In the small but growing conversation about yoga and hypermobility, there has been quite a bit of interest lately in yin yoga and its suitability – or not – for people with Hypermobile Ehlers Danlos, Syndrome, Hypermobility Spectrum Disorder and Marfan Syndrome (hEDS / HSD / MF): the hypermobility syndromes. And if it is suitable, whether it needs to be modified. And if it does need to be modified, how.
First off, let me say that I am neither a doctor, a physiotherapist, a scientist nor any kind of expert. What I know about yoga and hypermobility is experiential. It arises from 35 years of practising yoga in a hypermobile body and 18 years of working with hypermobile people as a yoga teacher. Among other things, I am a yin yoga teacher – I trained with Paul Grilley – though what I offer these days is mostly a restorative form of yin.
I’ve come across some fairly dogmatic opinions about yin yoga and hypermobility, and I don’t want to add another one. I feel that it’s inappropriate and pointless to pronounce on what another person’s practice should or shouldn’t be. This is something that can be known only from the inside. An authentic practice emerges, resonates, informs, pleasures. It has the capacity to repattern and recalibrate on a whole-person level. It leads us into the centre of of our experiences and reveals increasingly subtle sensations, emotions, and mental and nervous system activities, so that over a period of time, the practising body becomes an ever more intelligent system. This is an intimate and personal process, and it remains the exclusive property of the person experiencing it.
HEDS / HSD / MF is a grouping of – very many – genetic mutations, a few of which have been identified, the majority of which have not, all of them causing laxity and fragility in the connective tissue. When we think about connective tissue, we tend to imagine ligaments and fascia, but in fact connective tissue is a major component not only of the musculo-skeletal but of all body systems (vascular, reproductive, urinary and so on), and a person with hypermobility can experience the consequences of having ‘different’ connective tissue in some, all or many of these systems.
It’s evident from reading forum posts on yin yoga and hypermobility that some people assume yin yoga to be a generic term for a gentle form of hatha yoga. No wonder, then, that they are puzzled as to why this kind of yoga might be inadvisable for a hypermobile body. So to clarify, the yin yoga that we are talking about is a specific form originated by martial arts master and yogi Paulie Zink,1 developed by Paul Grilley, and popularised by Paul along with second-generation teachers such as Sarah Powers. Bernie Clark, author of The Complete Guide to Yin Yoga, describes yin like this:
Most forms of yoga today are dynamic, active practices designed to work only half of our body, the muscular half, the ‘yang’ tissues. Yin yoga allows us to work the other half, the deeper ‘yin’ tissues of our ligaments, joints, deep fascial networks, and even our bones.
In yin yoga we do this by holding a passive extension for a long time (about five minutes on average, but sometimes less and sometimes more). Paul Grilley explains that the nature of fascia is contractile. If we don’t counteract the contractive process, as we age, the fascial wrappings around our joints, muscles, internal organs and whole body beneath the skin, become progressively tighter and more restricted, often along distorted planes that affect our capacity for functional movement. The theory is that fascia responds to long, slow stretching by lengthening and unkinking. Gentle stressing in this way, according to the yin yoga paradigm, also makes the fascial tissues stronger (in much the same way that doing repetitions with a bar bell strengthens the biceps by causing muscle fibres to break down and rebuild).
If stressing / stretching connective tissue is central to yin yoga, and hypermobile connective tissue is delicate and already lax, it’s easy to see why there might be concerns about the suitability, helpfulness or even safety of this practice for a hypermobile body. But are these valid? In practice, I have taught hypermobile people who love yin yoga and find great benefit in practising it, and I have taught hypermobile people who have found they get overstretched and injured by yin and avoid it like the plague. Eva, Liz, Micky and Deborah say:
In yin classes I was always told to let go, yield, etc. If I let go in paschimottanasana or a split, I go to the maximum of my flexibility and it will either increase my hypermobility or will give me an injury. I’ve tried different approaches to yin, such as strengthening some muscles or not letting go completely, but I don’t think this is really yin yoga and I don’t find these approaches relaxing.
I think it’s important that we each find our own safest practice. For me, a mindful modified yin practice is very nourishing. But I do not dislocate and most of my [other] practice focuses on building strength.
I find yin extremely beneficial. I like the fact that with yin you work passively. I’ve noticed that every time I practise yin, it alleviates the usual aches and pains that I get during my morning astanga self-practice. It helps with letting go of emotional and therefore physical tension, and it’s great for the parasympathetic nervous system. Often a practice like astanga can create an accumulation of tension, and yin has taught me to let go of the subtle tension, or at least to be aware of it.
