Physical Activity glossary

Short Definition:
Tools and devices that support safe movement and exercise.

Long Definition + Context:
Examples include resistance bands, stability balls, yoga blocks, and balance pads, as well as braces (knee, wrist), compression garments, support systems like the Body Braid, ring splints, and POTS-friendly aids (shower chairs, mobility scooters). Adaptive equipment lets you maintain proper form, reduces injury risk, and builds confidence as you learn new movement patterns under PT guidance.

Short Definition:
The cumulative “wear and tear” on the body from chronic stress.

Long Definition + Context:
Repeated autonomic surges (from pain flares, orthostatic challenges, or mast cell events) force constant adaptation. Over time, this exhausts your stress-response capacity—worsening fatigue, pain sensitivity, and heart-rate/blood-pressure dysregulation during exercise. Managing allostatic load through pacing and downregulation preserves your reserves for safe activity.

Short Definition:
The part of the nervous system controlling involuntary functions like heart rate and digestion.

Long Definition + Context:
Comprised of the sympathetic (“fight or flight”) and parasympathetic (“rest and digest”) branches, the ANS is dysregulated in POTS (overactive sympathetic response on standing) and can be hyper-responsive in MCAS flares. Exercise programs include techniques to modulate ANS tone—gradual positional changes, breathing drills, and paced activity—to improve autonomic balance and reduce symptom spikes.

Short Definition:
Exercise and rehabilitation performed in warm water.

Long Definition + Context:
Buoyancy offloads body weight, reducing joint stress and blood pooling, while water resistance provides even muscle challenge. Ideal for EDS patients with painful joints and POTS sufferers with orthostatic intolerance—pool sessions allow longer workouts without dizziness or injury, and hydrostatic pressure improves circulation similarly to compression garments. This type of exercise should be individualized. It can simply be used as an offloading activity vs a larger exercise program.

Short Definition:
Smooth, coordinated movement with mindful control.

Long Definition + Context:
Emphasizes fluid transitions using core engagement and proper muscle sequencing to minimize joint strain. In Flōmetrics™, we practice slow, gentle, rhythmical, whole-body movements which retrain muscles and the nervous system to move in harmony, reducing pain and dysautonomia triggers.

Short Definition:
External devices that stabilize and protect joints during activity.

Long Definition + Context:
Includes knee/ankle braces, finger ring splints, kinesiology tape, proper footwear, compression garments and orthotic inserts. By limiting harmful ranges of motion and providing proprioceptive feedback, braces help prevent subluxations and dislocations. We integrate bracing into PT so you can safely progress strength and mobility exercises.

Short Definition:
Heightened sensitivity of the central nervous system to pain signals.

Long Definition + Context:
Chronic inflammation, frequent joint subluxations, or mast-cell mediators can “wind up” pain pathways in the spinal cord and brain, causing normal movement to feel painful. Flometrics PT counters this by combining gentle graded exposure, downregulation (breathing, relaxation), and neuromuscular re-education to retrain your brain’s pain thresholds—making exercise more comfortable over time.

Short Definition:
Tight stockings or binders that improve blood return.

Long Definition + Context:
Graduated compression socks (20–30 mmHg) and abdominal binders reduce blood pooling in the legs and abdomen on standing. POTS patients wear them during exercise and daily life to stabilize blood pressure and reduce dizziness. In therapy, we show proper fit and timing for maximum benefit.

Short Definition:
Exercises targeting abdominal and back muscles for spinal support.

Long Definition + Context:
Core muscles stabilize the pelvis and spine, reducing compensatory hypermobile movements at other joints. Key exercises include modified planks, glute bridges, and pelvic tilts. We tailor core work to avoid overextension and overexertion while building support and the pliability needed to protect your back and limbs.

Short Definition:
Loss of fitness and muscle strength from prolonged inactivity.

Long Definition + Context:
Chronic pain, dysautonomia, or flares often lead to reduced activity, causing muscle atrophy and worsened orthostatic intolerance. Reversing deconditioning is central to POTS and EDS care—starting with low-impact, core and lower extremity mat-level exercises or recumbent exercises and gradually progressing under PT supervision improves circulation, strength, and upright tolerance without overtaxing your system.

Short Definition:
Complete separation of joint surfaces requiring relocation.

