The Hypermobile Yogi – Classes

Inspired by an article on Yoga International (shared by yoga teacher Adam Husler), I’ve decided to take a moment to show how having Joint Hypermobility Syndrome (JHS) affects me as a yogi. It’s been a long while since I shared ‘My Hypermobile Life’ with you all, and I’m going to try to not repeat myself too much, but as each year (and injury) goes by, I get a better understanding of how my complicated body works…or doesn’t as the case may be. I’m going to break my yoga experiences down into 3 posts; Asanas. Classes. Recovery.

yoga, yogabloggers, hypermobility

Don’t lock your elbow. Don’t sink into your hip. Don’t overly twist your neck.

Class Planning

Through chatting to my own clients, most people’s approach to classes and working out is; Sunday night – plan and book classes for the week, go to class, get a sweat on, go home. It may sound ridiculous, but I have to consider a whole lot more before deciding whether to go to class or not.

Firstly, is my body ok? I listen intently to my body and pay close attention to niggles, aches and pains. With JHS, I suffer with chronic pain at times, so I’m used to being in pain, what I have to pay attention to is new pain, and decipher whether that’s something simple like ‘I’ve popped my shoulder out while asleep’ – yep, that happens – or something more sinister. Saying that however, I’d probably still go to class!

yoga, yogabloggers, hypermobility

Don’t turn your elbows backwards. Don’t just drop your chest. Don’t pop your shoulders.

Secondly is what kind of class my body needs. People with JHS suffer with chronic pain, heart palpitations (I also have a heart condition, or two), low blood pressure, fatigue, anxiety, sleep problems and depression. This is due to the body producing more adrenaline to compensate for the extra elasticity in the blood vessels. If I want to go to class, I have to decide whether it’s a fast paced, dynamic practice, a hot yoga session, or a slower, deeper, more technical class. On a day where I simply want to curl up and stay in bed…I’ll book into one of my favourite teachers’ classes and make myself go, regardless of the style, and I’ll just practice cautiously. I never regret going to yoga!

Other Classes

In terms of non-yoga classes, that’s a whole other ball game! High impact classes are almost a no-go for me, and other classes such as boxing, aerial or ballet have to be considered according to what else has been happening that week. Sometimes, I simply opt for a gym session where I can tailor my workout to what I need.

yoga, yogabloggers, hypermobility

Don’t crunch your lower back. Don’t drop your neck back. Don’t pop your shoulders.

During class, other than controlling my joints during each asana, it’s essential to consider the transitions between each posture. Sometimes, if I stand up from the sofa too fast, I get that head rush feeling, imagine how intense that can get in a hot yoga room, returning from a deep backbend. Add to that the likelihood that I might have crunched down on my neck in said backbend, that’s a recipe for passing out. Slow and steady wins the race, and even in super-charged Rocket Yoga, it’s important to take an extra breath of stillness when needed.

Keeping all that in mind, my decision to go to yoga is often made the morning of the class. I’d love to pre-plan my weeks to include classes, as most often I take the same classes each week, but I can’t predict how my body will feel. Quite often in the past, I have been overambitious with my body, and have had to cancel last minute.

yoga, yogabloggers, hypermobiltiy

Breathe!

Once I’ve done class, it becomes about recovery and making sure I don’t hurt the next day. Through nutrition and taking care of myself with adequate rest, it’s time to listen to my body and think about when my next class will be. My next post will focus on A Hypermobile Yogi – The Recovery.

All Images: Will Patrick

The Hypermobile Yogi – Asanas

Inspired by an article on Yoga International (shared by yoga teacher Adam Husler), I’ve decided to take a moment to show how having Joint Hypermobility Syndrome (JHS) affects me as a yogi. It’s been a long while since I shared ‘My Hypermobile Life’ with you all, and I’m going to try to not repeat myself too much, but as each year (and injury) goes by, I get a better understanding of how my complicated body works…or doesn’t as the case may be. I’m going to break my yoga experiences down into 3 posts; Asanas. Classes. Recovery.

