancy.

Participants can join the study anytime between 18-weeks of pregnancy and 5-months post birth.

Participants who are pregnant will be invited to attend three 1:1 online interviews lasting between 30-minutes and 90-minutes each. The first interview will take place around approximately 7-months pregnant, the second around approximately 3-months post birth, and the third around approximately 1-year post birth.

Participants who are post birth will be invited to attend two 1:1 online interviews lasting between 30-minutes and 90-minutes each. The first interview will take place between 3-months and 5-months post birth, and the second around approximately 1-year post birth.

Key things to know:

• Please take part if you are between 18-weeks pregnancy and 5-months post birth, over the age of 18, a UK resident, and have experience of living with hypermobility.

Stage 2 – recruitment now live! Click here for more information/how to participate

To explore the experiences and confidence levels of physiotherapists treating people with hypermobility and physiotherapy-related musculoskeletal (joint / muscle) conditions during and after pregnancy.

Participants will be invited to attend an online focus group interview containing a total of 5-8 participants. The focus group will last between 1-2 hours and will have two facilitators.

Key things to know:

• Please take part if you are a UK-based HCPC registered physiotherapist with experience of treating musculoskeletal health conditions in people living with hypermobility during and after pregnancy.

Stage 3 – to be done in the future

To develop, test and conduct a UK wide e-survey to explore the findings of stages one and two with a wide sample of people living with hypermobility with perinatal experience.

Patient and Public Involvement (PPI)

This project has recruited two individuals with hEDS/HSD and prior experience of the maternal journey to guide and advise the research project. This involvement allows the methodology and dissemination strategies to be refined, with the aim of improving the overall impact of findings and ensuring outcomes are accessible and meaningful. PPI participants can provide valuable insights into the research project from the viewpoint of those directly affected by the topic under study. Their input can help to enhance the quality and credibility of research, helping research to remain more ethical and patient centred.

Contributors

• Elizabeth Watson-Rose (lead researcher)

Doctoral Supervision Team:

• Catherine Minns Lowe (Professor in Physiotherapy Research and Education, Musculoskeletal Research Lead in the Centre for Applied, Clinical, Health and Care Research (CACHE), Physiotherapy Research Lead, University of Hertfordshire)
• Mindy Cairns (Associate Professor (Research) & Specialist MSK Physiotherapist, University of Hertfordshire)
• Gemma Pearce (Associate Professor, Coventry University)

Funding:

Chartered Society of Physiotherapy Charitable Trust (CSPCT) awarded funding to Elizabeth Watson-Rose for stage 1 and stage 2 of the project in 2025.