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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Monkey Girl: me, my ribs, the speaking body and some physiotherapists I have known

Once, in class, I’d reached out to touch a coil of braids on the head of the woman in the seat in front of me. I hadn’t been thinking at all, overwhelmed by the need to feel that intricacy of hair. She’d turned around. ‘My head doesn’t belong to you,’ she’d said icily, leaving me stuttering an apology, horrified at the way my chimp nature still popped out when I wasn’t paying attention.”—Karen Joy Fowler, We Are All Completely Beside Ourselves

Rosemary grew up with a chimp. While the chimp, in Karen Joy Fowler’s novel, acquires some human skills and characteristics, Rosemary also learns to emote and socialise a bit like a chimp. ‘There was something off about me,’ Rosemary says, ‘maybe in my gestures, my facial expressions or eye movement, and certainly in the things I said.’ Being autistic in a neurotypical world feels not dissimilar to this.

10482574_765329033510297_4537353880031777239_nI’m not horrified by my autistic nature – far from it – but I am very aware of its capacity for toppling things over. There’s a constant negotiation going on between my authentic monkey impulses and the way I know human beings are supposed to behave. The more I like someone, the more I want to bring all of myself to the table, but the bigger the risk of upsetting the teapot. I often feel like an over-large and over-enthusiastic dog who loves you just too much, and is just a bit too excited to see you. I’m scared I’ll knock you off your feet with the full force of myself.

There are some autistic people, I’m told, who show very little affect; I am not one of those autistic people. What I feel emits from my body like cartoon shock waves in the air. For many years, I tried to curb myself. This is called passing. It hurts. I walked around in an invisible straitjacket. I fitted right in. Unfortunately, I also had an eating disorder, ongoing low-level PTSD and chronic fatigue. I felt alienated not only from everyone and everything, but also from myself. I remember writing at the time that I felt like half a pound of bacon sealed in a plastic pack.

This is one reason why I live in the intersecting worlds of dance, movement and somatics. They’re speaking-body-positive. If I want to talk to one of my teachers on the Open Floor, I most often take their hand, partly because I can use and understand verbal speech more easily that way – touch closes that heart-stopping gulf that feels insurmountable by only words; partly because I feel plugged in when I’m physically connected. I imagine sonar detection must be a bit like this if you’re a bat. There’s a constant conversation of kinaesthetic chirrupings and whistlings when bodies are in contact, exchanges of information outside the closely defined meanings of verbal language.

Being hypermobile is for me intimately and inextricably connected with being autistic. It’s as if hypermobility were my body speaking autism. Just like autistic mind, crazy wisdom body is a maverick guide who navigates without a map. We find our trajectory by following footprints in the snow and parsing the arrows the birds make when they fly. Together we have ambled through a pleasant series of left fields, wire-walked precipital brinks and nearly drowned in a lot of raging seas. Never a dull moment, and our sense of direction must somehow have been good, because, by wit or wandering, we have finally made footfall on stable ground.

Since July, I’ve been re-aligning my ribcage. This means I’m embodying – slowly – a new and more functional form of internal support. For most of my life, I thought I had a congenital scoliosis. What I actually have turns out to be some kind of lopsided shiftingness which originates, I think, in the physical difficulty of getting upright at eighteen months1 and of staying at least periodically vertical for the following 50 years. As a hypermobile person, I’ve always found standing up a dizzy kind of challenge; with insufficient fascial integrity, the forces of nature tend inexorably towards collapse.2

What I’m doing with my ribs is called the Thoracic Ring Approach. It’s genius. I’m a little bit obsessed with it. If you grew up skew-wiff and ramshackle and sidling like a nervous horse, if you feel that some part of you has always been cowering in a corner, if your ribcage feels like a collapsed accordion and you’d like it to be a chamber that honours the fullness of your heart, if you’ve been leaning on that wall for fifty years and you feel it’s time to stand up and support yourself … Oh, wait, that’s me …

