32. Embracing Neurodivergency with Jessica Eccles, MD

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00:00:00 

Jennifer Milner 

Hello, and welcome to bendy bodies with the hypermobility MD, where we explore the intersection of health  and hypermobility for dancers and other artistic athletes. This is Jennifer Milner here with co-host Dr. Linda  Bluestein. Hello everyone.  

00:00:14 

Jennifer Milner 

Before we introduce today's guests, we'd first like to remind you about how you can help us help you. 

00:00:21 

Jennifer Milner 

First subscribe to the Bendy bodies podcast and leave us a review. This is helpful for raising awareness about  hypermobility and associated disorders. Second, share the bendy bodies podcast with your friends, family, and providers. We really appreciate you helping us grow our audience in order to make a meaningful difference.  This podcast is for you. Our guest today is Dr. Jessica Eccles, senior clinical academic psychiatrist at Brighton  and Sussex medical school in the UK and specialist in brain, body neuroscience. She led the first neuroimaging  study of hypermobility and her work has focused on neuropsychiatric manifestations of connective tissue  disorders. Her work on the relationship between hypermobility and anxiety has led to the first non-drug  treatment trial of a targeted therapy for anxiety and hypermobility. She has published ground-breaking journal  articles on the relationship between hypermobility autonomic dysfunction and altered interoception as well as  between pain, fatigue, brain fog and neurodevelopmental conditions.  

00:01:41 

Jennifer Milner 

Dr. Eccles, hello, and welcome to bendy Bodies.  

00:01:45 

Jennifer Milner 

We are so thrilled to have you here, and we cannot wait to dive in before we get started. We might be using  vocabulary today that is unfamiliar to some listeners. We would love for you to go through a few terms. Dr.  Eccles, can you explain the differences between neurodiversity neurodivergence and neuro-typical?  

00:02:15  

Jessica Eccles 

So really it's a very good question, Jennifer. I think, a lot of people can get confused in this areas. Ten first date  is a way of describing a group of people and then the group there are going to be variations and the way that  people think and feel, and the way that their beans are when one person is neurodivergent, that's the property of  an individual. Typically when we talk of neurodivergence, we think about brain differences, things like being an  autistic person, having ADHD, having dyslexia, which has difficulties with words, dyscalculia, which is  difficulties with numbers and dyspraxia, which is, a difficulty with, where you are sense of space, which, is to  do with.  

00:03:00 

Jessica Eccles 

I think, an important point is that, these things are not necessarily disabilities or disorders. They are differences,  and there are source of, great, creativity in the general population and throughout history. And, having people  who think differently is a very important for new USA for civilization as a whole. The neuro diversity  movement is advocate of moving away from the idea that such conditions are somehow aberrant or disordered  and need to be cured. Rather people should be properly supported and embraced to function at the best capacity  they can.  

00:03:47 

Jennifer Milner 

That was amazing. Sorry. That was a really fantastic description. And, that was beautiful. I was sitting there  trying to process all of it, as you were saying that, thank you. That was, that was excellent. It's so hard  sometimes for people to wrap their minds around the differences in vocabulary and the importance, as you said  of the vocabulary and the importance of not looking at it as, a disease or a disorder, but as a difference. I, you  just explained that incredibly well. Thank you. Your areas of expertise are listed as brain-body interactions, joint  hypermobility, and liaison psychiatry. Your research areas are neuroscience, psychiatric manifestations of connective tissue disorders and mechanisms of chronic pain and fatigue. In short you're one of the most  perfectly placed people to speak on this topic. What led you to pursue the path that you had been on? What drew  you to this research?  

00:04:48 

Jessica Eccles 

Well, that's a really interesting question, Jennifer. So, when I was at medical school, in the UK, I became  interested in the kind of philosophy of science and the philosophy of mind. I knew I wanted to specialize in  something to do with psychiatry and the brain when I was at medical school, when I was doing an orthopedics rotation, I was approached by one of the doctors there and told that I was hyper mobile. I, I had this kind of  interest in hypermobility. When I came to pursue my, academic psychiatry training in Brighton and Sussex  medical school, my then supervisor, professor Hugo Critchley when were talking about the type of work that I  would be doing, he was like, I'd like you to do a brain imaging study of hyper mobility. Have you heard of it?  And I said, well, actually, interestingly, you should say so. Cause actually I think I have it.  

