Having EDS means your body works differently. 

Shouldn’t your physical therapy work differently too?

At the Chalela Physical Therapy Institute, we approach physical therapy through the lens of neuroplasticity – the brain’s ability to adapt and change throughout life. Using biofeedback, our protocol retrains the brain, allowing our patients to improve faulty proprioception, strengthen deep stabilizers, and learn proper physical alignment.

As patients work with us, they learn to protect not only their joints and ligaments but their neurological and vascular systems as well, leading to improvements in their pain levels, neurological symptoms, and overall functioning.

Physical Therapy

We offer in-person physical therapy at our location on Daniel Island, South Carolina. We specialize in treating EDS & CCI for patients all over the world, but also see local patients who need classic physical therapy.


Susan offers wellness treatments and health management consultations for EDS & CCI patients who are not able to travel to come see us in person.

Frequently Asked Questions

Traditional physical therapy can not only be unhelpful to patients with EDS, it can actually be harmful due to weak collagen and comorbid conditions. First and foremost, our approach takes into consideration the myriad of ways that EDS can affect your body’s biomechanics. As you learn how to stay in proper alignment, you will be able to function day to day with less pain and other symptoms. We teach this alignment using biofeedback to correct faulty proprioception caused by EDS, strengthen deep stabilizers to act in place of loose ligaments, and avoid extreme ranges of motion to prevent further damage to ligaments.

For in person treatment, we accept many types of insurance as well as self-pay. Telehealth services are cash pay only to allow us to treat patients regardless of location.

If you are coming in-person, but are not planning to attend regular PT at our clinic, and just need a small number of consultation visits for guidance on EDS or CCI, you will be considered self-pay. Insurance can only be billed for in-person visits if you are consistently coming to the clinic for physical therapy. We cannot provide superbills or any codes for these visits, as they are considered consultations and not physical therapy.

If you would like to know if we accept your insurance, please text or call us at 843-364-3213. If you would like to get on our waitlist, please complete the form on the “Get on the Waitlist” tab.

Our waitlist is several months long. Though it is difficult to give an exact length of time, we are working as hard as we can to provide such essential therapy to as many patients as possible. Head to the “Get on the Waitlist” tab to reserve your spot on the waitlist!

We do have cancellations that occur, and we try our best to get new patients in off of cancellations as well, this may significantly shorten your wait time. Please be aware that due to the volume of patients that are waiting to see us for therapy, we have a very strict cancellation policy.

There are a few major differences between telehealth and in-person appointments. The first is that telehealth can be done from anywhere, so you do not need to be local to Charleston or travel to our office. We can even do telehealth with patients in other countries. Because we want to provide telehealth appointments regardless of location, these appointments are cash pay only, whereas we do accept limited insurances for in-person appointments. The treatment protocol is identical between in person and telehealth appointments, with two exceptions – the first is that telehealth does not allow for any hands on or soft-tissue work by our providers and the second is that you will need to have your own equipment to complete your exercises.

Our clinic has an equipment list that can be easily ordered online for your personal use at home, to keep up with what you have learned at therapy in-between appointments or during telehealth visits. Once you are a patient and you have learned how to use the equipment, you will be given access to the list for you to order.

Cranio-cervical instability ranges in severity from mild functional disability to life-threatening instability, and the path of treatment is determined in part by the level of symptom severity. Some cases of CCI require surgery to fuse the skull to the top of the spine to eliminate the instability that causes injury to the brainstem. This surgery has a difficult recovery, with possible but rare complications of hardware failure and a new onset of instability in the joints adjacent to the fusion. For patients who require this surgery, it can relieve many symptoms and improve their quality of life, but for most cases of CCI, our specialized physical therapy can provide the same relief without the risk of complications. As a result, many neurosurgeons require the majority of their CCI patients to try PT for a period of time before agreeing to a fusion. In our clinic, we have had great success in preventing the need for cranio-cervical fusions, and for those who have required fusions, PT can help prevent adjacent segmental instability from occurring. Our approach requires you to commit to working the protocol, completing your exercises between sessions, and giving your neck the time it requires to strengthen, so we encourage you to come in with a positive attitude and a willingness to be patient for the results and do your homework in-between sessions!