Thoracic Ring Approach emerged from the physiotherapy world, but in some ways it feels to me like a somatic practice that doesn’t know it is one. Like many somatic alignment processes, it presupposes that the body is naturally intelligent – that if you remind it where its ribs are meant to go, it will recognise the original template and recruit for itself the muscles it needs to support the new-old and more functional structure. In other words, it’s different from pulleys and levers and strengthening exercises for muscles which, if you’re proprioceptively challenged, you can’t isolate anyway. Give it a clue and the body will align itself towards optimum kinetic efficiency.

In other ways, Thoracic Ring Approach is definitely physiotherapy. It operates to all intents and purposes as if the physical body were an isolatable entity that could be addressed apart from the emotional body, the body of memories, the cognitive body and all the rest. The neurological body, actually that one’s being allowed in. It’s scientific. To a somaticist (an actual one) like me, this abstraction of physical body is either funny or frustrating or stupid, depending on your orientation to it in the moment. Because, clearly, how I support myself thoracically is not only a series of physical events but speaks to how I stand up in myself in emotional, relational, cognitive and all other ways. Which means that the unacknowledged part of this work – or the part that’s acknowledged only by me – is the call to support myself really. Not the pleasing façade behind whose illusion of substance I’m actually riding roughshod over my needs, isolating myself or playing truant, but the structure in which I’m able to line myself up synergistically and inhabit myself in a steady, congruent, measured way.

How I stack up thoracically is also intricately linked with how I carry my heart. My default position for a lifetime has been rib-crests-first – in which the rib crests stick out in front of the upper thoracic ribs. I’ve always thought of this as ‘false heart’. It means that you don’t meet anything or anybody with your real one. It’s taken me 51 years to be ready to embody the centred heart. It’s a commitment not just to random acts of radical vulnerabilty, but to a permanent and thorough-going physical, neurological and emotional repatterning in favour of heart first: clearly, honestly, unapologetically.

Something else you’re supposed to pretend isn’t happening in physiotherapy is inter-personal relationship. In somatic modalities, we recognise that when two bodies walk into the same room, a third body arises. This body is the thing that’s greater than the sum of the two parts. It’s totally unique, and it holds the creative potential. Somaticists, psychotherapists, experiential dancers and movers, we take it as read that in a therapeutic relationship a large part of the capacity for healing lies in the third body. As much as techniques and technology, people heal people.

I may have had more physiotherapists than lovers. UCH is the home of the hypermobility unit founded by the wonderful Professor Rodney Grahame, hypermobility hero. As a result of – gasp! – listening to his patients, Professor Grahame was instrumental in recognising hypermobility as a thing. I’d had a few not exactly helpful physiotherapeutic interventions, but I reckoned that at UCH the physiotherapists might be a bit more than averagely clued in about working with hypermobile people, so I got myself referred – to the locum in charge of the department. For a few sessions she took a very long time to do not very much, then finally told me I was able to manage my own condition and didn’t need physiotherapy. To be fair, I probably was able to manage it better than she was doing, but I was in chronic pain, I really did need guidance, support and structure, and I felt abandoned. Well, fuck you too, UCH physiotherapy department!

The environment in the physiotherapy clinic at my local NHS hospital felt toxic. It required an enormous investment of energy and expenditure of executive function to make an appointment there and keep it, so god knows what it was like to actually have to work in the place. In a dozen or so visits, I saw three different physiotherapists. The first one was good, but on secondment from another hospital so I only saw him once. The second one kept telling me what hypermobile people like. Hello? Isn’t it my job to tell you that? (Of course, everyone knows that hypermobile people are actually a globule and we all like exactly the same things.) The third one made me cry with frustration, and I discharged myself. If I can’t stabilise my shoulder blade, a good exercise is not: raise your arm keeping your shoulder blade stabilised. (Actually this is essentially what I’m doing now, but by means so crafty that serratus anterior didn’t realise it was being asked to do something until it found out it already had.)

