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Libby Hinsley, P.T. – "Yoga for Bendy People"
Episode 118th June 2022 • Clinical Corner with Leslie Kaminoff • Leslie Kaminoff
00:00:00 01:03:47

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Libby Hinsley, P.T. discusses her personal journey into yoga, physical therapy, and her eventual diagnosis with Ehlers-Danlos Hypermobility Syndrome, all of which led to the writing of her new book, "Yoga for Bendy People."

Libby's anatomy membership for yoga teachers can be found at: www.anatomybites.com

The Ehlers Danlos Society website has great hypermobility Resources: 

Hypermobility-specific podcasts: 

The premium version of this podcast, in which Leslie and his guest review and analyze a video recording of a private session is available to subscribed members of The Breathing Project.

Transcripts

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Okay. Recording is in progress.

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Hi Libby.

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Hi, happy to be here.

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Yes. I'm happy that you're here too.

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We, you know,

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one of the,

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this is the first recording I'm doing for this new podcast,

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just so you know,

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and you're one of the first people I thought of talking

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to, because the last time we had a lengthy chat about

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this very topic in the back of my head,

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as we were talking about all of this stuff that you

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specialize in,

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it was like,

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other people need to know this information,

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this, this would be a great conversation to share.

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And so now we get a chance to do it.

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And so congratulations on being the premier guest on this new

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podcast, which I'm calling Clinical Corner.

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That's awesome.

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That makes it even double special to be here.

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Okay. Yeah.

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And as I said in the email that I sent,

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you know,

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this, what I'm aiming for here is the opposite of dumbing

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things down,

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because we're aiming at people like us as our audience,

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people who work one-on-one with other folks,

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whether as a yoga teacher,

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a yoga therapist or yoga educator,

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or just a movement person in general,

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because I think there's a,

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a very wide swath of interest in the sort of things

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that we'll be talking about.

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And so we can really kind of get into the nitty

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gritty and talk shop a little bit,

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which is going to be fun.

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Great. Yeah.

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So why don't you just introduce yourself and just tell people

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a little bit about how you came to do what you

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do and,

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and have this particular focus.

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Okay. Well,

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I'm Libby Hinsley and I am,

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I've been a yoga teacher since 2005 and I'm in my

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first, you know,

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early years of teaching yoga.

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Of course,

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I got really interested in people's quick questions after class that

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they always have such as,

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like, why does my shoulder hurt?

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Why does my hip hurt?

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And I was like,

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I have no idea,

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but I'm interested in that stuff.

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And so that all led me in to go to go

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to physical therapy school.

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So I've been practicing as a physical therapist for about 10

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years and training teachers for about that same amount of time

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as well.

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So in the background of all that,

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of course,

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was just my life and in my life,

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especially in my yoga,

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practicing life,

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I had chronic pain and injury going on,

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sort of in the background and had all the classic sort

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of yoga related injuries that so many yoga practitioners have.

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And I had a long history before that to have shoulder

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injuries, especially rotator cuff injuries.

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I was like competitive tennis player for a long time.

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So anyway,

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I had shoulder crazy shoulders,

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sacroiliac, joint pain,

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hip pain,

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knee pain,

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foot pain,

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sort of like all pretty much head to toe pain,

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but especially ...not

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the kind of pain a young person should be having ...Definitely

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in fact,

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the decade that I had the most pain was my twenties.

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Wow. Yeah.

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And, and that was the decade.

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I got more heavily into yoga practice.

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And unfortunately I was drawn to types of Asana practice that

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were not right for me at all.

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I mean,

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they, you know,

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and there's nothing necessarily categorically wrong with any style of asana,

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but the question is,

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is it the right one for this practitioner?

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And for this practitioner,

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what I was doing was not the right practice.

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So it was okay.

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There's an interesting thing because people get drawn to two things

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based on what they're sort of already able to do to

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some extent,

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and that can end up being exactly the opposite of what

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unique is this new exacerbate,

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some of the,

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the, the imbalances that you may already have in your system.

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Yes. Well,

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exactly. I think we're drawn to the things that probably feed

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our existing dysfunctions initially anyway.

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And so that's what I,

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and I was moving really quickly and,

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you know,

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a lot,

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so it's just kind of Ashtanga Vinyasa style,

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fast paced,

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hot stuff,

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stretching as far as possible.