I love yin yoga, but I am getting to the opinion that yin doesn’t like me very much, especially when I have some damage somewhere. The stretching feels soooo good, but I’m pretty sure I over-stretch something that should be healing. And moving out of the posture can be really painful. Also, even on the good days, I do need to engage a few more muscles than classically you should do, particularly in my hips and core, to stop me collapsing as the ligaments relax.
In my own experience it’s observable how my responses to yin practice have shifted across different phases of my life. I used to practise yin fairly regularly – for a while every other day, and then about once a week. A year or two ago, I stopped doing yin altogether. The practice itself usually felt fine, but on several occasions afterwards I had been in pain – probably as a result of some torn muscle fibres, or muscles spasming to protect a joint. Lately, though, I’ve noticed that the balance of flexibility in my body has changed as a result of not having yin in my movement repertoire. I wondered if this is contributing to issues in my hips and pelvis, and I have re-introduced some yin practice. In the meantime, I have also experienced some significant shifts in my somatic and proprioceptive understanding, and it seems as if now I may be able to re-encounter yin in a more creative and adaptive way. Our bodies change over time, as does our capacity to understand and integrate the subtleties of different practices. Some we outgrow, others we grow into, and sometimes a practice we thought we had outgrown may become available to us on a level that we hadn’t realised existed.
Paradoxically, while too much yin can cause muscles to go into spasm, just enough yin can also help to release a spastic muscle. Most people assume that a hypermobile person will present as extremely flexible – and we often do – but where hypermobility has been accompanied by inactivity and deconditioning, and widespread muscle spasm has gone unchallenged, the person may be very, very ‘tight’ – although they will still often have tell-tale hyperextending joints, sometimes with subluxations and / or dislocations. In this scenario, a modified yin practice could be very useful, probably with shorter than the usually recommended hold times (over-stretching will cause muscles to go into even tighter spasm, remember) and with very carefully targeted work. An experienced teacher can help the person to avoid flopping into familiar and already overstretched areas, and instead to access areas that may have gone offline, so that more functional, less painful movement patterns can be established.
This kind of specificity in where and for how long I work is crucial to me in practising yin in a beneficial way. It’s complex and it isn’t usually within the capacity of a beginning yoga practitioner, or a practitioner who is only just discovering and coming to terms with their hypermobility. I rely on a lot of knowledge that I’ve emerged from working with a very good physio. I also don’t completely relax in postures, but prefer to squeeze and release and press into certain muscles and to relax into others.2 This way I can stay selectively engaged. As an autistic person, I find this approach a lot more satisfying too.3 Like Eva, though, I think it’s questionable whether this way of working is really yin any more, since yin is essentlally defined as a passive form in which we follow the bones, follow the line of least resistance and let go into the joints.
Although yin is a passive form, it’s not necessarily gentle. Most yin postures have fearsome potential as stretches, and if practised to an extreme in terms of range of movement and duration can be highly agressive to ligaments and tendons. And herein lies one of the gifts of yin. It has important lessons to offer about edge: where is too much, where is too little, where is the sweet spot that holds the potential for expansion into our experience in all dimensions – physical, emotional, mental, transpersonal? This is an especially important learning for a hypermobile person because a deficit in proprioception is part and parcel of hEDS / HSD / MFS. While we are innately endowed with limited proprioceptive resources, we can work with what we’ve got to cultivate our capacity to feel into and differentiate between edges. If practised with sensitivity and appropriate intention, for some people yin yoga can be a fertile terrain for this exploration.
One possibility for making yin yoga safer and more user-friendly for hypermobile people is to give it restorative slant. Micky described his yin practice to me as partly restorative. Eva and Ellen say:
After years of practising yin yoga and not having a clue what I was supposed to do or feel with my body, I’ve come to the conclusion that we hypermobile people should do restorative yoga rather than yin. I am convinced that the only way to do it safely and really let go is with the use of props.
The only yin that works for me is supported positions that don’t involve a stretch. Probably technically more restorative yoga than yin.
