Please remember throughout this post, I am not a yoga instructor, I am not a physiotherapist. This is all info I’ve learned through personal experiences with yoga and Ehlers Danlos. I recommend checking with your Dr or physio if you’re unsure about anything.
What is yoga? Extreme stretching? meditation stuff? skinny flexible ladies in patterned leggings? Not quite…
In reality, Yoga is a highly adaptable and individual practice, each persons yoga journey is unique. It can be a deeply spiritual experience or it can be a way to relieve tight muscles and stay fit. Some people dedicate hours a day to meditation and flexibility training, others just a few minutes of gentle stretching every once in a while.
As regular visitors to my blog will know I have a condition called Hypermobile Ehlers Danlos Syndrome (HEDS). Its part of a collection of conditions (Hypermobility Syndromes or HMS) causing widespread joint pain, repeated injuries, joint dislocations and subluxations, poor proprioception, fatigue and more. I also have Postural Orthostatic Tachycardia Syndrome (PoTS) which causes big increases in heart rate upon postural changes, heat intolerance, breathlessness, fatigue, dizzieness and in some cases syncope (fainting).
I often hear people with hypermobility syndromes say that yoga is 100% not recommended for bendie people. It will make our joints more flexible and thus more unstable. This is not entirely true. Some of the hypermobility specialists actually recommend regular gentle stretching to relieve pain and ease stiff muscles. So how do you stretch safely with HMS? The first step is knowing the difference between flexibility and hypermobility.
Flexibility is the quality of bending easily without breaking, within anatomy it often simply describes the range of motion around a joint. We need flexibility in order to move ‘normally’ and efficiently. Flexibility varies from person to person but there are ‘normal’ joint ranges that most humans adhere to.
Hypermobility is something else… hypermobility means that some or all of a person’s joints have an unusually large range of movement. People with hypermobility are particularly supple and able to move their limbs into positions others find impossible. Sometimes this is useful, swimmers, dancers and gymnasts are often hypermobile.
Being hypermobile isn’t the same as having a hypermobility syndrome though. People with a HMS often experience pain, fatigue, injuries and all sorts because their bodies aren’t able to cope with their hypermobility. Each persons body copes with this in different ways but there are some common themes with a lot of bendie people. A lot of people with a HMS experience muscle pain and stiffness, because our ligaments are rubbish we rely on tense muscles to support our joints, wear and tear injuries are also common as is osteoarthritis, for these reason it is possible to be hypermobile but not flexible! You can have joints that bend sideways or are unstable in ways that shouldn’t be possible… I have friends who are severely hypermobile and dislocate freqently but cannot touch their toes and actually have below average flexibility.
I am very hypermobile I have hypermobility in all of my joints, including joints that should (in normal people) be fixed in place like the sacro illiac and rib joints. This doesn’t stop me feeling stiff in the mornings, my muscles are tight in some places and lazy in others. Although I still present as very flexible I feel like I’m not!
Yoga is one of the things that helps with this but I have never been to a yoga class, and actually I wouldn’t nessesarily recommend this to people with a HMS to start with. Depending on your levels of fitness you might need to do some ‘prep’ fitness in order to be ready for a beginners class. Even beginners classes are about an hour long and stretch all parts of your body, for a bendie person (especially in the beginning) this is too long and too intense. You might feel great in the class but chances are you’ll feel terrible afterwards! Besides the strenuous nature of classes there is another issues. I’m a very competitive person so if I’m in a room full of people stretching I *might* be tempted to use my hypermobility to ‘win’ at stretching. This will likely result in injury. The exception to this is a one on one class with someone who is happy to work at your pace and focus on your needs, even better than this would be a yoga instrucctor who is medically trained.
Instead I learnt via Instagram. No really. I joined in with a beginners yoga monthly challenge hosted by two expert yogis @beachyogagirl and @kinoyoga. The challenge has one pose a day for the whole month and they do a new challenge every month. Each day the hosts post a tutorial video with an explanation and everyone else doing the challenge posts their photos and videos too. So I joined in. I couldn’t do all of the poses so I tweaked and adapted them and looked online for alternatives and I managed to make it through.
There are a few bendie things you’ll need to be aware of if you’re looking to get into yoga so here are my top tips and warnings for budding bendie yogis. (In no particular order)
* Look after your joints
- When stretching its important to stretch your muscles not your joints/ligaments. One of the common issues for bendie people is not really being able to feel a stretch, we get tempted to push further into a stretch to really feel the pull. Just because you can’t feel the stretch at the time doesn’t mean you’re not actually stretching! Start off doing a little bit of a stretch and if the next day you feel good then you can go a tiny bit further next time.