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And, and so I didn't really have a great understanding of

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my joint hypermobility at that time,

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but over the years,

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especially as I got into physical therapy and even more so

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when I started treating injured yoga practitioners,

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which is primarily who I see at this point as a,

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as a yoga therapist,

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PT, you know,

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within my private practice.

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And they all had the same stuff and it turns out

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they all have the same stuff I had always had too.

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And, you know,

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luckily for me,

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my chronic yoga pain and injury nagging aches and pains,

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the sacroiliac joint,

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the high hamstring strain.

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I mean,

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I had those for 10 years every single day for 10

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years. And that started to turn around when I got into

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a different way of practicing Asana,

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which is when I discovered the Viniyoga lineage.

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And that was in 2008.

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When I went to study at Desikachar's place in Chennai India

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for a month,

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you know,

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I did their immersion and it just changed everything for me.

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I just hear about that.

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I'm always interested in sort of the entry point for that,

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because it,

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back then,

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it was a little more obscure than it is now.

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Well, I had no idea what I was getting into at

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all. When I signed up,

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I had no clue.

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I just had read a couple of Desikachar's books in my

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teacher training,

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you know,

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my initial training in 2004 and I really loved his books.

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And so I looked into,

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and I thought,

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this place sounds awesome.

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I was considering going to physical therapy school.

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And I was reading about kind of how they deal with

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one-on-one clients and assessments.

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And I thought,

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Ooh, this is like a really neat,

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well, it was yoga therapy,

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right? And that's not the training I took there,

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but I just was interested in what they were doing at

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the center.

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And so when I showed up there,

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honestly, that first week or so of the month long immersion,

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I hated it.

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Coming from your background as an athlete and very active style

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of practice.

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I can see how that would be kind of a,

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a shock to the system,

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the way they practice there.

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It was a real shock to the system.

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I was like,

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what are we doing?

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This is so boring.

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And, you know,

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so there was that initial reaction,

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but then about a week into it,

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I discovered,

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wow, something magical is happening here in my body and my

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breath. I've never experienced asana in this way at all.

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And it turns out I totally fell in love with it

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After practicing.

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I would guess The thing is that my ...

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everything changed for my physical injuries and pain related to asan

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practice. And,

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and those things haven't really bothered me since.

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I mean,

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it took me a while to really integrate the new ways

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of practicing and to really change my habits in yoga.

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And even when I was,

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would go to attend a class,

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you know,

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making those modifications that I needed and that took a while

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to do,

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but once I did,

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you know,

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they just haven't bothered me since.

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And then a lot of other things happened in my life,

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like strength training and things like that that have really supported

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my body too.

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So that's how I got into that lineage of yoga and

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just been interested in it ever since Now,

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you did the PT training after you studied with the KYM,

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and I'm curious if,

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as part of your education to become a physical therapist,

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this whole issue of hypermobility was,

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was covered as a,

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as a topic.

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Well, it's really interesting that you ask because it really wasn't.

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In fact,

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you know,

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so a couple of years ago I was finally diagnosed with

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hyper mobile Ehlers-Danlos syndrome,

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hypermobile EDS.

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And when I learned about EDS and hypermobility syndromes in general

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in PT school,

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I would have never,

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in a million years thought I could have something like that.

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We'll have you sitting in class doing this with your thumb

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to see if I did.

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And, and honestly,

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I was always like the weird example in PT school of

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everything, you know,

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and the professors would be like this isn't normal for an

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adult. And,

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you know,

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but that's kind of as far as it went.

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And when it got into really kind of talking about more

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pathologies I had in my mind that someone with EDS basically

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couldn't walk without a mobility aid,

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or they would be dislocating every joint all the time.

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That's sort of like I had that really extreme view in

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my mind.

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That's not the case at all,

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of course,

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and people who have hypermobility syndromes are all a spectrum of

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impairments and disabilities,

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but I never really got a clear picture of what it

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meant to have a hypermobility syndrome.

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And neither does anyone probably who goes through PT school or,

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you know,

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physician training.

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And that is one of the biggest problems for this whole

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situation. And that's what I wanted to focus on here because

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as yoga teacher,

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educator therapists,

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that where we designate ourselves,

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we are really on the front line of being able to

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spot this and recognize it for people because it is so

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often overlooked in the medical realm.