00:05:46 

Jessica Eccles 

I got into the field through that particular brain imaging study, which was published back in 2012. What we did  is we, it was a relatively brain imaging center. It's a new medical school, Brighton and Sussex medical school.  We took all of the people who had previously been through the brain scanner as so-called healthy controls. And,  we assess them to see if they were hyper mobile or not. We looked at the differences between the hyper mobile  and the non-hyper mobile in terms of the structure of their brains. We found, the biggest difference was that, the  hyper mobile people had different, structure to the brain in an area called the amygdala, which is responsible for  fear and emotion processing. That really, kick fired my, research interest in hypermobility brain, body  interactions. At the same time, we found some interesting differences in brain structure that, had previously been  observed in autism and ADHD, which got us thinking more about the relationship, between hypermobility and  neuro developmental conditions.  

00:06:58 

Jessica Eccles 

That's so interesting.  

00:06:59 

Linda Bluestein 

Many people who are hyper mobile do have more anxiety. And, we know that there's some definite differences  there, but I think a lot of people are not really aware of the connection and they feel often guilt or shame over  the anxiety portion because, there's a lot of like, shouldn't feel this way. Or, I know when I first came across  your study back in, 2017 when I was writing a paper and when I came across your study, I was like, Oh my  gosh, this is so amazing and such fabulous information for people to have. I would like as many people as possible to be aware of your research, cause it's so important and validating for people. Because oftentimes I  think we blame ourselves for things that makes it just makes it worse. Right?  

00:07:47 

Jessica Eccles 

Yeah. I think that, people with hypermobility because of the way their brain and body interacts may be more  likely to experience anxiety perhaps because they have slightly different structure to their brain, but also because  of the sensitivity of their autonomic nervous system. Their involuntary nervous system that's responsible for  fight or flight responses. And, I think when you talk to patients and people with hypermobility, giving them that,  understanding that this may be why they're more likely to experience anxiety because of how their bodies are,  can be, a very, kind of restorative narrative. That makes a lot of sense. You first started in your field and when  you first started doing this and finding these connections and the difference in the brain structure between  hypermobile and non hyper mobile, and then, people with anxiety and without it, and starting to see these  differences, did you find a fair amount of research already out there on the brain body interactions, especially as  it pertains to hypermobility?  

00:08:54 

Jessica Eccles 

There was a, there's been a, a solid amount of research since the nineties, mainly in Spain about the link between  hypermobility and anxiety. That, that was very much undisputed. There were tens and tens of studies all saying  the same thing that hypermobile people are more likely to experience anxiety, but beyond that, there wasn't a  huge amount. We knew that, hypermobile people more likely to experience pain. I started thinking about the  relationship between hypermobility and fibromyalgia, which led into thinking about the relationship between  hypermobility and Emmy CFS. There were some, there was a literature, especially in children, about  hypermobility and difficulties with coordination. Developmental coordination disorder, which is called  dyspraxia. And there were a few, case reports. Individual patients, or a couple of patients where, it was  suggested that there was a definitely a link between say autism and Marfan syndrome or autism and joint laxity,  which got myself in Hugo thinking into the relationship between hypermobility and neurodevelopmental  conditions more generally. 

00:10:09 

Jessica Eccles 

So, we kind of went with that as a potential idea.  

00:10:15 

Jennifer Milner 

It's kind of organic the way that you followed one step to the next, I have said for years that, in my personal  practice, I see a really high percentage, or a high link between hypermobility and neurodivergence, and just  casually looking at it. I see probably 80% to 90% of my dancers with EDS or hypermobility spectrum disorders,  who also are neurodivergent in some way to diagnosed with ADHD, they're autistic, they are highly gifted, and  also have sensory processing disorder. They have all of these things that go with it. Just in my casual client  work, I have seen that and wondered there's got to be a link to it. You think that neurodivergence is something  that you see as more common in hypermobility than in the general population?  

00:11:12 

Jessica Eccles 

Yes. I think that's definitely fair to say. So, we've been doing some work in our, so I work clinically in a, what  we call a neuro developmental clinic, which is where we see people, with, autistic people, ADHD Tourette's  syndrome. We've published a pre-print hasn't been peer reviewed yet where we show that there are, you're much  more likely to be hypermobile if you have these diagnoses than if you are a control. Whilst were doing that  research, were pipped to the post a little by, a paper that encompass the whole population of Sweden. There are  some countries in the world that, have these very important health registries, so they can look at their whole  population and in the whole population of Sweden, they discovered that if you had a diagnosis of hypermobility  in dish, and so I, the day Jess or EDS, you were seven times more likely to have a diagnosis of autism or nearly  six times more likely to have a diagnosis of ADHD.  