A friend recommended Richard at Harley St Physio. For a couple of years, until he went back to Australia, I had a really good time with Richard. Richard, if you’re reading this, I still have an extensive collection of your Thera-Bands (especially green), and I always channel you when I want to create an original latex-based exercise to address, well, pretty much anything. I resolved a longterm issue with a thickened flexor hallucis longus tendon this way when the NHS specialist foot physio said there was nothing for it but cortisone injections.

I was introduced to the Thoracic Ring Approach by Darren Higgins at Vanbrugh Physio. I love Darren (yay!). Some of what I like about this relationship is that I feel contained without being constrained in it. I’ve written elsewhere on this blog about the problem of containment in a hypermobile body. With intermittent proprioceptive feedback it’s difficult, perhaps impossible, to establish a consistent sense of body boundary. It’s like being a dot-to-dot person, parts of me constantly threatening to trickle away through the in-between spaces. Because I’m also experiencing the autistic 42 per cent extra resting brain activity3 (and the exponential multiplication of 42 per cent when, most of the time, my brain isn’t resting), there’s an awful lot more that needs containing: a babbling stream of images, emotions, thoughts, ideas, interoceptive information. To encompass the range, multiplicity and shiftingness of it all, any kind of external relational holding also has to be elastic. If there isn’t room for expansion, I feel that I’m going to overflow the space – a frightening prospect of disembodiment and dispersal.

My friend Bruce values in a teacher something he calls ‘gravitas’. He’s queer and Scottish, so imagine it with a rolling ‘r’ and a camp sort of lilt. I think what he means by ‘gravitas’, is a kind of robustness that comes from having done what you do for a long time, from knowing the back and the front and the top and the bottom of it. It comes from confidence that this is enough, awareness that there’s always more, and the recognition that whatever you hold to be known, it’s never going to be the truth for everyone. I think he also means you have a sense of humour about yourself, and that you’re grown-up enough to be able mostly to roll with things, even if they’re a bit unusual. And I think he means that on the whole you don’t get toppled by over-enthusiastic dogs.

As a series of procedures that have to be followed the way they have be followed in order for the thing to work, Thoracic Ring Approach is itself a container. I always see it as an off-white shoe box, no writing or logo’s on it, and a lid that lifts completely off. It’s new shoes when I was five. This is a very good sign, because I love shoes. When I was five, I wanted to work in a shoe shop. You know when you go to empty the shredding bin and you take the lid off and all these little curls of paper spring out? That’s what’s in the shoe box. It’s really a bit too much. Once the lid’s off, you can’t keep it all in. That’s me. Bits of me keep escaping the process. So I like the boxiness of the box and the fact that Darren keeps putting errant bits of me back in. And that other bits spring out. And he puts them back in. Though lately, I’m getting quite good at staying there.

Just now, the process is still in process. I can’t quite do this ring thing independently yet, though one day I will be able to, and in the meantime I’m relying on Darren to hold the structure – energetically because he keeps being in the process with me; and practically because every time I get creative and maverick he stuffs me back in the box; and physically because he keeps manually putting my ribs back where they’re meant to be, and telling me when I’m holding them and when I’m letting them go, so we’re – slowly – creating proprioceptive intelligence over more sustained periods of time and across different activities. And in the meantime, new and more functional emotional, relational and professional structures are aligning themselves around me. But it isn’t really linear, more like butter forming in a churn.

1. Many hypermobile children start walking late. This is a great link: http://www.skillsforaction.com/infant-joint-hypermobility

2. Hypermobile people generally find standing difficult and tiring. Because our fascia lacks the tensility to hold us up effectively, we have to recruit a lot more muscle than a non-hypermobile person does in order to be upright. For many of us, hypermobility is coupled with Postural Orthostatic Tachycardia Syndrome (POTS), which means we may also feel faint when standing still.