The Asanas

Here’s an example of how my mind works during a sun salutation:

  • Inhale reach to the ceiling – make sure my ribs aren’t flaring open, pelvis isn’t tilted back, knees aren’t locked, neck isn’t dropped back
  • Exhale forward fold – don’t just flop over and touch floor, lengthen spine
  • Inhale look up half way – don’t lock into my swayback knees
  • Exhale step / jump back to high plank – don’t lock my elbows into a gross inside out position
  • Chaturanga – don’t sink into my shoulders, popping out my shoulder blades
  • Inhale up-dog – don’t sink into my super flexi lower back, don’t lock elbows
  • Exhale downward dog – Oh god, wide upper back, don’t flap shoulder blades, shoulders in their sockets, ribcage not sticking out, biceps turned in, no gross inside out elbows, don’t lock knees…anything else??

 

My Extreme Versions of Yoga Postures

hypermobility syndrome, yoga

hypermobility syndrome, yoga

Making funky shapes, getting seriously deep into postures and slopping into my rather hypermobile joints, versus actually holding a technically strong asana is a constant battle for me.

There are a bunch of postures that I can slip into with little warm up and feel easy to relax in. It’s more than likely however, that in those circumstances I’m not actually using my muscles effectively at all but simply relying on the instability of my joints to get there.

To make myself work harder, and if I actually want to improve, I have to come out of a posture, engage my muscles and find a less deep, impressive position in order to be safe. As a dancer wanting to always make aesthetically pleasing shapes, this is a struggle for my ego, and I’m the first to admit that!

hypermobility syndrome, yoga

hypermobility syndrome, yoga

Being hypermobile in a couple of joints is one thing, but as I’ve explained before, JHS is a more complicated condition. Joint trouble aside, there are many things I have to consider when I wake up and decide to go to class, these I’ll explain in my next post. A Hypermobile Yogi – The Classes.

Injury Chronicles #3

It’s about time I updated you all on this knee injury! Since my last Injury Chronicles Post, there’s been quite a lot of development, and not all of it good I’m afraid. As you know, there was two things going on with my troublesome knee, so here’s a little recap.

knee fitness, injury, mri scan

The problem with my knee was two-fold, I was suffering from an impingement of the fat pad under the knee cap, and, to quote, ‘quite a lot of fissuring’ to the cartilage behind my knee cap. The fat pad impingement was a vicious circle where the tissue was getting swollen, and then catching on the knee cap whenever I bent my knee. The more it caught, the more is swelled, and the more it swelled, the more it caught…nightmare! The cartilage damage was due to over-use and exacerbated by some over-zealous yoga.

So I last reported that I’d had a steroid injection in my knee to provide a big dose of anti-inflammatory hydro-cortisone  and hopefully ease the pain. A few weeks later and I could see improvement in one aspect of the issue, the impingement, but the improvement stopped there. I’ve been working hard on my physiotherapy exercises to improve the muscular connections around the knee, and to prevent tension around my hip from pulling in the knee-cap, but to cut a long story short, it’s not gotten much better.

knee injury,

 

Back to the consultant I went to talk about what to do next. As my pain has only improved by 20/30% and it should have improved by 60/70%, surgical intervention was recommended. Being that this is private health care (extremely grateful I took out Vitality Health Insurance at the beginning of this year), it’s now all happening very quickly and I’m in for surgery tomorrow!

Knee Arthroscopy

I’ll be having an arthroscopy at the King Edward VII – Sister Agnes hospital in Central London. An arthroscopy is a fairly non-invasive, keyhole procedure where two incisions are made in the knee, one for a tiny camera, and the other for the instruments required to carry out repairs. In my case, these repairs will likely be the removal of any damaged cartilage and smoothing of the surface underneath my knee cap in order to restore the smooth tracking of the knee. It’ll be performed under general anaesthetic (I’ll be asleep) and if al goes to plan I’ll be in and out on the same day.

arthroscopy, knee injury

Pros: There’s an 80% chance that this procedure will alleviate the pain in my knee completely and I’ll be back up and running in 6-8 weeks. It’s a minimal procedure with small scarring and I should be able to weight bear very soon after the operation.

Cons / Risks: With any knee surgery where cartilage is removed, the risk of developing arthritis increases, and I am already at high risk due to my bone demineralisation. I talked through this with my consultant and the potential development of arthritis would be after 10-15 years…which I’m not worried about.

Post surgery I’ll need to rest completely for 7-10 days, and then start gentle rehabilitation and exercise. In terms of teaching, apart from the occasional PT client, I’ll be out until the end of September…! But it’ll all be worth it to be pain free and able to train again!!

