How To Practice Yoga When You Are Hypermobile

Recently David received questions from several students about how to practice yoga when you are hypermobile. Here are a couple examples:

Till Torkler says: “I started yoga more for mental benefits than physical, but soon realised why I was never really good in sports. I am simply too weak to balance out my f****g flexible joints. I study medicine, so I’m somewhat decent when it comes to anatomy, but I have found nothing on additional exercises (next to ashtanga) to counteract the stretching and whatnot. What can a hypermobile human do to promote healthy motion in and outside of practise?”

Leslie Kigerl says: “Recently, I have been having some hamstring/inner knee problems on both sides, and was told by a doctor and by the physical therapist that I am hypermobile. I have never heard that term before, and the doctor said ‘Maybe yoga isn’t the best activity for you to pursue’. How do I work around the hypermobility issue and still have a yoga practice? I practice almost every day, and I am very unhappy about the thought of having to really cut back or not do yoga at all.”

Should you practice yoga when you are hypermobile?

These students ask a good question. How do you practice yoga when you are hypermobile? I am someone who is definitely on the hypermobile side. So, David has given me the opportunity in this post to respond to that question from my own experience. (You can find more about me, Christine, here.) I’ve now spent a number of years personally working through how I answer this question about practicing yoga with hypermobility for myself. In this post, I’ll share what I’ve learned from my own practice.

What is hypermobility?

Let’s start by first defining what we mean by “hypermobile”. Those with “generalized hypermobility” have multiple joints that are more mobile than average. That occurs in an estimated 10-20% of the population (Kumar and Lenert, 2017). If you experience pain and/or other symptoms or complications as a result of hypermobility, then you might be considered to have joint hypermobility syndrome. And, depending on the severity of symptoms, you may even need to consult a medical professional to address those issues. Those of us who simply experience generalized hypermobility without accompanying pain still need to focus on how to do things we love, like yoga, in a way that is healthy for our bodies.

There are a lot of ideas out there about how to practice yoga, or even whether or not you should practice yoga if you are living in a hypermobile body. So, what to do? In my mind, the answer to how you practice yoga if you are hypermobile, is directly related to the answer to a different question. Why do you practice yoga? Initially I practiced yoga because I simply felt better when I did it. It felt easier to concentrate. I felt calmer and I slept better.

Yoga is about more than flexibility

The question that these students are asking about practicing yoga when you are hypermobile also points out a common misconception about yoga. This comes up both in the yoga community and outside of it — a misconception that yoga practice is all about gaining flexibility. Ultimately I understand yoga to be a set of tools that we can use for multiple types of benefits. Physical health and wellness, including attributes like strength and flexibility, is one category of benefits.

Beyond physical health and wellness, we can also use the tools of yoga to move towards greater steadiness and ease of the mind. Steadiness of the mind, by which I mean things like increasing concentration and equanimity, is not about gaining flexibility in the body. So, whether you are hypermobile or not isn’t the most relevant factor when emphasizing those more subtle aspects of yoga practice.

What does practicing asana look like if you’re hypermobile?

I’m going to share my own experience with answering that question from the perspective of a practitioner who definitely has hypermobile joints. In my body, there was a time when it felt like everything moved whether I wanted it to or not. I lost track of the number of times that I twisted an ankle as a kid. My shoulder joints felt as if they could be pulled right out of their sockets if I allowed them to. And my sacrum intermittently has the feeling of popping in and out of place. That is the felt sense of moving around with hypermobility.

Through many years of practicing Ashtanga vinyasa yoga and through trial and some error in my own body (as well as with the guidance and suggestions of a great teacher!) I have found what works for me. If your body does not fit in the middle of the bell curve, then the common ways of doing poses, common alignment cues, etc. might not apply in the same way to you. Here are some suggestions for practicing yoga when you are hypermobile:

Pay attention to your body sensations

• Critically evaluate how things feel in your own body. For example, does that cue to line up the feet in warrior pose feel okay? It might be just fine or it might send pressure into the SI joints. Check into your body and adjust for what you feel.

You don’t have feel a “stretch”  in  every pose

• Just because you can stretch further into a pose, doesn’t mean you need to or that it’s a good idea. If tissues are already open in your body, you may not feel a stretch sensation. That doesn’t mean you need to go further. It just means that stretching isn’t your work in that pose. Try moving your attention to stabilizing or to something subtle like your breath. If you’re already very mobile, creating even more mobility can potentially destabilize joints that are already working hard to stay in place. For example, if you’re doing a forward fold, do you need to go so far that your sit bones are pointing at the ceiling?
• Pay attention to maintaining the integrity of the joint when stretching something. This is especially relevant to the very mobile shoulder joints. Don’t allow your body to take the easy way and excessively move things that are already very mobile.
• Support flexibility from the inside. Cultivate a relationship with your deeper musculature: especially the pelvic floor muscles, transverse abdominis, psoas major, and iliacus.

Cultivate strength and stability

• Put more time and effort into creating the particular kinds of and locations of strength in the body that work to stabilize the joints. All strength is not created equal! How you strengthen things in the body matters if your intention is to stabilize the joints, while also maintaining range of motion and functionality. Again, give some attention to supporting your mobility by exploring your connection to the center of your body. That includes pelvic floor muscles, transverse abdominis, and iliopsoas. Around the shoulder girdle, make friends with serratus anterior.
• Be okay with not being in a hurry. Acquiring the kind of strength that leads to stability in a hypermobile body takes consistent attention, practice, and lots of time. There are no shortcuts.

Pay attention to fatigue

• Realize that stopping when your muscles feel fatigued is especially important in a hypermobile body. You don’t have tightness around the joints to keep the tendons, ligaments, and other structures from getting over-stretched. You have to stop yourself.

Reference

Kumar, B. and P. Lenert. 2017. Joint hypermobility syndrome: recognizing a commonly overlooked cause of chronic pain. American Journal of Medicine. 130(6):640-647.