Yin Yoga and Hypermobility

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 Joint Hypermobility Syndrome / Ehlers Danlos (JHS / EDS).1 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 nerd anatomist, 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 a decade or so 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.

JHS / EDS is a group 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 JHS / EDS 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,2 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.3 This way I can stay selectively engaged. As an autistic person, I find this approach a lot more satisfying too.4 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 JHS / EDS. 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 myofascia5 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 JHS / EDS 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 JHS / EDS, 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.

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1. The terminiology of hypermobility is complicated and disputed among hypermobility clinicians. For the purposes of this writing, I use ‘Joint Hypermobility Syndrome’ and ‘Ehlers Danlos’ as two terms for pretty much the same thing. I also include Marfan Syndrome under this general umbrella.

2. I’ve never met Paulie, but he looks pretty damn hypermobile to me. Check out the pictures on his website.

3. This is pandiculation (yawning or the kind of intuitive stretching we do when we wake up). There’s an interesting article here.

4. 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.

5. The interwoven complex of fascia, ligaments, tendons and muscles.

References
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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On the edge: wire-walking for beginners

If we were to reduce yoga down to the bones, it’s breath, movement and attention that would be left at the bottom of my saucepan. When I say ‘yoga’, these three in union are what I mean. And whenever we breathe, move and attend to experience, we generate an encounter with a fourth thing, usually called in yoga ‘the edge’. In a beginning practice (especially a dynamic one), it’s not uncommon to equate ‘being on the edge’ with ‘going to the limit’. They are not the same. The edge is how I want to place myself in relation to a particular sensation, emotion or memory arising from embodied experience. It requires sensitive cultivation and implies what feels like an infinite number of possible responses – there are certainly a lot. I think we all know what ‘going to the limit’ means.

My practice, astanga vinyasa, is a gymnastic form, and is often considered to be the most physically challenging style of postural yoga. It consists of four (or six, depending on how you divide them) progressive series, demanding escalating degrees of strength, stamina and flexibility. It’s in the nature of this kind of practice to attract people, like me, who love to dance on the brink of the precipice. It may be only when injury or exhaustion forces us to re-evaluate how we are engaging with our practice that we begin to question the wisdom of habitually hanging on by our finger-nails. As we start to explore our physical, psychological and emotional experience more subtly, we may discover that the brink is not the only edge.

When we speak of edge, we are talking actually not of a singular position but of something more like a spectrum. Eric Schiffmann describes it like this:

Each pose has a ‘minimum edge’ and a ‘maximum edge’, as well as a series of intermediary edges between these … [The maximum edge] is the point where the stretch begins to hurt. It is the furthest point of tightness beyond which you should not go. If you were to force yourself beyond this point, you would definitely be in pain and might hurt yourself or pull a muscle. The minimum edge is where you sense the very first sensation of stretch, the very first hint of resistance coming from your muscles. (The Spirit and Practice of Moving into Stillness, Pocket Books, 1996).

Eric’s words imply that the edge is actually the middle: the centre point – or multiplicity of centre points – between too little and too much. What constitutes too little and what constitutes too much will vary from person to person, posture to posture, day to day, moment to moment. There will be times in your practice when you feel the need to press into your edge, and times when you feel the need to draw back. In other words, edge is not one location or a final arrival; it’s never discovered, mapped, done and dusted. Edge is an ongoing process, an endless dance of shifting experience. Nor is the edge really separate from us. There’s no thin black line out there against which we in here pit ourselves. Edge is intrinsic, a unique product of the interplay between our individual body and psyche with a particular posture in a particular moment in time.

Eric’s explanation might seem to imply that edge is all about extension – how much we stretch. Of course, it isn’t only. While, in the popular mind, yoga may be a form of esoteric contortionism, those of us who have practised it know that yoga postures engage us in contraction as much as extension – we breathe in and expand; we breathe out and find the tensility that enables us to maintain and stabilise. So edge arises also in our relationship with holding and contracting, as well as in the balance between holding / contracting and expanding. Since yoga is fundamentally about gradually enlarging our capacity to stay present to any and all of our experience, then feeling into how much of my own anger / frustration / grief / joy / excitement / inertia I can tolerate without dissociating – that’s also edge.