Has anyone undergone similar? When I speak to people, I’m surprised at the amount of people who’ve had something similar or knows someone who has.

Look After Your Body – It’s The Only One You’ve Got

*Long post warning!*

The saying goes: “I workout because I love my body, not because I hate it” which is a pretty good ethos to live by. Self-love is something that everyone could use a little more of, especially with pressures from work, home and social media flooding our already overworked brains.

quote, workout, love your body, fitness

Regardless of how you view your body, what’s most essential is that you listen to it. This has become even more applicable to me in recent months. I don’t share much of my very personal life here, but this is something important that could apply to you too.

We all get aches and pains, sore muscles, the occasional injury and being in an active profession, I am more likely to injure myself than the average 28 year old. Add to that my joint hypermobility syndrome and its complications, I am very much used to aches and pains!

I’ve never been too good at listening to my body. As a dancer I pushed through injuries until they were unbearable, ignored niggling warning signs and usually wound up having to take more time off than would have actually been necessary. On top of that I wasn’t exactly well nourished in my late teens and early 20s, and this has led me to writing this post.

I had an eating disorder from the age of 14 on and off until I was 24 / 25 years old. While I was never hospitalised, and I didn’t see myself to have a huge problem, I yoyo’d from eating almost nothing some days, to eating semi-decently when I had to. To put it plainly, I never ate well. The reasons for my disordered eating aren’t important, and actually changed as my condition progressed. In my mid-20s I discovered that to feel comfortable with eating, I had to know what was in my food, hence moving towards a fresh food diet, almost nothing pre-made/packaged. I now eat more than I ever have and am happier in my own skin than ever before.

yoga, meditation, love your body

Fast forward to now. In the last couple of months, I noticed a significant increase in my pain and fatigue levels. This mainly focused on my legs and lower back but could sometimes affect my whole body. Each day varied in its level, but on the worst days, I had to fight to not sit down in the middle of the street I was exhausted with so much pain (it may sound dramatic, but it’s very much the truth). Aside from the usual hypermobility issue that can cause unusual amounts of pain, there were a lot of other things going on; extra work, no days off, double shifts etc. so I slowly reduced down to the bare minimum of my schedule in the hope the pain would ease, only for it to continue to worsen.

Time for a trip to the Doctor!

Luckily, my Doctor took my random pain seriously and sent me off for X-rays suspecting arthritis, and bone profiling blood tests for vitamin and mineral levels. The longest week ensued while waiting for results, with images of knee replacements and Plan B career paths flying through my head. Blood tests revealed a Vitamin D deficiency and mal-absorption of calcium as a result, easily solved with supplements and small dietary changes. Thankfully, the X-rays didn’t show signs of arthritis but did flag up something else entirely…demineralisation of the bone, almost certainly a result of lack of nutrition as a teenager…..oh.

Without wanting this post to become an essay, I’ll draw to a close. It’s basically my fault. Supplements will help the pain and fatigue associated with the deficiencies and slow the demineralisation of the bone but it won’t cure it. You can’t RE-mineralise bone. I’m lucky to have discovered this now but I feel guilty for putting my body through the trauma. I’m very well nourished these days, and look after my body much more than in my younger years. Everyone begins a very slow process of bone demineralisation from the age of 25, but a 28 year old with thinning bone visible trough X-ray is unusual. You can’t change the past I know, but I can’t help but wish I’d have taken more care of my body. After all, it’s the only one I’ve got.

quote, love your body, workout, fitness

If reading this has struck a chord in you, then I’m glad. I can’t say that I didn’t know all the risks when I decided to restrict my eating, because I did, I just didn’t think I was bad enough for it to happen. I’ve learnt from my mistakes and will continue to do so forever. I’m not going to beg everyone with an eating disorder to stop right now, it’s not that simple, but if I make one person rethink their lifestyle, or share this post to a friend, I’ll be happy.

The Hypermobile Life #1

Tash

Having been inspired recently by the support in the blogging world for personal posts, I thought about writing my own. I have what could be called a disability, I don’t class it as one personally, but it is one of those silent ailments which affects me almost every day.

I have Hypermobility Syndrome.

