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Healthy Joints: 10 Things I Wish I’d Known about Hypermobility Before I Started Practicing Yoga
While it became fairly obvious that I was hyper-flexible early on in my yoga career, I never really understood to what degree. Nor did I fully grasp the implications of having hypermobility, aside from meaning that I was more flexible than most, and I never thought to consider the potential ramifications of exploiting my hypermobile joints long term.
I wish I had. Perhaps I could have avoided some of the injuries and years of chronic pain.
Hindsight is 20/20, I would have been better off had I refrained from stretching altogether, let alone folding, bending, twisting and pulling to the extent that I did—for years on end.
I was born with hypermobility, which means that my joints have an excessive amount of laxity (i.e. the ligaments in my joints are too loose). This laxity allows my joints to extend further and easier than most people’s joints. Laxity that made me really “good” at yoga. Experts estimate that 10 percent of the general population has some degree of hypermobility; however, only about five percent are affected by unpleasant symptoms. the condition is known as Joint Hypermobility Syndrome (JHS).
I fall into that five percent.
What is Joint Hypermobility Syndrome?
Joint Hypermobility Syndrome affects hypermobile people who score 5 or higher on the Beighton scoring system (a simple screening technique for joint laxity and hypermobility), and have pain affecting four or more joints, lasting for three months are more. Symptoms of JHS, as well as other hypermobility disorders, include headaches, TMJ, neck and low back pain, skin hyperextensibility, unexplained bruises, joint sprains and subluxations, fatigue, mitral valve prolapse, and neuropathic pain.
What’s becoming growingly evident is that hypermobility, which affects women three times more often than men, is vastly overrepresented in the yoga community. Well over 10 percent of people involved in yoga, especially teaching yoga, have some degree of hypermobility in their joints.
If you suspect that you’re hypermobile, it’s important to know the risks. And if you suspect that you’re hypermobile and have chronic pain, know that you are not alone. I've spoken with dozens of female yoga practitioners, young and old, who are dealing with the long-term effects of exploiting their hypermobility.
10 Truths About Hypermobility
Here are 10 truths I wish I’d known about hypermobility before I started practicing yoga:
There’s a test you can take to determine if you’re hypermobile. The Beighton scoring system (a 9-point scale) has been widely used by medical professionals to screen for generalized joint hypermobility for over 30 years. I scored 8 out of 9 on the Beighton scale, indicating I was at risk for several hypermobility disorders.
Joint laxity falls into three main categories: under-functional range of motion, functional range of motion and past-functional range of motion. Anything past a functional range of motion is beyond the healthy limits of the joints.
Hypermobility affects more than your knees and elbows. While I’ve always been aware of the hyperextension in my knees and elbows on the yoga mat (and worked hard to protect them), I did not understand that being hypermobile meant that I could hyperextend many joints in my body, including my shoulders, cervical spine, hips and sacroiliac joint (where the majority of my chronic pain resides). And that those joints would also need protecting.
Having hypermobility can lead to the development of chronic joint pain, particularly in the neck and low back, and excessive stretching can greatly irritate the problem.
Many yoga poses (as they are represented in most classes today) require multiple joints to move beyond what’s considered to be healthy, functional range of motion. The reason I was able to achieve pretty close to “perfect” alignment and perform almost all of the poses was that almost all of my joints can and will extend far past their healthy, normal limits.
The exploitation of a range of motion plus repetition leads to damaged cartilage, inflammation, arthritis, and/or chronic pain. Most yoga classes out there encourage the joints to move repeatedly past their functional limits. I have a torn labrum in my right hip accompanied by arthritis, and I have spoken to many female yoga teachers in the same boat. Joints only have so many miles on them before they start wearing down.
Hypermobile people have sensory proprioceptive issues, meaning that my nervous system (which controls movement) doesn’t indicate when my joints have moved beyond their healthy limits. In other words, people with hypermobility aren’t so good at knowing where exactly their joints are in space. When you have poor proprioception and can easily move your joints beyond the normal range of motion, the brain often loses a sense of where your limbs are in space, increasing the risk of injury.
Hypermobile people don’t feel as much as normal bodies. Along with sensory proprioceptive feedback, issues come with desensitization. Hypermobile people are often under-sensitized, which explains why I never felt any pain or discomfort while practicing yoga asana—until I became hyper-sensitized. My nervous system is now on hyper-alert, causing a pain reaction to the slightest stretch.
Hypermobile people excessively feel the need to stretch but shouldn’t. Which can be confusing. The body desperately attempts to create stability in joints that are too loose by excessively tightening and gripping large muscle groups. Stretching those muscles not only feels good but can almost feel necessary. However, for hypermobile bodies, the relief is only temporary, and further stretching only causes more strain.
If practicing yoga changed your flexibility relatively quickly, chances are you have a certain degree of joint hypermobility in your body. Progress won’t come quickly, or at all, for the stable body. And on that note, if poses like the Hanumanasana (Monkey Pose or Splits) without having to seriously warm up and work toward it, you’re certainly hypermobile in the hips and pelvis. A stable body can’t do the splits out of bed.
Bonus: Hypermobile bodies often don’t feel a stretch sensation unless the position is somewhat extreme and/or the sensation is very localized. For example, hypermobile students will often only feel forward folds in the backs of their knees, the SI joint region, or a quarter-size sensation right at the ischial tuberosities (aka the “sit bones”).
Meagan McCrary is an experienced yoga teacher (E-RYT 500) and writer with a passion for helping people find more comfort, clarity, compassion and joy on the mat and in their lives. She is the author of Pick Your Yoga Practice: Exploring and Understanding Different Styles of Yoga a comprehensive encyclopedia of prominent yoga styles, including each system’s teaching methodology, elements of practice, philosophical and spiritual underpinnings, class structure, physical exertion and personal attention. Currently living in Los Angeles, Meagan teaches at the various Equinox Sports Clubs, works privately with clients and leads retreats internationally. You can find her blog, teaching schedule, and latest offerings at www.MeaganMcCrary.com.