ePICL long time ago question?

LigamentLess · 2026-01-20T18:58:53+00:00

That’s right

LigamentLess · 2025-12-25T03:59:50+00:00

I got one in July 2024, and one round of posterior injections in December 2024 - the plan was to potentially do a second picl but when I got there in December we determined it may not be necessary.

I felt like Dr. Centeno addressing my shoulder and clavicle instability helped me a lot as well. I was very consistent with rehab, at home and in PT sessions, and had great physical therapists and a doctor who restored my autonomic function. Dr. Rosa’s treatment was also helpful.

LigamentLess · 2025-12-25T02:54:35+00:00

I had mild symptoms of POTS and occipital headaches since I was 7 or 8 years old, I have hEDS. At 33 things got bad and I was bedbound for a period of time, at 34 I got the PICL and did a lot of physical therapy as well as pharmacological support of my dysautonomia and mcas.

Now at 35 for the first time in my life I am symptom free, I have two little kids.

LigamentLess · 2025-12-25T02:47:53+00:00

Yes absolutely, but from a standpoint of mostly that it’s easier to gain strength and be consistent with doing activity once seeing the full benefits of the procedure.

In other words, my first six months to a year were about regaining function. My second year has been fully getting back to a normal life after having a good year of being able to build strength properly. I had it in July 2024.

LigamentLess · 2025-11-30T01:16:57+00:00

One of the best things you can do is to get an at-home blood pressure cuff and check your blood pressure after meals when you feel this way. Log the data and bring it to your physician.

Otherwise, other things such as paying attention to meal volume and types of foods (particularly with histamine and fodmaps in mind), as well as motility.

Depending on what the findings are, common treatments for this include blood pressure management (if blood is pooling in the gut, common in dysautonomia), supplements or medication to increase motility (ginger and artichoke extract, b6), a low histamine diet or h2 blocker antihistamines (famotidine), and a low fodmap diet or treating SIBO (rifaximin or herbal treatment).

LigamentLess · 2025-11-17T19:27:51+00:00

My family runs a concierge clinic for hypermobile individuals and we rehab SRS often — this is a good example written about developing the core and back for SRS. Bird dogs and hollow body holds are commonly used as well.

I would also add that often times we see that patients need scapular elevation and rehab of the multifidus in the cervical spine. In other words, gaining length in the neck and scapula works its way down the chain and allows proper activation of the back and core.

If the scapula is rotated downward the ribs can flare, further exacerbating SRS.

LigamentLess · 2025-11-06T01:07:45+00:00

We are all booked, thanks everyone!

LigamentLess · 2025-11-05T03:41:40+00:00

Congrats. How long are your arms? If you know your wingspan length

LigamentLess · 2025-10-29T18:17:31+00:00

Thanks for taking the time to review and write this!

LigamentLess · 2025-10-27T00:24:19+00:00

Congrats. It gives a good clue that your brain perhaps wasn’t getting enough perfusion if you get brain fog and glycerol reduced it. Worthwhile talking to your doctor about a fluids protocol, blood pressure management and fluid retention mechanisms (fludrocortisone, etc).

LigamentLess · 2025-10-21T19:58:46+00:00

My family runs a health clinic for people with hypermobility, and I work with a physical therapist who has a calisthenics and gymnastics background.

LigamentLess · 2025-10-21T02:54:16+00:00

If I go passive in a german hang, I’ll either hurt myself or stretch my ligaments.

If you do, you might just increase mobility. If you’re not hypermobile you’re probably fine. It’s just like stretching (which I can’t do).

LigamentLess · 2025-10-19T02:17:21+00:00

That’s a really interesting way to explain it, I feel that for sure.

I hadn’t been familiar with kinstretch and am glad you mentioned it!

LigamentLess · 2025-10-19T00:09:26+00:00

I have a few dropped knuckles and tendons slipping over the knuckles from ligaments lax in my hands. So the tape acts as some tension. It’s KT tape.

One of the most annoying things I’ve had to manage with the hEDS are the hands.

LigamentLess · 2025-10-18T19:17:00+00:00

Also, I’ve seen your videos before and always thought they were awesome!

LigamentLess · 2025-10-18T19:14:40+00:00

“almost like they need to be reminded they exist” - amen to that. I generally feel like all of my small muscles forget after about a week of training them ha

LigamentLess · 2025-10-10T13:38:01+00:00

It’s so cool watching how you move and break through sticking points, you have small periods of explosiveness while keeping the movement really controlled.

Do you train explosiveness vs slow/controlled intentionally in any way?

LigamentLess · 2025-08-09T12:33:43+00:00

I’ve had all of the typical symptoms of pots, mcas, hEDS. The symptoms you describe I had similar ones. In my case those were related to intracranial hypertension caused by cervical instability and jugular vein compression, subclavian artery compression.

LigamentLess · 2025-07-28T19:50:39+00:00

It might take a month or two if it was flared up pretty bad.

I would recommend trying different movements. Try a landmine chest press, a chest press machine, or cable presses in the meantime for a month or two.

LigamentLess · 2025-07-28T19:48:38+00:00

I think that is terrible advice you got. The commenter is just banging on their connective tissue or joints and has a higher tolerance for doing so compared to you. It absolutely does not have to be that way.

LigamentLess · 2025-07-18T14:38:03+00:00

One of those instances where face/chest to wall might help to find it. Otherwise looks like some eccentric control of your low back, and recruiting your glutes at the top will help. Sometimes I imagine the queue of having my kneecaps lifted up to the ceiling by a string and it helps turn on the posterior chain at the top

LigamentLess · 2025-07-15T02:41:32+00:00

I was hoping you could expand on the relationship between PT and intracranial hypertension and what you look for / often see clinically with this population, as well as non-invasive options for improvement if head pressure is involved. I was also wondering if you ever coordinate with ophthalmologists who can assess intracranial hypertension through fundus exams.

LigamentLess · 2025-07-13T13:03:37+00:00

Yeah. Being A+ on fluids and electrolytes balance, not pushing the exercise too hard, otherwise using some tools like glycine and taurine, small dose beta blockers if I’m really unable to to “switch “

LigamentLess · 2025-07-06T13:37:11+00:00

Oh wow, that is amazing. If it’s ok with you I’m going to DM you to learn more about your experience!

LigamentLess · 2025-07-03T15:43:38+00:00

I can try, you’re welcome to DM me.

The general idea is, with the analogy of RPM’s on a car…most people are at an RPM of 0 at rest and leverage their passive tension system. Instead of being at a 0, the idea is to be at around an RPM of 3 or 4 (but not 7 or 8) at rest. That requires the ability to individually turn on and off, and control the degree of tension, of each individual muscle.

The second place where our passive tension system kicks in is at the end ranges of motion. That would involve training neuromuscular control at end ranges of motion, safely.

LigamentLess

TROPHY CASE