00:12:19 

Jessica Eccles 

That is really very compelling, to come from a whole population. Of course not everyone in that population with  hypermobility will have been diagnosed and be in the registry. The same is true of the neurodevelopmental can,  since they're not all people, all autistic people will have received a diagnosis, same with ADHD, those figures  times seven times five or six. I've read probably just the tip of the iceberg and in our clinical work. We find that  it's very rare to see a autistic person or a person with ADHD who is not hyper mobile and long alongside the  hypermobility. We often see other elevated phenomenas, so pain, fatigue, autonomic dysfunction, sensory,  sensitivities allergies. I think it's all coming together. I think we can be quite convinced that there is a link, but  that does not mean to say that all, hypermobile people have, developmental conditions or all people with  neurodevelopmental conditions are hyper mobile, but there certainly seems to be something very, intriguing  going on.  

00:13:37 

Jessica Eccles 

I think it's important to recognize this, because that means that say, if you're seeing someone with hyper  mobility, you think, should I be screening or looking for ADHD or autism or Tourette's syndrome? And if you  see someone with, autism ADHD or Tourette's syndrome, you're thinking, should I be looking to see if they  have joint hypermobility, because this may explain a lot of the physical problems that they experience. Things  like I mentioned, pain and fatigue, but another big, issue is see gastrointestinal disturbance, and, a lot of patients  with neurodevelopmental conditions, complain of irritable bowel and irritable bladder. So, realizing that this  may be recognizing this may be related to hope. Mobility can be quite important for them.  

00:14:31 

Jennifer Milner 

I think that a large population of our listeners are parents of hypermobile, artistic athletes. I think that a lot of  them out there right now are maybe crying quietly or feeling a huge sense of relief that, you're putting a name  and a face to instincts that they have had for a long time about their dancer and about their child. I have a dancer  who, is extremely hyper mobile, undiagnosed with any disorder, but probably there and who has trouble  partnering, with the partner because the sensory issue, the touch of his hand or the feel of his pulse, can be really  difficult for her. Those dancers feel like they're crazy when they're in the classes and they're so distracted by the  tag of their leotard, or they're having such a hard time focusing. As we know, females present very differently  than males do for ADHD. What you are saying today, I think is really validating a lot of people and a lot of their  feelings and making them think, Oh my gosh, I'm not crazy.  

00:15:36 

Jennifer Milner 

We are so grateful for you for this.  

00:15:39 

Jessica Eccles 

Yeah. Well, there's, a phrase, lots of issues think connective tissue differences. I think, yeah, it really does seem  to join the dots in many different ways.  

00:15:57 

Jennifer Milner 

It does. That's a phrase we use a lot. Help me connect the dots one more time. I know you briefly mentioned it,  but what do you see as the link between neurodivergence and hypermobility? Are you able to pinpoint  something or are you just at the point where you're able to say it's a higher likelihood?  

00:16:16 

Jessica Eccles 

Unfortunately I think we're just at the point where we're able to say it's a higher likely likelihood. I think, were  talking earlier about the relationship between joint hypermobility and anxiety, and that is a story that is quite  easy to tell and to understand in terms of differences in brain structure differences in autonomic nervous system  functioning. There is a story about, how that may be related to connective tissue issues in the periphery. That  mean that, blood doesn't return to the heart so well, which means you're more likely to have a high heart rate  and, fight or flight response. It makes the anxiety and hypermobility story makes a lot of sense, conceptually,  the anxiety and not anxiety. The hypermobility and neurodivergent, story's slightly harder to kind of tease apart  mechanistically my gut instinct is that these conditions, these are things that you are essentially born with,  maybe perhaps inherited together or some process to do with connective tissue development is also affecting  brain development.  

00:17:29 

Jessica Eccles 

But this is just a hypothesis.  

00:17:32 

Linda Bluestein 

And, and in your 2012 paper that you had published, you actually used, if I remember correctly, you used a  Biten score of greater than one for the hypermobile group. Right. So, I thought that was fascinating looking at  that you commented that you were using more inclusive criteria for those purposes, and you also talked about,  the connection with the severity or the degree to which someone was hyper mobile. Are you able to comment on  that at all?  