If the edge is the new middle, perhaps we can lift it out of its geometry altogether. When I’m teaching about edge, I often reframe it as ‘the expansion zone’. This feels to me richer, more plastic and more pregnant with potential. The expansion zone connotes that state of receptive witnessing where unanticipated changes can self-arise, organically, without me forcing the agenda. If I fall just short of the expansion zone, I’m too slack, too comfortable; if I push past it, I’m too strong, too urgent. What we’re aiming for here is that just-right feeling – not too sweet, not too sour; not too hot, not too cold; not too hard, not too soft. The one that when it emerges seems quite naturally to meet the moment.

When I offer mindful attention to my edge, I’m less likely to injure myself as I practise, and that’s important. Beyond that, though, my relationship with edge on my mat has everything to tell me about how I meet with edge in the rest of my life. If I practise yoga constantly at the outer limit of my endurance and on the verge of pain, this is a reflection of how I pitch myself in life. If I reflexively back away from challenges on my mat, choosing postures I find easy and non-threatening, the odds are that I am remaining in the shallows, emotionally and physically, in the rest of my life. Many of us go on habitually redrawing the same patterns in the sand and wondering why they never look any different. As we familiarise ourselves with these patterns in the laboratory of our practice, we become gradually more able to recognise them in life and can slowly begin to choose new trajectories.

Astanga vinyasa involves a process of dynamic surrender. ‘Dynamic’ means going for it, offering the best of our energy and our sense of direction, hanging on in there and staying wide awake. ‘Surrender’ means letting go into what’s really happening in the present moment – which may be that we don’t have much energy, we’ve lost our way and we’re falling asleep. Learning to walk this edge skillfully requires a lot of practice – which is why astangi’s practise every day. The more we practise, the more we find there’s space around the edge to play. We develop finesse and audacity. We may choose to lean back and take it easy; we may choose to take a risk – not out of habit or compulsion but because we’re feeling into what the moment uniquely requires.

ImagePhilippe Petit wire-walks between the Twin Towers

Hypermobility on the mat: some pointers for teaching yoga to people with Ehlers Danlos / Joint Hypermobility Syndrome and Marfan Syndrome

hypermobilityThese suggestions for working with yoga students with Ehlers Danlos / Joint Hypermobility Syndrome and with Marfan Syndrome (EDS / JHS / MS) are written in response to the many requests for help and advice I receive from teachers of hypermobile students. They are neither exhaustive nor gospel. They are the result of personal experience rather than expertise. I have been practising yoga with Ehlers Danlos (Hypermobility Type) since 1981 and have experienced many different attitudes and approaches from teachers. In the last decade-and-some, I have also been fortunate enough to teach many students with hypermobility.

While teachers with a normal mobility range are sometimes, understandably, anxious about how to work with hypermobile students in a beneficial way, most of the principles for teaching hypermobile people are also good practice for working with all students, so hypermobile people are easy to integrate into a general yoga class. Individual techniques for individual postures are outside the scope of this writing, but pretty much any principle for alignment and physical integrity you have learnt is potentially a great tool for hypermobile students. The following are some general possibilities to explore.

• Many beginning students share the popular view of yoga in our culture as the cultivation of flexibility. Frame physical practice as a movement towards balance and integrity. For some students this will mean working on strength and stamina; for others it will mean focusing on loosening restrictions in fascia and muscle. This approach will also serve your stiffer students, who may feel that they are ‘bad’ at yoga because they are not flexible.

• Guide hypermobile students to release (micro-bend) the insides of their elbows and the backs of their knees so that they are using postural muscles to support themselves rather than ‘hanging’ in their joints.

• If you are familiar with spirals, use them to guide alignment – as far as I can tell, it is impossible to both spiral and hyper-extend knees / elbows at the same time.

