Yoga for Well-Being in hEDS/HSD

Jun 10, 2022 | Samantha Campbell | @samanthacmaa | Comments (8)

In the spirit of guiding your well-being journey with hEDS/HSD, I thought I would share a form of exercise that is for everyone, that can be done without equipment, in only a few minutes, and that encourages moments of relaxation during exercise---you guessed it- YOGA.  Yoga integrates mind, body, and spirit to achieve oneness with the universe.

Many patients ask, is yoga safe for people with hEDS/HSD? The answer is “YES”! Not only is it safe, but it is encouraged. The key understanding being that we use the physical therapy guidelines to prevent joint injury, just as we do for any exercises. Low impact is better, and yoga is included in that category with swimming, walking, elliptical, etc.

If you have never practiced yoga before, it can be awkward and feel uncomfortable when first learning poses.  It is imperative to practice self-compassion, patience, and accept your current limitations.   Learning the four steps to beginning yoga, will help in your journey to wellness.

First, it is important to learn basic yoga breathing, also called Dirga pranayama-an active form of breathing which involves breathing continuously through the nose, both inhalation and exhalation.  Inhalation starts just below the belly button, moves to the low chest, then to just above the sternum and exhalation starts just above the sternum, moves to the low chest, and to just below the belly button.

Second, sit in easy pose (Sukhasana)-buttocks on the floor, legs crossed, feet below the knees, hands on the knees, or the lap, palms face up or down.  Press hips into the floor, lengthen the spine, shoulders down and back, chest forward toward the front of the room. Relax face, jaw, belly, rest tongue on the roof of the mouth, behind the front teeth.   This pose is designed to provide a sense of calm.  However, if you are experiencing knee and hip pain, then try using a blanket under the knees or hip bones.

A variation to Sukhasana is the accomplished pose (Siddhasana) which involves placing one foot close to the inner thigh and the other foot close to the ankle, so heels are almost at midline.

While in Sukhasana or Siddhasana, practice mindful meditation-be in the moment, quiet your mind.  Regular meditation can help well-being, reduce stress, anxiety, improve memory and concentration, and provide inner peace.  If meditation is difficult, then try an intention or a brief prayer (sankalpa) of what you want to accomplish with your yoga poses, for the purpose of giving you deeper focus as you practice.

Third, practice yoga poses starting with simple ones first and as you get more comfortable, add poses.  Don’t overdo, don’t push through pain-if you feel pain, stop and go to a different pose, until you become more familiar and comfortable with poses.

Lastly, always end your practice of yoga with Shavasana, or relaxation pose.  This involves, lying on your back, and relaxing your body for 5-10 minutes, and ending in a seated position with meditation to transition “back to the world.”

Set SMART (specific, measurable, attainable, realistic, timely) goals, which can be used not only for yoga, but for life.  For example, set a goal of practicing yoga stretches for 5-10 minutes every 2 hours throughout your workday.  By setting this goal to practice yoga, you are also setting a goal toward self-care, self-compassion, and well-being!

Remember: “The nearer you comes to a calm mind, the closer you are to strength.” Marcus Aurelius

Do you have a specific yoga routine that works well? Learn more about self-care with hEDS/HSD and share with others in the discussion group!

Author: Bala Munipalli, M.D.

Interested in more newsfeed posts like this? Go to the Ehlers-Danlos Syndrome blog.

I am wondering what the support is to say that yoga is good for people with EDS hypermobile. The way it has been explained to me, it clearly is not. I mean, if all you're talking about is meditation and breathing in poses, it might be okay, depending on the pose. But even the health of meditation can be questioned. (Is it good to focus on removing yourself from the world? For some people, this could actually encourage unhealthy withdrawal.)

People with hypermobility are not mobile in every joint, nor hypermobile the same amount. So, the hypermobile person is going to stretch the joint which is the most mobile. Exactly what you don't want to do. It has been explained to me, by people who say 'yoga is good for everything', that you don't stretch that much. I wonder why exactly, you would do the cobra pose and not stretch. Is this called "not stretching cobra"?

Yoga is generally not good for people with hypermobility. Meditation is not good for "everybody". They happen to be very cheap to teach with lots of teachers ill equipped to deal with something so complicated as hypermobility.

However, these integrated medicine departments seem so happy to push it on every patient. It is so much easier then dealing with the complex reality which is hypermobility.