I’ve written another post outlining some facts about Hypermobility Syndrome if you fancy some background reading, but for now, here’s my little story (which is, incidentally, quite long, apologies):

I’m 27 and my current injury list goes as follows:

Dislocations / Subluxations (and partial dislocations):

  • Right shoulder x3
  • Right knee cap x2
  • Right thumb, left thumb
  • Multiple sacroiliac alignment issues

Soft Tissue Damage (usually sprains, tears, over-stretched, inflamed):

  • Right & Left ankles (too many to remember)
  • Right hip-joint inflammation
  • Shin splints right and left
  • Right groin
  • Tendonitis, both elbows
  • Right shoulder

Breaks / Fractures:

  • Left wrist
  • Left scaphoid
  • Left elbow
  • Right foot
  • Left little toe joint / foot

I’ve been told that this list would be shocking if it belonged to a 70-year-old, let alone a 27-year-old! The most shocking thing for me, is that most of these injuries are NOT from dancing, but everyday, hypermobile life.

I was an active child, I did tumble-tots (please say some of you remember this) and started ballet and dance at the age of 3. I always had scraped knees from tripping up or twisting my ankles, and sometimes I just fell over, for seemingly no reason at all.

It wasn’t until a severe ankle injury, followed by a shoulder dislocation aged 15/16, that this clumsy child was investigated further. I was diagnosed with Hypermobility Syndrome (HMS), more specifically, Joint Hypermobility Syndrome (JHS). I scored a whopping 9/9 on the Beighton Score Hypermobility Assessment. I don’t think my local physiotherapist knew what to do with me! It wasn’t until I met my current physio at performing arts school, that I fully understood what JHS was all about.

hypermbolity syndrome dancer beighton score

The Beighton Score

Despite injuries and set-backs it was no surprise that I decided on a career on the stage. I moved to London age 18 for dance college but within 3 months of full-time training I had suffered two serious injuries which resulted in me having to leave and defer my place until the following year to allow for full recovery. Devastating as this was, I recovered, and despite more injuries, graduated in 2008 and went into the performing world.

I’ve worked as a dancer and actress since then but injuries have been frequent. I nearly lost a job, dancing at Disneyland Paris, because I dislocated my kneecap 2 months before the contract started. Thankfully, I managed to recover just in time. As I’ve got older however, the injuries are taking longer and longer to recover from.

A couple of years ago, I decided to remove myself from the dancing world, the main reason being that I cannot recover from injuries well enough any more. I haven’t given up, and don’t want to look on it as giving up. I miss dancing properly, but I’ve moved my skills to another area: dance related fitness.

You might think that being a dancer with JHS might have some advantages; super bendy feet and legs etc, but it also makes for a weak dancer. My muscles need to work over-time to prevent constant dislocations and needless to say, they’re not always successful.

JHS 8

I was nick-named ‘banana feet’ at dance school.

The most bizarre thing, as I mentioned earlier, hypermobility affects my daily life almost more than in dancing.

Let me explain…

  • I most frequently ‘pop’ my shoulders out….in my sleep. Yes, I’ve woken up on many occasion in excruciating pain having to put my arm back in its socket. Talk about a rude awakening!
  • Something as simple as brushing my knee against a desk or cupboard or chair, or my cat walks over it, and out pops my knee cap.
  • This is a weird one…until I found Pilates, and the core strength it gave me, the force of being on a plane as it landed and engaged reverse thrust, would dislodge my sacroiliac (pelvis) joint.
  • I once twisted my ankle and fell, fracturing my elbow, scaphoid and dislocating my thumb in one fell swoop.
  • The thumb joint subsequently required reconstructive surgery, it’s now ‘normal’ and you can see that my other thumb is permanently partially subluxed.
JHS 6

On the left – reconstructed thumb. On the right – partially subluxed thumb.

There are some lesser known side effects of HMS and JHS…

  • Local anaesthetic takes much longer and at a higher dose to work. I discovered that the hard way having steroid injections for a hip joint inflammation injury…yeouch!
  • I bruise like an absolute peach!! My physio once gave me finger print bruises during treatment.
  • I have a heart murmur, diagnosed at birth but most likely linked to HMS.
  • I’m at a high risk of pregnancy and birthing complications.
  • Proprioception (knowing where your body is in space) is lacking with HMS, this increases risk of injury. Yes, I sometimes walk into door frames (yes you can laugh).

So there you have a little (ahem, long) snippet of hypermobile life. If you read this far….THANK YOU, maybe leave a little comment so I can thank you properly.