In restorative yoga the emphasis is on comfort and ease rather than stretching. Soft props such as bolsters and blankets support the body, and we slow right down to access the parasympathetic nervous system, creating opportunities for rest, integration, and physical and emotional healing. Clearly the potential for traumatic injury to myofascia4 is far smaller in this scenario; however, even a restorative practice can go pear-shaped for a hypermobile practitioner if they are already biomechanically out of kilter. Bear in mind that for many hypermobile people, sleeping is a high-risk activity. Those most severely affected may need to wear splints and braces at night to keep their joints in a neutral position; most of us are accustomed to waking up with joint and muscle pain. Restorative yoga can be counter-productive where fascial laxity is such that when the person lets go (allows postural muscles to switch off) they collapse into positions that distort the joints. Often in this scenario the resting position is further compromised by dysfunctional muscle patterns, in which some muscles are very tight and unable to release, whereas others are completely switched off and unable to fire, so that the person is biomechanically lopsided. In this situation, structural repatterning work (with a suitably skilled physiotherapist, yoga therapist or other structural bodyworker) may be of most benefit.
There’s more to yin yoga than stretching, though. Yin is also a meridian system. Paul Grilley explains:
Spiritual adepts from the earliest times have described an energy system of the body that is vital to its health. In India they called this energy prana and in China they called it chi. The Chinese Taoists founded the science of acupuncture, which described in detail the flow of chi through pathways they called ‘meridians’. It is chi, in all its forms, that keeps us alive.
Central to Paul’s approach to yin is the work of Dr Hiroshi Motoyama, a yoga-practising shinto priest who is also a double PhD scientist with a long track record in researching the science of bodymind. Motoyama’s work suggests that the meridian system is located in fascial tissues. Another well-known researcher in the field, Dr James Oschman, explains:
All movements, of the body as a whole, or of its smallest parts, are created by tensions carried through the connective tissue fabric. Each tension, each compression, each movement causes the crystalline lattices of the connective tissues to generate bio-electric signals that are precisely characteristic of those tensions, compressions and movements. The fabric is a semiconducting communication network that can convey the bioelectric signals between every part of the body and every other part.
If this is indeed the case, the implications for hypermobile people – those of us who have a different sort of fascial tissue – may be immense, complex and wide-ranging. As far as I’m aware, these possibilities have been discussed little if at all. Maybe it’s still all a bit woo woo for the majority of people to contemplate.
I’m often asked if I can give guidelines for working as a yoga teacher with hypermobile people. I can’t. While it’s possible to make some suggestions as a starting point (I already have – you can find them here), the way hypermobility presents is very individual, and it’s really necessary to encounter and be in collaboration with the particular hypermobile person in order to offer anything meaningful. Some people with hEDS / HSD / MF are almost unbelievably flexible and able to perform the most mind-bending contortions with no pain or other unwanted complications even into later life. Others may not have such breathtaking mobility but suffer from very debilitating fertility issues, digestive problems, chronic pain, sleep disruption, anxiety, prolapses, incontinence … Perhaps to some extent this diversity is due to the range of different gene mutations involved in hEDS / HSD / MF, although, of course, there are many factors that determine how our genes express. When I’m working with a hypermobile person, I do my best to let go of theories, pre-formed solutions and paradigms, and approach with beginners mind and waving antennae. I use my eyes, and I rely on the body of experience I’ve accumulated, but it’s also through my hands, my skin, my nerve endings and that intuitive sense that lives who-knows-where in my body that I feel into what might be this biomechanical system, this emotional experience, this nervous system response, this neurology.
Yin yoga and hypermobility: good thing / bad thing? I don’t really know. It all depends. I do feel that that yin yoga as a practice is sufficiently rich, alive and malleable to be different things to different people, that there’s enough elasticity in it to allow for varying slants and approaches. If a practice attracts you, I’m all for wriggling through the wire and finding a way in.
1. I’ve never met Paulie, but he looks pretty damn hypermobile to me. Check out the pictures on his website.
2. This is pandiculation (yawning or the kind of intuitive stretching we do when we wake up). There’s an interesting article here.
3. It’s well recognised by autistic people and by those who work with us at grass roots level (especially with children) that there is a significant intersection between HMS / EDS and autism. However, there is a reluctance among medical professionals to acknowledge the relationship because there is little, if any, scientific research on the subject – and if there’s no research, it doesn’t exist, right? Autistic people generally don’t do well with physical stillness. We need to move in order to regulate our nervous system – after all, this is what stimming is all about.
4. The interwoven complex of fascia, ligaments, tendons and muscles.
The Complete Guide to Yin Yoga: The philosophy and practice of yin yoga, Bernie Clark, White Cloud Press, 2012.
Yin Yoga: Outline of a quiet practice, Paul Grilley, White Cloud Press, 2002.
‘Being Flexible About Flexibility’ is a good article on hypermobility, flexibility and yin yoga by my friend and colleague Norman Blair.
My very good physio is Darren Higgins at Vanbrugh Physiotherapy Clinic.
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