I would ask that, since these articles are supposed to be related to medicine, that the people writing them would please supply peer reviewed articles from respected medical journals.

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@cierann

I am wondering what the support is to say that yoga is good for people with EDS hypermobile. The way it has been explained to me, it clearly is not. I mean, if all you're talking about is meditation and breathing in poses, it might be okay, depending on the pose. But even the health of meditation can be questioned. (Is it good to focus on removing yourself from the world? For some people, this could actually encourage unhealthy withdrawal.)

People with hypermobility are not mobile in every joint, nor hypermobile the same amount. So, the hypermobile person is going to stretch the joint which is the most mobile. Exactly what you don't want to do. It has been explained to me, by people who say 'yoga is good for everything', that you don't stretch that much. I wonder why exactly, you would do the cobra pose and not stretch. Is this called "not stretching cobra"?

Yoga is generally not good for people with hypermobility. Meditation is not good for "everybody". They happen to be very cheap to teach with lots of teachers ill equipped to deal with something so complicated as hypermobility.

However, these integrated medicine departments seem so happy to push it on every patient. It is so much easier then dealing with the complex reality which is hypermobility.

I would ask that, since these articles are supposed to be related to medicine, that the people writing them would please supply peer reviewed articles from respected medical journals.

Jump to this post

Welcome, @cierann. You are so right. Everyone is different. While some yoga postures may be right for one person with EDS, they may not be right for another. EDS is as individual as the person themselves.

Dr. Munipalli agrees and underlines:
"If a person with hypermobility is practicing yoga, they should avoid prolonged passive stretching at end range, avoid positions that could cause shoulder dislocation and remember that the focus on practicing yoga is more for the inner experience than performance. Yoga supports patients with hypermobility by providing calming to the nervous system, mind-body focus, self-care, stability particularly with smaller and slower movements. It also helps patients with hypermobility to be conscious of not stretching excessively which promotes injury."

As the blog post states, Mayo Clinic uses "the physical therapy guidelines (https://connect.mayoclinic.org/blog/ehlers-danlos-syndrome/newsfeed-post/exercise-for-heds-and-hsd/) to prevent joint injury, just as we do for any exercises. Low impact is better, and yoga is included in that category with swimming, walking, elliptical, etc”

Any physical activity can be dangerous to a point, even “low impact“ activities. So if anyone feels like they need more individual guidance, they should consult a therapist who is familiar with treating hypermobility.

Personally, I do not regard meditation as removing myself from the world, but rather connecting with it. Again, this underlines how everyone is different as you said. 🙂

Ann, I like to get to know more about you? Do you live with EDS? If yes, how long? What activities do you like to do?

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Here are some additional resources for people living with EDS interested in yoga practices.
Yoga for Bendy People: Optimizing the Benefits of Yoga for Hypermobility by Libby Hinsley, Jill Miller
https://www.amazon.com/Yoga-Bendy-People-Optimizing-Hypermobility/dp/B0B2TSN3W3

Yoga for Bendy People was written for yoga teachers and practitioners who want a deeper understanding of hypermobility syndromes and how to optimize the benefits of yoga for people who have them.

A well-designed yoga practice not only avoids injury, but leaves the body better supported, the nervous system better regulated, the mind clearer, and the heart more connected to its purpose.

Author Libby Hinsley is a long-time yoga teacher, teacher trainer, and physical therapist. As a person living with Hypermobile Ehlers-Danlos Syndrome, she is passionate about raising awareness about hypermobility in the yoga community and beyond. She has experienced the chronic pain, joint instability, and yoga-related injuries so common among bendy practitioners.

In the book, she offers guidance on how to develop a sustainable yoga practice tailored to the unique needs of bendy practitioners — body, mind, and spirit.

Readers will:
- Learn about the latest hypermobility research and most common syndromes
- Discover how to avoid the common injuries bendy people face in yoga practice
- Understand how asana, pranayama, meditation, and more, can support bendy people

REPLY
@colleenyoung

Welcome, @cierann. You are so right. Everyone is different. While some yoga postures may be right for one person with EDS, they may not be right for another. EDS is as individual as the person themselves.