I’m not writing for sympathy, but more to share my experience in the hope that someone, anyone, will relate, or take away a bit of knowledge about HMS. This post is #1 because I might add new posts each time something happens I feel would be useful to share.

If you’re a dancer, teacher, trainer or anyone who would like advice or to share your own experience, do not hesitate to email me at balletdancefitness@gmail.com

Thank you for reading!

Hypermobility: The Basics

JHS 4

I started writing my post about living with Hypermobility Syndrome, but found that I was almost writing a whole essay! So I’ve decided to write two posts, this one about some of the facts about Hypermobility Syndromes, and another one to follow about my personal experience.

Hypermobility affects 20-30% of society in one way or another. It can range from simple double-jointed-ness (that’s a made up word, I know) to a severe disability that falls somewhere under the Hypermobility Syndrome (HMS) umbrella (shown below).

hypermobile EDS joint hypermobility

Credit: Hypermobility Syndromes Association

HMS is an inherited condition that affects the connective tissues throughout the body. In terms of genetics, there is no formal test to detect HMS in individuals, and within families, there can be varying degrees from asymptomatic to severe and debilitating. In most patients, its most common sign is joint instability, however, in some cases blood vessels, the cardio-vascular, respiratory and digestive systems or skin can be affected.

My experience is with Joint Hypermobility Syndrome (JHS).

JHS is commonly diagnosed using the Beighton Score. The following criteria are tested to assess the joint mobility:

  • One point if while standing forward bending you can place palms on the ground with legs straight (no warm-up)
  • One point for each knee that bends backwards
  • One point for each little finger that bends backwards beyond 90 degrees
  • One point for each elbow that bends backwards
  • One point for each thumb that touches the forearm when bent backwards

hypermobility beighton score

hypermobile beighton score

hypermobility beighton score

Although this is a standard test, it is now widely recommended that doctors assess other parts of the body such as neck and shoulders to fully diagnose this condition.

With a Beighton Score of 4 or more a person can be diagnosed with HMS. As you can see from my body in the photos above, I tick all the boxes apart from one hand which has had reconstructive surgery. One of my legs is also more hypermobile than the other.

 Even if a person has less than 4 of the above criteria, there are also other points to take into consideration. It is not common knowledge that these are associated with HMS and JHS:

  • Easy bruising, scarring, and stretch marks on the skin.
  • Weakness of the abdominal and pelvic wall muscles.
  • Unexplained chest pains – often diagnosed as a heart murmur or mitral valve prolapse.
  • Blackouts or near blackouts associated with low blood pressure or fast heart rate.
  • Symptoms that sound like Irritable Bowel Syndrome with bloating, constipation, and cramp-like abdominal pain.
  • Shortness of breath – can be diagnosed as asthma because the symptoms seem the same.
  • Resistance to normal doses of local anaesthetics.
  • Severe fatigue.
  • Anxiety and phobias.

Sufferers from JHS or indeed any HMS may have a varying combination of these symptoms, which is why it is so important to take the whole body into consideration when assessing for diagnosis.

In mild cases, JHS can be considered, and I’m not sure I agree with this, as advantageous in dancers, gymnasts and other performing artists.

JHS 5

Images: My Facebook

Regardless of how severe the condition, JHS sufferers are at high risk of dislocations and soft tissue injury, not just during sport but sometimes in everyday actions others wouldn’t think twice about (ever dislocated your shoulder in your sleep?). Injuries can typically take longer to recover from than normal and complications with healing can occur causing the patient to experience continued pain.

In fact the chronic pain experienced in JHS and other HMS cases can be a life changing component of the condition. Being hypermobile is not simply about getting injured and extended recovery times, it’s about the parts of everyday life that can become painful, or dangerous. There are side-effects linked to HMS that not so many people are aware of such as hypotension and bowel complaints and problems during pregnancy. Misdiagnosis is common and knowledge is lacking.

I’m writing these posts to share the knowledge and experience. If you’re reading this, a teacher or trainer, and someone says to you, ‘I have hypermobility syndrome’ I want you to know what implications that has for a person, particularly an active person. Training and working out is, of course, possible in every way, it’s just useful to know the potential limitations.

For more about my personal experiences, watch this space for my own story of The Hypermobile Life.

  • Information Sources: Hypermobility Syndromes Association
  • Images, unless stated otherwise: Juan