Long Definition + Context:
In EDS, lax ligaments allow joints (e.g., shoulder, kneecap, fingers) to fully slip out of place. Dislocations are painful, may injure surrounding tissues, and often require ER care or PT-assisted reduction. Flometrics® teaches gentle self-reduction techniques for small joints (when appropriate) and stabilization strategies to prevent recurrence.

Short Definition:
Movement-based vs. muscle-holding exercises.

Long Definition + Context:
Dynamic exercises contract muscles through motion (e.g., lifting through a range), while isometric exercises contract without movement (e.g., wall sits). For hypermobile joints, isometrics safely build strength without risking end-range instability; dynamic work is then added in controlled ranges to enhance functional strength.

Short Definition:
Calming the nervous system to reduce pain and flare risk.

Long Definition + Context:
EDS and POTS involve heightened sympathetic arousal. Downregulation techniques—diaphragmatic breathing, gentle rocking, slow warm-ups—signal safety to your brain, lower stress responses, and prevent muscle guarding. We integrate these into every session so your body’s primed to build strength without triggering symptoms.

Short Definition:
Staying within your personal “energy budget” to avoid crashes.

Long Definition + Context:
Similar to pacing, this theory encourages you to track perceived exertion and fatigue, then keep activity within a safe window (“envelope”) so you neither underuse nor exceed your capacity. It’s especially useful for those with POTS or PEM—ensuring consistent, sustainable exercise gains without triggering prolonged flares.

Short Definition:
Inability to perform expected exercise levels due to symptoms.

Long Definition + Context:
Characterized by extreme fatigue, dizziness, or pain even after mild activity. Common in POTS, ME/CFS, and chronic pain. We address this through meticulous pacing, graded mat-level workouts, and close monitoring so you steadily improve tolerance without provoking post-exertional malaise.

Short Definition:
A sheet of connective tissue that surrounds muscles and organs.

Long Definition + Context:
Fascia provides structural support and transmits force between muscles. In EDS, fascial tension can contribute to pain and decreased mobility. Myofascial release techniques (foam rolling, manual therapy) and targeted movement help restore healthier fascial tension, improving movement quality and reducing discomfort.

Short Definition:
A temporary worsening of baseline symptoms after stress or activity.

Long Definition + Context:
Flares manifest as increased pain, fatigue, or dysautonomia episodes up to 48 hours post-exercise. Our approach uses flares as feedback—adjusting intensity, duration, and pacing to find your personal “sweet spot” where you build capacity while minimizing flare frequency and severity.

Short Definition:
Using devices to track pulse during activity.

Long Definition + Context:
Chest straps or wrist monitors help POTS patients stay below symptom-triggering thresholds (e.g., +30 bpm over baseline). We teach you target zones for recumbent vs. upright exercise and how to interpret readings to guide safe, progressive cardiovascular conditioning.

Short Definition:
Exercise routines adapted for loose, unstable joints.

Long Definition + Context:
These avoid end-range stretching and high-impact movements. Examples include modified Pilates, controlled yoga poses with micro-bends (no locked joints), and resistance-band strength work. Emphasis is on form, muscle engagement, and joint alignment to build stability over flexibility.

Short Definition:
Excessive joint range of motion due to loose connective tissues.

Long Definition + Context:
Seen in EDS/HSD, hypermobile joints move beyond safe ranges, leading to instability and injury. Our PT programs focus on strengthening surrounding muscles and proprioception training to compensate for lax ligaments and protect joints during all activities.

Short Definition:
Compression of soft tissues (tendons, bursa) against bone during movement.

Long Definition + Context:
Commonly occurs in the shoulder (rotator cuff against the acromion) or hip (femoral neck against the acetabulum), causing pain and inflammation. In hypermobility, altered joint mechanics increase impingement risk. Targeted PT activity and strengthening correct movement patterns to relieve pressure and restore pain-free mobility.

Short Definition:
The fibrous sleeve enclosing a synovial joint.

Long Definition + Context:
Composed of an outer fibrous layer (stability) and an inner synovial membrane (lubrication). In hypermobility, the capsule can be overly stretchy, contributing to instability. PT strengthens surrounding muscles to offload the capsule and preserve joint integrity.

Short Definition:
Exercises targeting muscles that support specific joints.

Long Definition + Context:
Often isometric or confined to safe ranges (e.g., quadriceps sets for knees, rotator cuff holds for shoulders). Over time, these reduce subluxation risk by training muscles to maintain proper alignment and decrease pain frequency.

Short Definition:
A ring of cartilage deepening a joint socket (shoulder or hip).