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And I know personally from workshops and other things that I've

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taught, having been able to spot people and say,

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Hey, have you heard of hypermobility,

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Ehler-Danlos, whatever.

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And people are like,

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no. And then,

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you know,

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you say just a little bit about it.

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And all of a sudden the light bulb goes off in

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their entire life starts making sense.

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This is coming from a non-medical person.

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This is coming from just someone that's in the front of

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rooms, where groups of people are moving and you can spot

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right away when something stands out as being beyond the range

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of what normal range of motion should look like.

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Right. It's true.

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I mean,

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there's so much to that because the problem is so many

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yoga teachers don't know what normal human movement should look like.

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You know,

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just because they don't have a lot of training in that.

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And because they're used to looking at people who move more

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than normal,

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you know,

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because I think yoga,

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you know,

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hypermobility is so over-represented in yoga populations.

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So yoga teachers start to think that it's normal to move

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that way.

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So they're looking out at a room and the very bendy

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ones they think are the normal ones and the,

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the normal ones they think are the,

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the tight ones.

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You know,

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I've never personally thought that,

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but that's the only because I started off with a background

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in things like biomechanics and sports medicine,

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and, you know,

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you know,

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just a little bit more of a,

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of an anatomical basis to what I was seeing,

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but in a typical class where people are involved in what

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I tend to call the unbridled pursuit of unlimited flexibility,

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then you're like a star pupil and you're often demonstrated on,

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or with you become the teacher's personal Gumby toy.

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And a lot of injury can happen that way.

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It's true.

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It's true.

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And so I agree that yoga teachers are in a unique

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position to recognize things and to help people understand their bodies

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better. And there's like a fine sort of needle to thread,

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I guess,

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in that,

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which is to not be alarmist about it.

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I mean,

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I think that's one thing to kind of bring out in

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our conversation is it's okay if someone has hypermobility,

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they're not going to literally fall apart on their yoga mat.

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And I think a lot of people have so much concern

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that they're going to break and that they're highly fragile and

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this type of thing,

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I think we need to temper that,

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but also recognize that this can be the thing that helps

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someone make sense of their entire life.

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So, and that was the case for me too.

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It is the...the

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unifying principle,

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basically of all the things in my life that I never

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thought were related because we're not just talking about bendy joints

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and all the musculoskeletal fallout that happens from that.

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We're also talking about,

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I mean,

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that's just the tip of the iceberg.

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I want to get into that because there is a long

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laundry list of things that,

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and we just,

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in our previous conversation,

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we discussed this,

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that clusters around this diagnosis.

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And we'll get to that in a minute,

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but I'm just curious,

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do you recall,

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was there a single moment when the light bulb went off?

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I mean,

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do you have,

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was it a sudden revelation when it all kind of came

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together and you were like,

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oh wow,

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this explains my life.

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Well, it was the moment I got the diagnosis,

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but, but leading up to that,

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it was several years of progressive sort of dawning realizations,

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both being around a good friend of mine who has Ehlers-Danlos

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syndrome. And we were teaching together on chronic pain.

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And that's another area that I specialize in the neuroscience of

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pain. And,

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and those often are the same,

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the chronic pain and the hypermobility people are usually very commonly

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the same people.

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And so I was learning a lot just in my clinical

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practice. It just kept on sounding so familiar,

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you know,

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like, oh,

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that sounds a lot like me and I just kind of

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kept connecting these different dots.

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And it was after the birth of my second child in

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2016, that my health really fell apart in a bigger way.

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And I'd always had all kinds of chronic weird stuff,

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but it was not until then that things really came apart.

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And I started having more serious symptoms,

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cardiac symptoms and digestive problems and more pronounced,

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you know,

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multi-system involvement.

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And that's when I started seeking medical stuff.

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I went through the whole gamut that people always go through.

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I saw all the specialists,

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I got gaslit repeatedly,

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just like every,

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you know,

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this medical kind of gaslighting that happens when physicians don't understand

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what's going on and they don't know about the condition.

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And they're,

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they're very dismissive and it's you,

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it's not intentional to be dismissive,

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but that's what happens to people.

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And so I went through all that.

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So you go through your entire training as a physical therapist

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and the clinical work you do.