3. I’ve written elsewhere about this too. According to a recent study, the resting brains of autistic children produce 42 per cent more information than those of non-autistic controls.

A Cascade of Epiphanies: in which I put my foot behind my head and end up writing about injury again

Recently I’ve been again in the strange and exquisite process of injury. I didn’t volunteer. I don’t always feel grateful. It’s almost a cliche that injury is a gift, but the gift is another of those bad-fairy ones: you-didn’t-want-to-sleep-for-a-hundred-years-but-in-the-end-you-get-the-prince kind of thing.

It feels like about a hundred years ­– easily – but despite a cascade of tender little epiphanies, I haven’t got the prince yet. And since I’m still in process with this one, I’m not going to write about particularities. Seeds need to germinate in the dark.

Practice without epiphany would be an odd kind of practice to me, but injury seems to act as a particular kind of awareness cluster – an escalation, an intensification, also often a redirection, a refocusing and re-envisioning. It’s a call to pay attention, an opportunity for a kind of meta realignment, which contains biomechanics – signposts for practical physical restructuring – but is also much bigger, carrying personal mythopoeic meanings with the potential to unravel, rewind and reorient. It speaks to the occluded histories of my body, to ways of being in the world so familar as to have become transparent to me, and through all of this to the potential for fuller human becoming.

My practice is cyclic. I’ve been fortunate in that hypermobility deprived me early on of any illusion of linearity in these things. There are times of more; there are times of less. Over-arching this one-step, two-step in the realm of performative physical capability, is a boader pattern of integration, enlargement, attunement on an increasingly subtle level. What seems to arise is on the one hand a more precise and intuitive faculty of discrimination ­– viveka – and on the other, the slow inexorable seepage of love.

A long time ago, I put myself in apprenticeship to my body; it’s the teachings that emerge from being a body, and from reflecting on and as that body, that really inform me. I have little interest in abstract yoga philosophy. I’m sceptical about enlightenment and the ‘higher’ states of awareness: samsara as something attainable, something ‘over there’. What’s happened to me is more like a slow settling, a sifting and shifting, like an old house on friable ground. The more it settles, the more the walls crack. The situation is essentially imperfectible. It’s the humanness of this that absorbs me.

After 33 years, I feel that my practice is really just beginning to get interesting. Maybe I”m a slow starter. Matthew Remski’s WAWADIA project has produced quite a bit of discussion of a kind of asana plateau, which happens, apparently, somewhere around three to five years into practice – like the yoga version of the seven-year itch. Maybe this has to do with the limited attention span of neurotypical people (a source of ongoing amazement to those of us on the spectrum). Autistic people are orientated to detail and pattern. We will happily do the same thing every day for years and years, because it never is the same thing. Repetition is revelation: my practice is always full of surprises.

I think it also has to do with an essential human resistance to change. Few of us embark on a yoga practice with a knowledge of how deep and thorough-going will be the transformation it requires of us. We expect yoga to be contained in the magic one hour or ninety minutes. We expect it to be pleasant and enlivening. We don’t expect it to crack out of stasis our old habituated patterns, or to surface deeply embodied historical trauma. The most commonly given reasons for coming to a yoga class by my beginning students are: to get fit, to increase flexibility, to lose weight and to relax. When practice starts to require of them much, much, very much more, they frequently slide silently out.

I know that many schools consider two years’ practice to be sufficient to embark on yoga teacher training, but to me, two, three or five years is scarcely a beginning. To me, a practice becomes a practice when it’s seen you through at least a couple of generations – through births, deaths and marriages, love and loss. It seems to be symptomatic of the Tesco superstore mentality afflicting our culture that we jump ship so readily. If there’s always another product on the shelf with another promise of youth, fitness and vitality, why bother to negotiate inconvenient and difficult obstacles? Why bother to learn anything at all?