Long Definition + Context:
The labrum improves joint stability by creating a suction seal. In EDS, labral tears can occur from micro-instability or subluxations, causing pain, clicking, and limited range. PT focuses on strengthening surrounding muscles and improving proprioception to offload the labrum and prevent further injury.

Short Definition:
Connective tissue band linking bone to bone across a joint.

Long Definition + Context:
Ligaments provide passive stability and proprioceptive feedback. In EDS, defective collagen makes them lax and injury-prone. PT emphasizes muscular stabilization so that muscles, not overstretched ligaments, bear joint loads—protecting against subluxations and dislocations.

Short Definition:
Activities that minimize joint loading and impact forces.

Long Definition + Context:
Includes swimming, water aerobics, cycling (especially recumbent), elliptical, and gentle yoga. These improve muscle tone and cardiovascular fitness without jarring forces that can injure unstable joints or provoke POTS symptoms. We guide you on equipment settings and movement modifications.

Short Definition:
Release of histamine and other mediators from mast cells.

Long Definition + Context:
Physical stress—like overheating during exercise or repetitive joint trauma—can trigger mast cells to degranulate, causing flushing, itching, or hypotension. Understanding triggers (heat, high-impact movement) allows you to choose cooler environments (pool therapy), gradual warm-ups, and pre-exercise H1/H2 blockers when needed, so you can stay active without provoking MCAS symptoms.

Short Definition:
Assistive devices used to facilitate movement or support.

Long Definition + Context:
Examples: canes, walkers, rollators, or wheelchairs for workouts or community ambulation. Mobility aids allow POTS or severely painful EDS patients to remain active—safely achieving exercise goals and reducing deconditioning while preserving independence.

Short Definition:
Intentional activation of specific muscles during movement.

Long Definition + Context:
Focused cues (e.g., “gently draw belly button toward spine”) teach you to recruit appropriate muscles for stability and power, minimizing compensatory guarding. This mindful approach builds correct motor patterns essential for long-term joint protection.

Short Definition:
Involuntary muscle tension around a painful or unstable area.

Long Definition + Context:
Guarding protects injured structures but can become chronic, limiting mobility and increasing fatigue. Through gentle movement and downregulation techniques, we help your nervous system release unnecessary tension so you can engage the right muscles and improve flexibility safely.

Short Definition:
Sudden, involuntary muscle contractions that cause pain.

Long Definition + Context:
In EDS, spasms may occur as muscles overwork to stabilize joints; in POTS, electrolyte imbalances can trigger cramps. Management includes gentle range of motion, magnesium supplementation, hydration, and specific myofascial release techniques taught in PT sessions.

Short Definition:
The nervous system’s ability to reorganize and form new connections.

Long Definition + Context:
Through repeated, controlled movement patterns and proprioceptive training, your brain learns safer ways to move—bypassing maladaptive pain or guarding circuits. In EDS, this means improving joint control and reducing fear-avoidance behaviors; in POTS/MCAS, it can help recalibrate autonomic responses to positional or thermal stress.

Short Definition:
Therapy enabling safe performance of daily tasks.

Long Definition + Context:
OT practitioners teach joint-protection techniques (adaptive kitchen tools), energy-conservation strategies (seat aids for showering), and ergonomic modifications. Their goal is to maintain independence by adapting environments and routines—complementing PT’s strength and movement focus.

Short Definition:
Difficulty tolerating upright posture due to symptoms upon standing.

Long Definition + Context:
OI includes POTS, orthostatic hypotension, and reflex syncope. Exercise for OI begins with horizontal or seated movements (recumbent bike, supine leg lifts) and slowly introduces upright postures as conditioning improves. Compression, pacing, and hydration are integrated to enhance tolerance.

Short Definition:
An abnormally large heart-rate rise upon standing.

Long Definition + Context:
Defined as an increase of ≥ 30 bpm (or exceeding 120 bpm) within 10 minutes of standing. This hallmark of POTS can limit upright exercise intensity. Training focuses first on recumbent/cardio machines, compression, and volume expansion, then slowly introduces upright activity—monitoring heart-rate thresholds to safely expand tolerance.

Short Definition:
Balancing activity and rest to prevent overexertion.

Long Definition + Context:
A deliberate strategy: short bursts of exercise/rest cycles (e.g., 5 minutes on, 5 minutes off) or alternating harder and gentler days. Pacing minimizes flares and post-exertional malaise by respecting individual energy limits—helping you build capacity sustainably.