• Guide students to draw their limbs gently into the sockets rather than pulling them out, and to feel into the spaces for movement within the joint. The general principle is to relate back to the centre rather than pulling towards the extremities. If you teach a vinyasa style, bandhas are key here – and generally very helpful for hypermobile people.

• When teaching bandha be aware that a hypermobile person may tend to grip everything and hang onto it for dear life, so emphasise that bandha is a subtle art, offering lots of opportunities for somatic exploration.

• In a hypermobile body, overworked and very flexible muscles often compensate for tight, contracted ones. Look out for this and suggest ways in which the student might rebalance, by stretching or letting go in the tight places and strengthening the over-extended ones.

• Hypermobile people, by definition, have difficulties with proprioception, the ability to sense 1) the position of one’s own body in space, 2) the orientation of one body part to another, 3) the range of movement in a body part, 4) the degree of effort involved in carrying out a movement, and 5) which muscles need to be switched on and which switched off in order for a movement to be made in the most economical way. At the same time, many hypermobile people (particularly those – a significant number of us – who are autistic too) also have heightened interoception – awareness of stimuli arising within the body – and so may be receiving an overload of other sensory information. Be mindful of the potential for labelling sensation-sensitive students as hypochondriac or self-dramatising because they are registering somatic experience in a range that for the teacher is under the radar.

• A hypermobile student may find it helpful to have something to push into or resist against – this provides greater proprioceptive feedback and de-emphasises extending the joint as the main action. For example: ‘Press your elbows into my hands’ (to work with hyper-extending elbows in downdog), or ‘Press your shin up into your hand’ (to work with a hyper-extending knee in utthita trikonasana).

• Educate students about edge as a range of possibilities. Because of the limitations in their proprioceptive ability, hypermobile people may need guidance to be able to feel the softer edges on the spectrum. If a hypermobile student consistently chooses a hard edge, be aware that this may be because it’s the only edge they can feel, rather than concluding that they are an aggressive practitioner.

• Be prepared to adjust the hypermobile student’s alignment, in the same place, in the same way, again and again. Because of the proprioceptive deficit that is integral to hypermobility, most hypermobile students will need to feel the new alignment many more times than a non-hypermobile student in order to embody it.

• Offer only one verbal / physical adjustment at a time, even if there are many things in an asana that you feel need attention. Proprioceptive challenges, together with interoceptive overload (which can act as a kind of interference), make it difficult for hypermobile students to integrate multiple or complex changes into their body and they will quickly get overwhelmed by too much information.

• Refer students to the internal – energetic, somatic, psychological – dimensions of yoga. Remind them that the intention of physical practice is to create a simulacrum for life, in which our habitual patterns (samskhara-s), so naturalised as to be transparent to us, can become opaque, and once visible may be worked with consciously. Physical practice is simply an opportunity in which yoga may occur; it is not itself yoga.

• In making physical adjustments, focus on helping the student to feel the dynamics of the posture rather than increasing the amount of stretch in it. Adjustment focused on stretch puts hypermobile students at high risk of injury. A good adjustment holds the structure of the posture for the hypermobile student so that they can embody it.

• Be aware that wide range of motion is only one aspect of hypermobility and that EDS / JHS / MS is one of a group of overlapping conditions. A hypermobile student may also be experiencing:

Dyspraxia.
Dyslexia.
Dyscalculia (difficulty with numbers and sequences).
Dysautonomia / POTS (disregulation of the autonomic nervous system: so they may feel faint coming up from head-down postures, and dizzy in head-back postures).
Fibromyalgia / chronic pain.
Chronic fatigue / general need for more rest than usual.
Irritable Bowel Syndrome.
Eating disorders / self-harm.
Higher than usual rates of anxiety / a sensitive nervous system that easily gets stuck in fight, flight, freeze / low-level PTSD / OCD.
Austism / Asperger’s Syndrome.