00:17:59 

Jessica Eccles 

Yes. I mean, so in some ways it was very practical decision to do that in that their literature is quite contentious  in terms of, at what point do you decide that this degree of hypermobility is significant. Even at that point, it's  still very contentious, but some authors would suggest for some would suggest five and maybe I was naive, but I  thought, well, if there's not, no, that some so, and by doing it as none or some, were able to very conveniently  divide the group in half, which made a lot of sense, statistically, but what we did find, which was interesting and  relates to this topic is that the higher, the Biten score, the smaller an area of the brain and parietal cortex, that's  responsible for processing where you are in space, was so that makes sense in terms of what we're hearing about  hypermobility and coordination problems and dyspraxia.  

00:19:02 

Jessica Eccles 

It is an interesting, it is an interesting point, is that the only way that we can measure the degree of  hypermobility? Probably not. I've, one of my, research projects at the moment is looking at, in anxious people to  see if the number of connective tissue features predict any aspects of autism or related conditions. Our initial  findings are that it's not so much the biotin score, but the number of connective tissue features in the Ellis Dan loss, syndrome criteria. Things like soft stretchy skin or acne, actually, prolapses, things like that, the  cumulative total of those seems to, predict number of sensory processing, differences in autistic traits.  

00:19:56 

Linda Bluestein 

Really interesting, especially given that the bite and score in the group that we're really speaking to in dancers is  particularly problematic because it's biased towards the upper extremities and dancers tend to get more injured  in the lower extremities and tend to have more issues in the lower extremities. I've, observed that even in my  patients that are not dancers, that they often have more issues in the lower extremities. They have a lot of issues  with maybe, ankles and hips and things that are not included in the bite and score at all. So,  

00:20:27 

Jessica Eccles 

That, that is a very important point, that, although it is a useful tool that misses out several of the really  important subluxing UL joints, and also, but what is interesting as well is that changes with age. Some people  become less, high whether or not becoming less hypermobile, but their biotin score may, go down. We  published some work in January that showed that pain and fatigue symptoms correlated with the biotin score,  the historical biotin score rather than the current Biten score. That, it's important when you're talking to patients  to determine if they've how hyper mobile they've ever been, rather than merely how hyper mobile they are now.  

00:21:11 

Linda Bluestein 

Sure. And, and I, I love the five point questionnaire for that reason. Although I often find when I ask people  about, can you never, could you ever touch your thumb to your forearm? And they go, what, it's easier to do that  in real time and to remember, but, yeah, I'm glad you pointed out about other joints cause like the shoulder,  which we know definitely lots and lots of people have problems with is not included in the bite and score or in  the lower limb assessment score, and things. I'm glad that you talked about, dyspraxia and, we'd like to talk also  about, proprioception, because especially we find it quite fascinating that dancers and athletes have difficulty  with proprioception. Because so often we tend to think of them as having, we th we would think that they would  have good proprioception and so ones that are hypermobile often really struggle with that.  

00:22:05 

Linda Bluestein 

It makes it very difficult for them to avoid going into that hypermobile range and things like that. So, can you  talk about the relationship between neurodivergence and proprioception, and dyspraxia more?  

00:22:20 

Jessica Eccles 

This is, a really big feature in that, the kind of the spectrum of neurodivergence includes things like, dyspraxia  dyslexia, dyscalculia, which, in and of themselves, and not necessarily diagnostic of anything else, but taken in  combination or in a history they're often an indicator that there may be another neurodevelopmental,  phenomenon going on. In our clinics, we often discovered, well, not discovered, but it seems that, almost all of  the patients, have had some issues either with dyslexia or dyspraxia or dyscalculia. I think people often forget  about dyscalculia and dyspraxia and they, Oh, yes. I was diagnosed with dyslexia at school, or that was query.  Dyspraxia there's definitely, a substantial body of work linking hypermobility to dyspraxia.  

00:23:16 

Jennifer Milner 

Well, and I see girls mostly, because I, I work with a lot of the, like the pre-professional dancers and it is  surprising, to the teachers that have the dancers that I work with because I, I do one-on-one work. The teachers  will call me and say with my extremely hypermobile dancers, why are they so clumsy? Like why can they  organize themselves to do this incredibly complex dance move? And yet they can't figure out where they are in  space without the mirror and trying to have that conversation, and educate the dance teachers has been really  interesting. And, and it's really disheartening for the dancers because they think this is my chosen career. This is  what I'm working towards. Why can I not balance with my eyes closed? because a lot of them are  underdiagnosed.  

00:24:07 

Jessica Eccles 

Yeah, no, definitely there, I mean, there's a huge amount of underdiagnosis, but I think there is also some talk about proprioception as a potential treatment target. I mean, this is completely, out there, but, the potential that  could be movement therapies or proprioceptive therapies that could improve things like anxiety, and other  States, that by improving proprioception, you may improve interoception, you may improve wellbeing in a more  general way.  