Matthew reckons that most people enter yoga in search of some kind of therapeutic outcome. I’m not most people, so I don’t know whether this is true or not. I started practising yoga when I was eighteen, I didn’t have any physical parts in obvious need of fixing, and I couldn’t have told you why I was doing it. In retrospect, it’s clear to me that I was hungry for embodiment. I was autistic, anorexic and out of my depth, and everything was a last-ditch stand. No habitat I could locate felt vast or wild enough to reflect my internal experience. I was desperate for a sense of containment, of physical integration, of the parts adhering to the whole. I urgently needed to discover some kind of coherent centre. I suppose that, in a very broad sense, this could be seen as a therapeutic motivation, but really I viewed it more as an artistic mandate, in which I was both the art and the artist. I still do see it that way.

Most of my life I’ve lived to move, not moved to live. I tumbled head first into astanga vinyasa because I was enthralled by the movement and captivated by the preoccupation with edge. I wasn’t all that interested in what it could do for my health and wellbeing. It turned out that many of the arrows pointed in both directions, but I can’t in honesty say that all of them do. The ongoing challenge is to nudge the situation into some form of do-ability. As I’ve tipped over onto the descending flank of the hill, my orientation has shifted – a little bit. The materials are in slow metamorphosis. They are gradually producing a different kind of art and a different kind of artist. At 51, I know that each day of astanga vinyasa is a day of grace. I know that one day the practice will spit me out – not, I hope, before I’ve been thoroughly chewed up by it. I’m going for complete mastication. I’m giving it my all.

Foot behind head


It takes a village to keep a hypermobile body in something like working order. I would like to thank Darren Higgins at Vanbrugh Physio. I can’t tell you how long I’ve been looking for a physio I can actually work with – found one! I would also like to thank 
my wonderful osteopaths and much – very much – loved companions on the path of the dance Indi Ajimal and Cyprian Londt. And where would I be without Scott Johnson and Andy Gill at Stillpoint Yoga London? Lots of love, guys.

 

 

Crazy wisdom body: pain, injury and practising with what is

“There is nothing that does not grow light through habit and familiarity. Putting up with little cares, I’ll train myself to bear with great adversity.”—Shantideva

For a period of my astanga life, I referred to my practice as ‘the path of pain’. I was joking, but only a bit. The path of pain was nothing to do with masochism. I tried very hard not to hurt myself and I got intensely frustrated when I hurt myself anyway. The more I endeavoured to move ‘forwards’, the more I seemed to be pushed ‘backwards’ into a situation increasingly ‘imited’ by injury.

I was told that astanga injuries are the result of aggressive practice – an observation in some instances with sound foundation. I believed that in some subtle way, beneath my conscious awareness, I must be forcing my body. But this was puzzling because I would watch more robust types pushing themselves obviously much harder than I ever did and with no apparent deleterious effects. I now also felt guilty and wrong, but I didn’t know how to be right.

I don’t remember exactly when it began to dawn on me that I was hypermobile. I was formally diagnosed with Hypermobility Syndrome: Ehlers Danlos Type by Professor Rodney Grahame in 2007. By then, it was confirmation of what I already knew. When Rodney Grahame asked me what I wanted to get out of diagnosis, I explained that I would like to be able to set better boundaries for myself. What I meant was that I wanted to believe myself; I wanted to give weight to my own experience; I wanted to move into my own internal authority and be able to proceed consistently from it.

I have chronic tendonitis, triggered trigger points, over-stretched ligaments, frequent minor subluxations, and a hole in my right medial meniscus. In the medical model, these would be termed ‘symptoms’ of hypermobility. I prefer to relate to them as phenomena. This way, I’m less likely to problematise them and more likely to get interested in them in an open way. It’s my tendency for anxiety, dissatisfaction and a kind of improving antsiness that turns ‘little cares’ like this into a thing. But after several years of familiarisation, pain no longer feels like pain in the troublesome sense. I can only hope I’m a bit more prepared for great adversity.