• Be aware that while developing strength is desirable for hypermobile people, EDS / JHS / MS is a genetic condition of the collagen. While muscle strength can compensate to some degree for lack of tensility in the fascia, it can never create the kind of stability that is inherently present for non-hypermobile people (i.e. people with normally coded collagen). This compensatory form of stability is not automatic and must be consciously turned on and maintained. For this reason stabilising their body can be physically and mentally exhausting for hypermobile people.

• Know that yoga is very often not easy for hypermobile people. In fact, EDS / JHS / MS presents many additional challenges in asana work. These may include chronic pain, difficulty in stabilising the body due to lack of fascial support, limitations in proprioception (which, together with stability issues can make balance very difficult), dysautonomia (which may cause faintness, dizziness, a racing heart and unusual fluctuations in body temperature), frequent dislocations and injuries (which may require a longer healing time in a hypermobile body), and difficulty in building muscle mass.

• Avoid framing the holding of a posture as a feat of endurance. A hypermobile student may lack the fascial tensility to hold a standing posture for what would be a normal period of time for other students, even when they have good muscle strength. Holding beyond their comfort range may not increase the student’s stamina but cause muscles to go into spasm, and tendons, ligaments and fascia to become inflamed and over-stretched.

• If you teach a yin style, be aware that for some hypermobile people an optimal yin stretch may be one to two minutes, and extending the hold time may result in damage to tissues. The appropriate duration will vary from person to person, and for the same person in different postures. Encourage students to track their own edge and emphasise that it is always OK to come out of a posture. The optimal hold time is not five minutes but when you feel ‘cooked’. I have written specifically about yin yoga and hypermobility here.

• Be extra-mindful of your own projections. Hypermobile students sometimes receive projections related to the teacher’s own desire to be flexible, and may be inappropriately praised or criticised as a result. Remember that hypermobility is not something that the student is doing; it is something they are being. There is no choice or agency involved in being hypermobile; it is simply a genetic condition.

• If you are teaching a student who regularly dislocates (and may also be able easily to put themselves back in joint), keep teaching towards structural integrity and avoid communicating any sense of fear or horror you experience in response. Be aware that this kind of dislocation is an everyday occurence for some hypermobile people and for them may not be a big deal.

• If your student is not aware that they have EDS / JHS/ MS, it may be helpful to let them know that you cannot diagnose, but that you think they may be hypermobile. Many beginning hypermobile students struggle enormously with balance and stability, and may be having other unexplained health problems. It can be very useful for them to know that there is a reason for this. Explain simply and without drama, and offer as much information as they want to receive. For some students this will be a lot, for others little.

• Offer help to stabilise, strengthen and align the student’s extension rather than asking them to pull back out of it (or not to go so far). This way you are offering them something more rather than taking something away. Most students will be responsive to this approach.

• Be aware that for all sorts of reasons, hypermobile people do need to stretch. We all do. Unstressed tissues are degenerating tissues, and many hypermobile people have some muscles in a state of chronic contraction.

• Be aware that in people with the, less common, vascular type of EDS the blood vessels, gut wall and uterus are very fragile and at risk of rupture (which may be life-threatening). Prevention of trauma to the skin (eg bruising) is very important. A person with vascular EDS may need to pad vulnerable areas of their body and avoid any postures that might cause them to fall. Be very careful of their skin if you make any physical adjustments.

• If you teach an aerobic form of yoga, be aware that for people with Marfan Syndrome (a form of hypermobility that also affects the heart and circulatory system), aerobic exercise is usually contraindicated because it can place too much stress on fragile tissues in the heart, veins and arteries and may lead to heart attack. Whereas many people with EDS / JHS are unaware that they are hypermobile, those with Marfan Syndrome are most often already diagnosed. This is because EDS/ JHS / MS runs genetically true to type, so it is likely that there have been instances in their family of early heart attack without the usual indicators of coronary disease (for example, a relative with low blood pressure, low cholesterol and a normal weight who had a heart attack in their forties). It is recommended that people with Marfan Syndrome do regular low-intensity, low-impact activities in which their heart rate does not go above 100 bpm. They should work at about 50 per cent of maximum effort. A strenuous yoga class may not be appropriate for them. You can download a guide to Marfan Syndrome and physical exercise here.