00:24:41 

Jennifer Milner 

That makes sense, though, that makes a lot of sense. I would, I would be interested to see that, in general girls  seem to be underdiagnosed in the neuro divergent population. Since ballet is often comprised mostly of girls,  especially in the early years, as I was saying, we could see dancers spending most of their career either unawake  unaware that they may be neurodivergent or masking to be able to interact with others on a daily basis. If  someone suspects, perhaps after listening to this podcast, that they are neurodivergent what first steps might you  suggest they could take?  

00:25:14 

Jessica Eccles 

Well, I think, it's important to talk to you, in the UK, we call it a general practitioner. Your family medicine  doctor, to see what the options are in terms of pursuing a further assessment, it can be really helpful too, to read  things online and even potentially to do some screening questionnaires, to see if this stories and the experiences  of other, neurodivergent people resonate. A, a good resource that we recommend to our patients is something  called attitude.com. They have a lot of, interesting articles about neurodivergence. I think, doing of research,  seeing if these stories resonate, particularly finding stories of other neurodivergent women, because as we know  the female presentation or the presentation, and women can be different, as you say, women are much more  likely to be able to mask the symptoms and go under the radar. What we notice a lot is that masking has a toll in  terms of kind of feeling socially exhausted, and needing quite a bit of time to rest and recover after social  interactions.  

00:26:30 

Jessica Eccles 

That's actually really interesting because fatigue is such a common complaint. That's an interesting potential  contributor to that I hadn't. Yeah, no, it's something I'm definitely thinking about in terms of, the relationship  between pain and fatigue, conditions like fibromyalgia and Emmy CFS and possible relationships with  neurodivergence, it's just ideas at the moment, but there are studies to be done, within that field.  

00:27:01 

Jennifer Milner 

We love the studies that your brain thinks of directions you go, and the benefits that it gives to all of us. So,  think away and grow with that and grow with it. I think, on the topic of the dancers and the girls being able to  mask it better, I think a lot of dancers may end up saying, Oh, I'm just, I'm an introvert and not realizing there  may be a deeper issue running through it, especially if they have other symptoms going on as well, if they have  possible for proprioception or, ADHD. It is definitely something worth getting checked out because it would be  helpful to know, and to perhaps get some help with it.  

00:27:45 

Jessica Eccles 

Absolutely. I think that's also something that we're coming to appreciate more and more is how often comorbid  or how often these things happen together. Just because you have a autism diagnosis or autistic doesn't mean to  say that you can't have ADHD and vice versa,  

00:28:03 

Linda Bluestein 

That makes sense. In terms of as neurodiversity, and when we start discussing this more in the general  population, do you have any advice that you would give to, teachers or parents that, could help them be more  effective in their roles with a neurodivergent dancer?  

00:28:20 

Jessica Eccles 

I think, kind of, speaking to what I was saying earlier is that, it's really important to think of these conditions as  both a source of strength and also a possibly a source of need. Identifying things that are going well and the  strengths of the individual and respecting those and working with those and not thinking, Oh, I have this disorder. I won't be able to do what I want to do in my life. Also being appreciative that there are some things  that maybe needed so adapting or, adjusting to routines, particularly what Jennifer was saying as well about  sensory preferences and being aware of the potential for sensory overload or sensory overwhelm and making  sure, I mean, it's a good, attitude, for everything, but that things are paced appropriately and that all of the  appropriate, adjustments can be made, given, the underlying issues. I think really, that it shouldn't be thought of  as something that should hold you back or be a hindrance at something to be embraced.  

00:29:32 

Jessica Eccles 

In the UK, in fact, there is an organization called embracing complexity, that represents different, charities that.  

00:29:42 

Jennifer Milner 

Deal with, you know, divergence. I, I liked that as a phrase, that complexity is something that we're scared of,  but it is something to embrace and, that, really important artists and thinkers. I like to have imagined that my  neat new projects is, exploring the relationship between creativity, hypermobility and divergence. That that's so  interesting because, there's a lot of conversation in the dance world, right now, as we've used the time for the  pen, from the pandemic and from lockdown to, look at what is going on in the dance world that we need to  address and what things could we change. This would be a great time to do it. One of it is, should you suffer for  your art? And there's that whole thought that, you have to suffer, you have to be willing to cut off your ear,  right. In order to create great art.  