Every patient is different, and we tailor our treatment to what each patient requires. Most of our patients come 2-3 times a week at first, with a gradual tapering as they gain strength and knowledge of how to continue this work at home. Some patients traveling from out of town will complete a single session to a few sessions with us consecutively while they are in-town and continue on their own or via telehealth.
We understand life happens and appointments need to be canceled or rescheduled! We do also have a long waitlist and want to ensure as many patients as possible are able to be seen. As such, we have a very strict cancellation policy, but are always understanding of emergencies and illnesses. If you need to cancel an appointment, please text us as soon as possible at 843-364-3213 and let us know your reason for cancellation.
    • If you need to make any changes to your appointment within one week of the scheduled time, there is a $10 fee. 
    • If you need to change or cancel your appointment within 48 hours, there is a $50 fee.
  • Cancellations or no-shows made within 24 hours of your appointment will incur a $125 fee.


Traditional hands-on therapy can be harmful to EDS patients due to weak collagen and the unique nature of the condition. The hallmark of hEDS is laxity in the ligaments that are meant to stabilize joints correctly. Because these ligaments are too loose, the secondary stabilizers – muscles – are often in spasm in an attempt to stabilize hypermobile joints. Traditional PT would use hands-on techniques to reduce the spasm, but unless something else is stabilizing those joints, doing so can cause further injury to ligaments – and, especially in cases of the spine, potential damage to the nervous system. Because of this, we focus first on strengthening the deepest levels of muscle to help maintain proper alignment of the joints with limited hands on work. When we do hands-on work, it is with the knowledge and expertise to do so safely. We find this approach to be successful in long-term pain reduction and in the reduction of other symptoms while protecting joints from further damage.
During the first appointment, we will be completing a full evaluation – looking at your medical and surgical history, your current level of functioning, the impact your conditions are having on your life, and the severity of your hypermobility. From there, we start working from the ground-up…literally. Even if your chief complaint is your head, we start our work at the feet as every level of alignment is affected by the levels below it. It is impossible to attain proper cervical alignment if your back isn’t in proper alignment which can be caused by your pelvis being out of proper alignment which can be caused by your knees being out of proper alignment…and so on. At this appointment, we will begin the process of determining what outside supports (orthotics, braces, etc.) will aid in our work together. From there, we will work with you to outline your treatment goals so we can get to work! If you plan on using insurance to pay for your therapy, much of your initial evaluation will be geared toward questions insurance requires us to ask in order to approve and cover you for treatment. If you plan on coming in-person regularly, that is fine! However, if you are just in town for a limited period of time and want to maximize your initial evaluation before you transition to telehealth, or just as a one-off, we recommend using self-pay and forgoing insurance for your appointment.
EDS and CCI are both medical conditions that require a physician to officially diagnose, so we are not able to provide an official diagnosis through our work with you, though we can often help point you in the right direction for who to see to obtain a diagnosis. For an EDS diagnosis, we recommend seeing a geneticist who can test for the known EDS genes and clinically diagnose those types without known genes, like hypermobile EDS. For a CCI evaluation, we recommend seeing a knowledgeable neurosurgeon who will order the type of imagining needed for diagnosis. Both of these diagnosis journeys can take time, and since physical therapy is often the recommended first line of treatment for both, we encourage you to start working with us while you go through that process.

We are a specialty practice that only sees patients who have either EDS or CCI, or are hypermobile and need PT for hypermobility-related concerns. If you are in need of regular PT and do not have any of these conditions, please talk to your doctor about where they recommend you recieve treatment for your physical therapy needs.


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