• If your student is an experienced yogi, by all means offer suggestions for change, but be mindful not to sweep in and reconfigure their practice for them. Remember that the practice is the student’s. Because of the proprioceptive deficits involved in hypermobility, most hypermobile people receive limited information about where they are in space and where their body ends. As a result, control over their own body may be an issue for them and they may feel threatened by any suggestion that you are trying to take over. If your student appears resistant to your suggestions, consider this as a possibility and explore how you could work with them more collaboratively. A style that supports what they already know and adds value to how they already practise will generally be well received. Be aware, too, that hypermobility sometimes attracts a surfeit of technical imput. You may or may not be giving the experienced student something new. Enquire and offer rather than impose.

• Some people with EDS / JHS / MS are housebound wheelchair-users, others are elite dancers, gymnasts and circus performers. In a yoga class, some hypermobile people will easily be able to enter physically challenging postures and will travel swiftly through progressive yoga practices such as astanga vinyasa, becoming adept practitioners of advanced series. Others will be dogged by injury and chronic pain. One possible reason for this disparity is that hypermobility is in fact not one but a group of many different genetic variations in the collagen. As genetic testing becomes cheaper and easier to carry out, more of these variations are being identified. Avoid evaluating hypermobile students on their physical performance. An EDS / JHS / MS student who is often injured may not be weaker or more pushy or more inconsistent in their practice than another who sails easily through increasingly more challenging sequences of asana. They may simply each have a different genetic variation in their collagen.

In general, hypermobile students try really, really hard, love working with their body and are a joy to teach. Trust your instincts, and honour and enjoy this opportunity to explore together.

I offer occasional workshop days on EDS / JHS / MS for (non-hypermobile) yoga teachers and for hypermobile yoga practitioners. For more information see www.embodyyogadance.co.uk or email jess@embodyyogadance.co.uk.

Articles about yoga and hypermobility
‘Six Tips for Teaching Yoga to Hypermobile Students’ – very good article by yoga teacher and physiotherapist Ariele Foster.

Hypermobility and Yin Yoga – another article by me.

General information about  EDS / HMS
A Guide to Living with Hypermobility Syndrome, Isobel Knight, Singing Dragon, 2011.

Teaser for a documentary on ED / HMS by Lara Bloom – a really good five-minute introduction.

The Hypermobility Syndrome Association (UK).

Ehlers Danlos Support UK.

The Ehlers Danlos Foundation.

Ehlers Danlos Syndrome Network CARES Foundation (US).

The National Marfan Foundation (US).

Postural Othostatic Tachycardia Syndrome (POTS)
POTS UK.

Useful article on POTS in the British Journal of General Practice.

Dyspraxia
Dyspraxia Foundation.

Autism
The National Autistic Society.

Autism Womens Network.

Getting it together: yoga for newcomers

It may be that you have joined a yoga class to get fit. This is the first step onto the mat for lots of people these days, and like all beginnings it is a worthy one. If you continue to practise regularly, however, you will begin to notice that while you may be experiencing benefits to your general fitness, there is also something bigger, deeper and more mysterious going on.

The Sanskrit word yoga is usually translated as ‘union’. BKS Iyengar (one of the great modern teachers and practitioners of yoga, and the founder of the Iyengar yoga system) describes this as ‘integration’; in other words, accepting and owning all the parts of ourselves. In the context of yoga, this integration is not only personal but also transpersonal: it entails experiencing and embracing our part in the universe, and experiencing the numinousness of that whole, which includes us and is so much bigger than us.

It’s important to understand that the physical postures of yoga are just a scaffolding. They are not themselves yoga. Yoga is the process of whole-person awakening that happens through engaging mindfully with the scaffolding of the postures. ‘Mindfully’ means that you notice what you are experiencing as you move through the postures, being aware of sensations, emotions, thoughts, energy moving, memories arising … and, just noticing, let them be.