- Watch your alignment. I almost always have someone watch me stretch when I learn a new pose if this isn’t an option then work in front of a mirror. Lack of proprioception can lead to injuries very easily. People with hypermobility often twist their joints without realising and this is certainly an issue for me. I’ve often looked back at photos of me and thought my legs looked really odd! Correct alignment is much more important than how far into the stretch you can get. This goes for all of your joints, knees, ankles, hips and wrists seem to be my ‘problem’ areas but this might well be different for you. Taking photos can also help with this. Do the pose, look at the photo and spot any issues you have and try to correct them next time.
- Don’t slump into your joints. Don’t be tempted to simply rest your body at the end of your range of motion, this is particularly important for lunges and straddles etc. Yoga should be an exercise in strength more than flexibility. The way I build strength while not straining my joints is to make sure I’m using my muscles to hold me within the ranges of flexibility and not hypermobility. A good example of this is not letting your knees hyperextend when doing standing poses. Use your leg muscles to prevent knee hyperextension.
* Pace yourself
- Too much of any activity is likely to cause problems. You can read my blog post on pacing HERE.
- You do not have to complete every yoga pose known to man in one day..or one month..or one year..or ever!
- When learning poses don’t be tempted to hold the stretch for too long. When trialling a new pose I generally stretch for just 5 seconds to start with.
- Don’t feel like you have to stretch if you’re feeling rubbish, and if you’ve had a recent joint sublux or dislocation then don’t stretch that joint until you feel confident it will stay where it belongs!
- Don’t do too many poses in a row. I often split my days worth of yoga into one or two poses in a row followed by a break. This serves a number of purposes, firstly it allows me to manage my fatigue, secondly I’m not overusing my muscles, third it helps me pinpoint which if any poses are causing problems. If you do 10 poses then get knee pain how do you know which pose is causing the problem? If I’ve only done two poses and I get knee pain it should be much simpler to figure out which pose needs adapting.
* Your yoga is for YOU
- Just because the beautiful, beach tanned, super fit ladies and gents in california can stand on a rock in the splits on one leg for 5 minutes while the sun sets does not mean it is safe for you! Just becase another EDSer can do a handstand doesn’t mean it is safe for you! and just because you could do tree pose yesterday doesn’t mean it is safe for you today! I know its frustrating but the kinder you are to yourself the faster you’ll make progress.
- There are likely to be some poses you are never able to do safely. This is ok. We are all individuals.
- Footwear is very important, I go with grippy socks or bare feet if i’m only doing a few poses but if I’m training hard or doing a lot of standing poses I wear ankle braces and studio shoes (for dancers). This gives you the freedom of bare feet but decreases the chances of ankle injuries and falls.
- Don’t be afraid to splint up or tape your joints if you need to. Don’t be afraid to hold onto the back of chairs etc to help you balance, if you need to.
- Yoga blocks and yoga straps are available online and are great aids to help you if you struggle to reach the floor, need a bit of support or struggle to hold your toes etc.
- There is a growing trend for Adaptive Yoga. This is where people change poses to suit their needs, Chair Yoga is becoming much more popular for people who cannot stand for prolonged periods or who are still working on the strength component of poses. If you are sat on a chair don’t just flop, if possible tense the muscles you would be using if you were standing, even if they don’t take your weight fully you can still work the muscles a bit. There are chair yoga classes available in lots of places now and there are chair yoga and adaptive yoga tutorials on youtube too.
*Hormonal… (Mainly for those with a uterus)
- One of the things to watch out for is hormonal changes. Changes in the levels of certain hormones like progesterone can have a profound effect on levels of hypermobility. I currently don’t have periods due to medical intervention but when I was having regular periods the hormonal fluctuations meant that at certain points in my cycle any strenuous activity simply wasn’t safe, my joints were too unstable to do anything besides gentle waterbased exercise and the minimum of physiotherapy. You may well find that yoga simply isn’t safe when you’re on your period. The other time to be very careful is during pregnancy. Pregnancy hormones increase flexibility in everyone so for hypermobile people it can cause big problems with pelvic stability, during this time added stretching probably isn’t wise!
My final though is that yoga shouldn’t be your only source of exercise. Pilates is highly recommended by most HMS experts and lot of HMS patients too! Along side my yoga practice I have an extensive physiotherapy plan covering most of my joints and I also do lots of other sport. Yoga makes up about a third of my fitness routine nothing more. If you’re stretching regularly it really is important to do lots of pure strength work too.
I hope this has been useful and has eliminated some of the fear a lot of bendie people associate with yoga. This is just a collection of my personal expereinces but the tips and tricks have served me well. If you have anything to add please don’t hesitate to let me know. I would love to hear from you about your yoga experiences.
Ciao for now.