00:30:39 

Jennifer Milner 

I think it's incredibly validating for, people to hear, like you said, at the beginning, neurodivergence has been a  source of creativity throughout civilization, right? The source of huge creativity. We don't want people to think  about neurodivergence as, an illness or as a problem or something that needs to be fixed. We're talking about,  ways to get you help in order to be the best you that you already are. Right. We want people to think about what  makes them different, makes them incredibly special and also means they may have a lot to offer the population  and let's help them offer the great creativity without feeling like they have to go through the suffering that goes  with it to help them alleviate some of that. So I exactly, I really appreciate that. You have been speaking about it  from such a positive tone and wanting to encourage, people who might think that this is something that they've  got going on.  

00:31:40 

Jennifer Milner 

Yes.  

00:31:43 

Linda Bluestein 

I have a question too, on that exact same, thread. I believe that, so many of the people that I work with, they  really struggle because they're significant people in their life, whether it's their spouse, their family, their friends,  they don't understand why it is that this person has so much pain, why they have so much fatigue, why they have  difficulty concentrating and focusing. So, I think that anything that you can offer in terms of, we all know how  our own body feels and how our own body works. We're talking to other people that are hyper mobile and  struggle with some of the same things, you're like, Oh yeah. You know, we get it. When we're talking to people  that have never dealt with those things, who are very linear thinkers who are very, like they're not distractable or  that, they don't have pain or whatever.  

00:32:37 

Linda Bluestein 

Do you have any for how to, get them to be more understanding or be more open-minded with the person who is  experiencing these conditions?  

00:32:53 

Jennifer Milner 

I suppose, really? if they can and they have the time to take time to read more about them, about these  conditions and about how they may affect their friends and family. I think with everything, knowledge and  education is power really in terms of moving forward. And, if they can avail themselves of as much good  information as is possible, that would be fantastic. Yes, you have given us so much to think about and to, encourage so many of our listeners and we are really grateful. Was there anything that we did not discuss today  that you wanted to make sure that we got to now? I think we've covered everything. I, I think there is so much  that we could talk about and different avenues and rabbit holes go down, but I think we've covered the important  points. Well, we appreciate it. We will have to have you back so that we can cover, other rabbit holes.  

00:33:56 

Jennifer Milner 

We can go down other rabbit holes with you, because this has been fantastic. Where can people learn more  about you and your work? So, if you want, you can, follow me on Twitter. I'm at bendy brain. Otherwise if you  type my name and hypermobility into Google, so Jessica records hypermobility, it will take you to my,  institutions webpage, which is Brighton and Sussex medical school in the UK, which has all of my contact  details and links to articles. Also, I do have a few videos on YouTube about similar topics, and I will say I've  watched those videos and they're excellent. They're great. Anybody who's interested in going down these rabbit  holes by yourself with her online, I highly encourage you to do that. Thank you so much. You have been  listening to bendy bodies with the hypermobility MD today. We've been speaking with Dr. Jessica Elle, senior  clinical academic psychiatrist at Brighton and Sussex medical school in the UK and specialist in brain, body  neuroscience, Dr.  

00:34:59 

Jennifer Milner 

Echols, thank you so much for taking the time to come on the venue bodies podcast and for sharing your  expertise with us today. Thank you. It was a pleasure. Thank you,  

00:35:06 

Linda Bluestein 

You so much. We really appreciate it. Thank you for joining us for this episode of bendy bodies, with the  hypermobility MD, where we explore the intersection of health and hypermobility for dancers and other artistic  athletes. Please leave us a review on your favorite podcast player. Remember to subscribe so you won't miss  future episodes. Be sure to subscribe to the bendy bodies, YouTube channel as well. Thank you for helping us  spread the word about hypermobility at associated conditions. Visit website www.bendybodies.org. For more  information, for a limited time, you could win an autographed copy of the popular textbook disjointed  navigating the diagnosis and management of hyper mobile Ehlers Danlos syndrome and hypermobility spectrum  disorders just by sharing what you love about the bendy bodies podcast on Instagram, tag us at bendy  underscore bodies and on Facebook at Vandy bodies podcast. The thoughts and opinions expressed on this  podcast are solely of the co-hosts and their guests.  

00:36:12 

Linda Bluestein 

They do not necessarily represent the views and opinions of any organization. The thoughts and opinions do not  constitute medical advice and should not be used in any legal capacity whatsoever. This podcast is intended for  general education only, and does not constitute medical advice. Your own individual situation may vary, do not  make any changes without first seeking your own individual care from your physician. We'll catch you next  time on the bendy bodies podcast.