Dr. Munipalli agrees and underlines:
"If a person with hypermobility is practicing yoga, they should avoid prolonged passive stretching at end range, avoid positions that could cause shoulder dislocation and remember that the focus on practicing yoga is more for the inner experience than performance. Yoga supports patients with hypermobility by providing calming to the nervous system, mind-body focus, self-care, stability particularly with smaller and slower movements. It also helps patients with hypermobility to be conscious of not stretching excessively which promotes injury."

As the blog post states, Mayo Clinic uses "the physical therapy guidelines (https://connect.mayoclinic.org/blog/ehlers-danlos-syndrome/newsfeed-post/exercise-for-heds-and-hsd/) to prevent joint injury, just as we do for any exercises. Low impact is better, and yoga is included in that category with swimming, walking, elliptical, etc”

Any physical activity can be dangerous to a point, even “low impact“ activities. So if anyone feels like they need more individual guidance, they should consult a therapist who is familiar with treating hypermobility.

Personally, I do not regard meditation as removing myself from the world, but rather connecting with it. Again, this underlines how everyone is different as you said. 🙂

Ann, I like to get to know more about you? Do you live with EDS? If yes, how long? What activities do you like to do?

Jump to this post

As an old lady who grew up an athletic Tomboy, and practiced Yoga for about 10 years at maybe age 55-65, I have to say that Yoga must be done with extreme care by those of us with hypermobile joints. I was the only person in the Yoga class who could easily do most poses, and I believe doing those poses helped lead to the issues I have had since.
Yoga's ability to teach deep relaxation is terrific, but I would not suggest doing the poses unless your musculature is terrific and even so .... be careful!

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Doctors, PLEASE stop recommending this sport/religious practice/whatever the heck this is to people who actually have EDS. Especially stop recommending it to people like me who have *Classical* EDS. I have mild to moderate INHERITED, DIAGNOSED BY A GENETICIST Classical EDS and am currently lying flat on my back with my legs elevated, ice packs on my knees, and a heating pad on my ankles. I exercise daily with light weights and a treadmill. I’m not an athlete, but I am trying to be active.

After ten minutes of “yoga class” whatever, I sprained both knees and ankles. I want to finish my usual routine for today, but a wild yoga experience has happened. Instructor claimed to “understand,” which I assume to mean she is one of those people who self-diagnosed with EDS on Tumblr.

After I noped, she became dismissive. She also “had flu-like symptoms,” but insisted “I don’t feel like I have the flu inside.” She asked me, “What do you want?” from the class. Well, strength and weight loss. Multiple docs told me this was a thing. Multiple docs were *very wrong.* I mean, I just saw a grown, allegedly sane woman bounce up and down repeatedly on her own kneecap. Outside of religion, I can think of no conceivable reason a human would subject themselves to such a practice. There is zero upside to doing such a thing to your body, and none of what I saw is “relaxing.”

This is pretty a wooey business, in my opinion, yet for some reason, educated people act like hypermobile people can get something out of it. I know what I got out of it—bruises and sprains. I was also emotionally beat up to the point that I was on the verge of tears, embarrassingly. Never again!

(Diagnoses: Classical Ehlers-Danlos Syndrome, Atheist, no impressed with yoga)

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I love yoga and find it very helpful in maintaining my mental and physical health.

When I sit in Sukhasana pose, my legs go numb and tingly; I have hEDS and wonder if this might have anything to do with it?

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@janma

I love yoga and find it very helpful in maintaining my mental and physical health.

When I sit in Sukhasana pose, my legs go numb and tingly; I have hEDS and wonder if this might have anything to do with it?

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Welcome, @janma. I wonder if when you sit cross-legged, you may be compressing the nerves and blood vessels in your legs, which can lead to numbness. Do you find that moving around afterwards, normal sensation returns? Have you tried sitting slightly elevated (on a block or rolled mat, in Sukhasana pose?

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@colleenyoung

Welcome, @janma. I wonder if when you sit cross-legged, you may be compressing the nerves and blood vessels in your legs, which can lead to numbness. Do you find that moving around afterwards, normal sensation returns? Have you tried sitting slightly elevated (on a block or rolled mat, in Sukhasana pose?

Jump to this post

Thanks Colleen! I sit elevated by a low foam block, or a bolster, with my bent knees resting on blocks, which helps minimally. I definitely think it’s compressed nerves/blood vessels, as feeling returns after moving around upright. I just wondered if my loose hip joints had anything to do with it ☺️

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