Buddhist mythology tells us that throughout his life the Buddha received regular visits from the demon-god Mara, bearing doubt, discouragement and temptation of every kind. Each time Mara arrived, the Buddha’s servant, Ananda, wanted to bar him entry. He was, in Ananda’s eyes, the daddy of all bad influences. But every time, the Buddha welcomed Mara in, greeting him with the words, ‘I see you, Mara’ and inviting him to sit down for tea. Pain became a path for me when I started inviting my body for tea – not the fictional body, but the one that actually exists, with its tender joints, strung-out hamstrings, travelling carpals and all the rest. Because the reality is that none of these things is a distraction from my practice or an obstacle to it; they are themselves the ground of my practice, the royal road to enduring presence (‘enduring’ meaning ‘hard’ – a presence that remains solid and reliable), out of which flowers a particular kind of resilient joy.

In our culture, the sublimely perfected ‘yoga body’ is much desired. That it is also imaginary and therefore ultimately never attainable makes it the ideal commercial product, ripe for the commodification that it has richly received. The sexed-up, fantasy photoshops of adverti-media are in our faces all the time, while we rarely encounter images of actual bodies doing actual yoga or text describing the process of yoga as a real experience. Those of us who teach yoga are both products and promulgators of the industrial yoga machine. We, too, in our publicity most often depict the practice of yoga as blissful, love-evoking, leading smoothly to radiant health and a younger-looking body. We seldom offer an honest perspective on the actual complexities involved in the relationship between practice and product (pun intended – think about it, people), or of the intersections of yoga practice with our habitual human patterns of addiction, overwhelm, neurosis, anger and pain. No wonder. Such views feel tantamount to taboo.

It’s a radical act to acknowledge what we’re really experiencing in our bodies, on our mats, here and now. It’s revolutionary and it’s evolutionary. Hell, yeah! Let’s do it, people! Let’s put the kettle on, crack open the chocolate digestives and drink tea with the bodies we actually have. Because in the words of that great teacher Dr Doolittle, ‘It’s the truth, it’s actual, everything is satisfactual’. It seems that we are habituated consistently to prefer the fugitive promise of the dreamed-for body to the always-ready-and-waiting satisfactuality of the real one. But it doesn’t have to be like this.

That injury is a teacher is almost a truism, but it took me a while to understand how profound these teachings can be. They are not simply biomechanical in nature but have also to do with how we are in our whole life, as it manifests in our body. From where I’m standing, my body often appears unpredictable, illogical and capricious. Just when I think maybe I understand what’s going on, it throws in something that knocks me completely sideways. When the only possible response is to burst out laughing, you know you’re in the presence of a bona fide crazy wisdom teacher.

My physical technique background is in ballet, so I’m well schooled in the heroic capacity for carrying on regardless. And in a way, I’m very grateful for that training. It has been a valuable precursor to its meta-quality, which contains commitment and consistency, through rough-going as well as smooth; it’s a kind of indestructible self-discipline that keeps on keeping on, even when there is no apparent way through. It’s the habit and commitment that the bodhisattva Shantideva refers to in the quotation. Rather than forcing my body, denying the pain or trying to breathe through it (which to me would be anti-practice), this meta-quality entails getting on my mat anyway and doing what is do-able today. It invites mindful exploration of sensations and the emotional responses they evoke (or vice versa) without seeking to fix or change anything, but simply allowing any resolution to emerge, or not. It includes what’s happening on all levels, so that as little as possible gets swept under the yoga mat. Anger, resentment, envy, fear, grief – these too: chocolate digestives.