Short Definition:
Rehabilitative service to restore strength, function, and movement.

Long Definition + Context:
Licensed physical therapists design hypermobility-focused programs (e.g., Flōmetrics™) that first calm pain pathways through downregulation, then progress through stability exercises, proprioception training, and gentle strengthening. PT is foundational for improving joint support in EDS and orthostatic tolerance in POTS.

Short Definition:
Delayed worsening of symptoms after even mild exertion.

Long Definition + Context:
Common in ME/CFS and seen in dysautonomia patients, PEM can involve profound fatigue, flu-like pain, and brain fog 12–48 hours after activity. Avoiding PEM requires meticulous pacing, symptom tracking, and gradual progression—prioritizing consistency over intensity.

Short Definition:
Exercises to improve body-position awareness.

Long Definition + Context:
Activities include balance work (standing on one leg or foam pad), coordinated tasks (catching a ball on an unstable surface), and joint-position drills with eyes closed. Enhanced proprioception reduces injury risk by teaching your nervous system to sense and correct joint angles subconsciously.

Short Definition:
The movement potential of a joint, from flexion to extension.

Long Definition + Context:
Measured in degrees, normal ROM varies per joint. Hypermobile individuals often exceed normal ranges, risking end-range injury. PT focuses on functional ROM—sufficient for daily tasks but within safe limits—while strengthening muscles that control motion.

Short Definition:
Workout performed in a reclined or seated position.

Long Definition + Context:
Examples: recumbent bike, rowing ergometer, mat-based core work. For POTS patients, these minimize blood pooling and tachycardia, allowing safe cardiovascular conditioning. As tolerance improves, upright variations are introduced.

Short Definition:
A metaphor for tracking limited daily energy using “spoons.”

Long Definition + Context:
Each planned activity “costs” spoons; once spoons are gone, rest is required. This visual tool helps you plan exercise sessions alongside life’s demands to avoid exceeding capacity. Integrating Spoon Theory with pacing and the Energy Envelope ensures you use your limited energy wisely and recover before the next activity.

Short Definition:
Resistance-based exercises to build muscle strength.

Long Definition + Context:
Using light weights, resistance bands, or body weight with high repetitions protects hypermobile joints. Focus is on controlled form and gradual progression—key for compensating for lax ligaments and improving functional stability in EDS.

Short Definition:
The activity level of the “fight or flight” branch of the ANS.

Long Definition + Context:
Elevated sympathetic tone raises heart rate, blood pressure, and muscle tension. In EDS/MCAS/POTS, excessive sympathetic activity can trigger flares and fatigue. Exercise protocols incorporate slow warm-ups, biofeedback, and breathing drills to prevent sympathetic spikes—so you build strength and endurance without triggering dysautonomia or mast cell release.

Short Definition:
Viscous fluid within joint capsules that lubricates cartilage.

Long Definition + Context:
Produced by the synovial membrane, it reduces friction and distributes load. Inflammation from repetitive subluxations can alter its composition, leading to stiffness and pain. Gentle exercise and proper hydration support healthy synovial fluid dynamics, improving comfort and joint longevity.

Short Definition:
Viscous fluid within joint capsules that lubricates cartilage.

Long Definition + Context:
Produced by the synovial membrane, it reduces friction and distributes load. Inflammation from repetitive subluxations can alter its composition, leading to stiffness and pain. Gentle exercise and proper hydration support healthy synovial fluid dynamics, improving comfort and joint longevity.

Short Definition:
Therapy using a tilting table to retrain upright tolerance.

Long Definition + Context:
The table shifts you from supine to upright incrementally, challenging the autonomic system to adapt. Over weeks, it can improve orthostatic tolerance in POTS. This is usually done under medical or PT supervision and complements volume-expanding and compression strategies. When an actual tilt table is not available, there is still positional orthostatic blood pressure and heartrate monitoring and training. This can be highly beneficial as it can be performed consistently over time in order to effectively gather clinical data, gauge symptoms, and improve tolerance.

Short Definition:
The strength of vagus-nerve-mediated parasympathetic activity.

Long Definition + Context:
High vagal tone is associated with resilience to stress and faster recovery after exertion. Techniques like slow exhalations, humming, or specific breathing patterns can stimulate the vagus nerve—improving heart-rate variability and helping EDS and POTS patients tolerate activity with fewer symptoms.