Hypermobility in Yoga

Have you ever wondered how are some people so naturally flexible? They can walk into a yoga class and without warming up go into a full forward fold. These people may be hypermobile. While they can perform asanas that require flexibility effortlessly, they are also at risk of injuring themselves.

Hypermobility is where joints can easily move beyond their normal range. This is because the tissues that hold them in place, the ligaments, are too loose or “lax”. Sometimes that could be due to the bone structures in the joints. Weak muscles around the joint may exacerbate hypermobility.

Hypermobility may also be a result of diseases affecting connective tissues (e.g. ligaments) such as Ehlers-Danlos Syndrome. Most of the time, hypermobility is inherited and cannot be prevented. Many people with hypermobile joints do not face any issues throughout life, in fact, most of us are on the spectrum on hypermobility – some of us have naturally hyperextended elbows and knees. But for those who experience pain and complications – on the other end of the spectrum – they may be considered to have Joint Hypermobility Syndrome.

Hypermobile people usually find themselves naturally “good” in yoga as they are able to get into many difficult poses that require flexibility. In fact, some of them can do a full split without warming up! However, with hypermobility comes instability. One way to visualise this is to look at our shoulder, which is the most mobile joint in our body and also the most commonly injured and dislocated.

In a non-hypermobile body, the ligaments are naturally “tight” to restrict our joint movements to a certain range. This creates joint stability. In hypermobile people, they lack this natural signal of tightness to stop them from going beyond the normal range of motion, thus risking injuries. With the deeper range of motion, they may overstretch their muscles which besides hurting the muscles, also weakens them, making the muscles less efficient at supporting their weight during impact activities.

So… can hypermobile people still do yoga?

Yes they can! Here are some things they should note to protect themselves:

  • Use muscle control to prevent excessive hyperextension e.g. engage the quadriceps to ensure that knees are not locked in standing postures
  • Micro-bend the knees and elbows
  • There is no need to feel a stretch in every pose. Just because they can go further, doesn’t mean that they should or that it is safe to do so. If no stretch is felt in a pose, it just means that stretching is not their work in that pose. They can shift their focus to stabilising themselves and their breathing.
  • In poses, think of bringing the joints into the centre of the body e.g. in Warrior II, think of the arms moving into the shoulder sockets
  • Strengthen the muscles around the joints through light resistance in yoga. Complement the yoga practice with a strengthening routine at the gym.

If you are a teacher, you can do the following to ensure a safe practice for your hypermobile students:

  • As always, pay close attention. Notice their joints and how their bodies move during the warm up.
  • Create stability for them. If a student seems to be going beyond a safe range of motion, gently encourage them to do “less”. At the same time, understand that for hypermobile students, it may be more difficult to “back off” than to go deeper as stabilising requires more strength.
  • Cue micro-bends in elbows/knees and engagement of the muscles surrounding the joints.
  • It may be helpful to give hypermobile students some resistance, for example, give them something to push into like their elbows into your palms while in Downward Facing Dog
  • Remind students that it’s not about how far we go in an asana, but how we get there

Hypermobility is also something to take note of in other physical activities such as high impact exercises, gymnastics, dance etc where injuries may occur if joints are not taken care of.

Are you now wondering if you are hypermobile? You can find out how mobile your joints are by doing the Beighton Score Test, which is a simple system to quantify joint laxity and hypermobility. It uses a 9-point system, where the higher the score the higher the laxity. However, scoring a 9 doesn’t mean you are hypermobile. It is always recommended to have a diagnosis confirmed by a medical professional.

But whether we are hypermobile or not, we can make a conscious effort to engage our muscles and not lock our joints in our yoga practice 🙂

Beighton Score Test:

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