Being fully in our real, actual body, whether it’s obviously injured and in pain or not, requires of us sensitivity, honesty and patience. It invites an awake, listening receptivity to what is – whatever is. Because this is what’s happening now, and this, and only this, is the teaching. If I frame my reality so that it’s only ‘good’ yoga if nothing in my body hurts, I’m always going to be in the wrong, partly because I’m genetically hypermobile so some degree of pain and injury is tantamount to a given, no matter how or what I practise; partly because as a human being it’s a dead cert I’m going to encounter the full range of human experience. We breathe in, we expand, we integrate, we grow; we breathe out, we contract, we dissolve and die. A holistic yoga practice is a process of creating a container big enough and elastic enough to include all of this – all of this.

Namaste, amigos!

Whose practice is it anyway?

I love teaching myself. I taught myself Russian when I was sixteen, and I have taught myself Sanskrit. When I can follow my own thread, mark out for myself the territory and press into my own exploration, I feel liberated, as if there is finally enough room to extend and to breathe. I am autistic, and autistic people are generally autodidacts. We are also, on the whole, highly focused (some would say obsessive), self-sufficient and happy to do things for the most part alone. So neurologically – autism is hardwired: my autistic characteristics don’t change if I work on myself or meditate a lot, although both those things offer me skills to deal with the challenges of being autistic, just as they offer you skills to deal with the challenges of being neurotypical … Neurologically, I have a particular angle on what it means to practise and on the kind of relationship I want with teachings and a teacher.

I am also an astanga vinyasa practitioner: I belong to a tradition that is strongly guru-oriented. Astangis generally speak with reverence of their teacher, and when I first meet another astangi, a question that usually comes up early in the conversation is, ‘Who’s your teacher?’ My answer is always, ‘I am.’

I don’t in any way deny the valuable teaching I have received from many wonderful teachers, for which I am very grateful, but none of these people has ever felt like My Teacher. In the two instances when I have been very close to teachers (in the yoga therapy and dance movement areas of my work), both relationships have felt more personal, more fluid, more equal, and more full of the human flaws of both of us than the traditional astanga teaching relationships described to me appear to be.

For me a yoga practice is a somatic, psychological and emotional exploration within a physical framework. My mat is a place where my essential humanness has an opportunity to come out to play: my feelings, responses, compulsions and escapes, my crazy mindfucks and moments of searing beauty, my ego trips and the way that I navigate all of this. I’m an anchorite in a leaky coracle. There’s nobody else in the boat.

Because I want to witness all of this, when I choose to go to a teacher it will be to someone who mostly lets me be and just puts a finger on when the whole thing is threatening to overturn. It will be someone with the humility not to know where I’m travelling or whether what they can offer is what I need, but the willingness to offer it anyway, without attachment to if or how I use it.

I’m not sure that it started out this way or that the result is the product of the intention, but much of the traditional practice of astanga vinyasa appears to me to be unhealthily  focused on the word from Mysore, which many devout students observe like papal bulls. One of the most ludicrous astanga ‘rules’ to emanate from Mysore – and I have no idea if anyone at the Shri K. Pattabhi Jois Ashtanga Yoga Institute ever actually made it, and if they did whether it was intended as a general edict or as a particular instruction for a particular student – is that you shouldn’t warm up before practice. What?! I have no doubt that this works for some people, because almost everything works for someone, but I am fifty and hypermobile. Do I warm up before embarking on a highly gymnastic practice? You’d better believe it! It’s essential in order for me to be able to complete my practice reasonably safely. I also often teach stretches and strengthening exercises to indivdual students who I think could benefit from them, and I suggest that they do them before they practise.

If we give ourselves over without discrimination to a teacher, without consideration of whether an instruction is appropriate to us (you will know this not by evaluating it in your head, but by trying it on in your body and seeing how it feels), then we lay ourselves open to losing the true, experiential centre, the connection with the internal locus of our practice. I love receiving suggestions from a teacher, but that’s what they are: suggestions: generous offerings for the student to explore and implement if they work. If my practice consists of introjecting the teacher’s received word, what am I really practising? Isn’t it fundamentalism?