Every yoga class should really come with a big bold WARNING sign and a lot of exclamation marks. Yoga is a dangerous practice. If you practise regularly and sincerely, it will transform your life from the roots up. You may be impelled to change anything and everything from your diet through your closest relationships, your job, where you live, and what time you go to bed and get up in the morning. The physical alignment you have been working with in trikonasana, parsvakonasana and all those other postures with difficult Sanskrit names are practice for this. You are being drawn into alignment with your truest purpose in life. There is often discomfort, confusion and a sense of disorientation in realignment. You will probably be familiar with this from your yoga class too. Transitions like this are not always easy or welcome. Many people stop practising yoga when they begin to feel the pull to shift position in this way. Ultimately, however, you are being moved towards your greatest integration, health and well-being.

Our ability as yoga practitioners is marked not by whether we can sit in lotus position or stand on our head for ten minutes, although working towards these things may be part of the scaffolding, but by our capacity for engaging with these transitions kindly and steadfastly, offering compassion to all our human silliness, and patience to our reluctance. Mr Iyengar says:

Yoga allows you to rediscover a sense of wholeness in your life, where you do not feel like [sic] you are constantly trying to fit the broken pieces together. Yoga allows you to find an inner peace that is not ruffled and riled by the endless stresses and struggles of life. Yoga allows you to find a new kind of freedom that you may not have known even existed … Ultimately … there is a serene core of one’s being that is never out of touch with the unchanging, eternal infinite. (Light on Life, xiv)

Good luck with your practice.

Light on Life, BKS Iyengar, Rodale, 2005

‘Progress’

Practise, practise, all is coming.

When we start to practise astanga vinyasa, most often we are concerned with the scaffolding. That is, with physical technique – with alignment, bandhas, jump-through, jump-back, strength, stamina, flexibility and so on. This is appropriate, because until we have built the structure, we cannot inhabit the house. Often, though, we translate this priority for engaging with some basic principles into the belief that there’s somewhere ‘we’ (usually meaning ‘our body’) have to get to – and as soon as possible. We construct ‘somewhere’ according to whatever we feel our own physical deficits to be. So the nirvana of arrival may be stretching our hamstrings, losing weight, jumping back without touching down, getting into a more challenging variation or a more advanced posture, being able to do padmasana, sirsasana, urdhva dhanurasana … and so it goes on.

Generally, though, over the months and years, our attitude gradually starts to shift. We become more engaged with what’s happening now than with what might (maybe) be happening sometime soon. We begin to dwell more often in the reality of the moment. This shift begins to happen when the yoga mat becomes home, a place we need to go to every day in order to re-find ourselves. It is therefore an outgrowth of a regular self-practice (and something that cannot result from attending no-matter-how-many classes). It’s not dependent on a teacher. No teacher can give us this; we already possess it and only need to uncover it in ourselves.

When we are engaged with practice in this simple, regular way, ‘progress’ is no longer something that we reach for, but something that occurs, quite ordinarily and routinely, when a space opens up and we move, quite ordinarily and routinely, into that space. Space opens out of the act of stepping onto our mat, with a willingness to be present (and a willingness to be present to our inability to be present), day after day. It may manifest as a tiny increase in strength or flexibility. It may manifest as a little more capacity for abiding through difficult emotions. It may manifest as the opportunity to catch sight of the place that bores us, frightens us, brings us so much joy we just can’t bear it, and, for a second, look it in the eye. It may manifest as the growing tendency to get onto our mat even when the loudest voice in our head is telling us that there isn’t time and our life is too busy. It may manifest as injury and the need to find new ways, both physical and psychological, of being in our practice – and the willingness to look for those ways rather than roll up our mat and have a break.

Progress can look like going backwards. It takes a certain bigness of mind to embrace this kind of progress – and it’s the bigness of mind that makes the difference, the bigness that recognises the prince in the frog. The miraculous thing is that, even in what appears to be a setback, spaces are always opening out. We just have to be able to see them and expand into them – and with time and practice, this way of responding becomes our natural impulse.