I would really like to be an anchorite. Every time I unroll my mat, I feel as if I’m rowing to the island: seabirds, rocks, unpredictable tides, and folded into the familiar wilderness, the tiny daily surprises. One of my motive springs has always been to resolve to what is essential; I am constantly paring down my life, not to diminish it, but to uncover the core of inner meaning and feeling that lies irreducible there. Paradoxically, this place is passionate, rich and expansive. This feels like a personal and mostly private undertaking. Too little contact with the outside and, it’s true, it could fatally involute, but too much and it could die of exposure.

I don’t care whether my teacher goes to Mysore or whether they know how Sharatt is teaching bharadvajasan this year. I do need them to have used their own practice over many years and through different phases of life to penetrate layers of their own understanding, to weather life crises, to expand, to deepen, to perceive with increasing subtlety. It is through engaging, regularly and over the years, with this ground of practice that, as teachers, we have something to offer students beyond the architecture of the postures, which are not in themselves yoga, but simply a context and an invitation for yoga to occur.

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.movingprayer.co.uk or email jess@movingprayer.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.

Looking both ways

Here I am starting once again by announcing that I’m 48. My age feels important just now. Right here, in the middle of my life, I find myself, like double-headed Janus, looking both forwards and back. I’m still leaning into the new, still learning, still acquiring physical abilities, still going to places I haven’t been able to access before in my body, getting stronger, releasing more restrictions; but at the same time I’m facing into the time of dissolving. I experience more pain; there’s more wear and tear in my body; there’s less and less certainty of what I will and won’t be able to do on my mat on any given day; I have to offer more respect to the crazy wisdom teacher of my body. At 48, I’m about to crest the summit, and what comes next is dropping onto the downhill slope, the path of letting go.

I’m not yet ready to abandon the physical aspects of my astanga vinyasa practice, and I may not be for a very long time to come, but my practice has had to become more responsive to how I am in the moment. If I’m stepping onto my mat with the intention of practising a particular series, I always have that structure in my mind, but what emerges from my body may be more of a creative interplay with the structure than a straight reproduction of it. Sometimes it looks pretty much 100 per cent kosher. Other times it really doesn’t. I don’t have a huge amount of control over that, nor can I predict how my body will be on any given day. Nor am I interested any more in imposing a rigid structure on my body; I’m more engaged by how my body is in relation to the structure, where it meets it, where it doesn’t, where it needs to go off on its own therapeutic loop, and what that loop looks and feels like.

All of this has prompted me to wonder how, as Mysore-style astanga teachers, we can hold space for practitioners in the phase of dissolving. Perhaps other astangis have less of an issue with this as they age: because I have Ehlers Danlos, my body has always been full of anomalies, and it is even more so now. Nevertheless, as astanga vinyasa matures in the West, there are going to be more and more of us working with it as a practice of disintegration of the body, letting go of physical capacities, and readying ourselves for death.

I mostly practise on my own, mainly because, for me, practice is primarily about the intimate relationship between me and myself. But there are also times when I want to share in the energy of the group breathing and moving together, and I’m finding it difficult to find spaces where it’s possible for me to do this without harming myself or compromising the truth of my physical experience. In some ways I understand why this is so. In any Mysore practice space there are usually many people who are still establishing and embodying the structures. I know from my own teaching, that it can be difficult to keep these people on course if there are others in the room following their own choreography. It can be hard to know from the outside why a person is doing what they’re doing. It’s easy to make judgements, to assume that they lack self-discipline or are being disrespectful. And sometimes this may be the case. But if we don’t allow space for experienced practitioners in the dissolving phase in our Mysore spaces, it seems to me that we are offering a skewed, one-halved version of astanga vinyasa, one that is about youth, about physical ability, about attachment to forms.

I don’t have a simple solution to these complexities. However, if you’re a Mysore-style teacher who feels able to hold the complexities, I’m always looking for places to practise that feel safe and respectful.

Namaste!