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There you go through a whole range of medical exams and,

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you know,

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specialists, and it's still not coming together for anyone to say,

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Hey, we know what this is.

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So who finally figures it out A geneticist.

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So I finally,

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I downloaded the diagnostic criteria for hypermobile EDS,

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which is a clinical diagnosis.

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You know,

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we can talk about EDS a bit more,

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but it's the only one of 14 subtypes.

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It doesn't actually have a blood test to confirm it.

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It is made by a clinical diagnosis,

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a checklist of,

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of attributes.

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And I downloaded that and I just,

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This, this,

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and this symptoms or histories or whatever,

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then it qualifies,

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but it's not like they're running a blood test or checking

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your DNA,

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or, you know,

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That's Not a lab test.

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Exactly. Unless they need to rule out a different type of

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EDS because all the other 13 types do have a blood

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test, a molecular marker associated with them.

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So you could,

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you know,

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rule those out as part of the confirmation,

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if they thought that was necessary.

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But there's research underway to try to determine what is the

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genetic cause.

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Like, could we pinpoint it and do a blood test for

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it that is underway.

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It's not well understood for hypermobile EDS and some of the

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reasoning for that,

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or the hypothesis for that is that it's complicated.

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That there's a lot going on that it's not just one

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easily explained genetic alteration,

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but it's a whole host of them.

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It has to do with collagen.

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It might have to do with college and producing cells,

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their behavior,

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the fibroblasts behavior,

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and their inability to contract,

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to create tension across the tissue.

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It may have to do even with the genes that regulate

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inflammation. So it's just more complex With whatever genetic predisposition leads

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to it and never develop it because there's so many factors

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that can,

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that can cause the expression of these genes in your life.

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And so it is it's complicated and you can have EDS

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and not be hyper mobile.

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Well, yes.

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Or you could,

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you could have EDS.

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Yeah. It's so,

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oh, this just looks like it's a tangled ball of yarn,

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you know,

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and some people,

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even with EDS don't appear hyper mobile because they may have

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so much compensating muscle tension that their flexibility is really limited.

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And it's me in our first conversation,

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it's just someone who actually has hypermobile EDS can not,

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will not necessarily self identify as being flexible.

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They feel the tightness that they're using in their nervous system,

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in their musculature to literally hold their joints together.

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Yeah, exactly.

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They feel tight and they are tight sometimes and they can't

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touch their toes.

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And so there there's all kinds of problems with the standard

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sort of hypermobility assessments that we use because they don't screen

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for that.

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Cause you could be completely bound up around your loose connective

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tissue and not exhibit excessive range of motion.

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And, but you still have it.

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Exactly. And sometimes you can tease that out through passive versus

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active range of motion.

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But so,

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so all of that is to say,

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you know,

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the hypermobile EDS diagnosis is clinical.

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And so in my sort of story of my coming to

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this realization,

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I just downloaded it.

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I tested myself,

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I looked up what all the things are.

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I looked at my body,

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I did my,

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all the things.

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And I was like,

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oh, looks like I have this.

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And so I took it to my primary care doctor who

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was wonderful,

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but she doesn't know about it,

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but she said,

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Hey, it looks like you found something here.

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I'm going to refer you to the geneticist.

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And, and that's often the pass-off is to a geneticist who,

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and he was,

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he knows all about it.

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And so I had that visit with him and I write

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about it in the book.

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And he said,

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yeah, this basically is,

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sounds like a classic case of hypermobile EDS,

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you know?

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And I was just like,

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and that was the moment I was like,

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ah, the relief and the validation was really surprising.

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Honestly, I didn't really expect it to be that powerful Really.

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And this is where someone with a heavy duty clinical background

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and education,

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and I'm thinking of people that have none of that who

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are suffering with this,

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their entire lives and,

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and what a profound life altering realization it can be when

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they're finally handed an explanation for everything,

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not only what they've been experiencing,

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but it tends to run in families.

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Does it not?

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I mean,

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you have to look at the,

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at the,

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the, the family history and,

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you know,

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relatives who have a similar body types and symptoms.

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Exactly. Yeah,

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exactly. And there's always,

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you, even for someone like me who had studied it a

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lot, studied chronic pain a lot,

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and you see people with hypermobility clinically all the time.

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There's always that just nagging thing.

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Like, well maybe what I'm experiencing is normal.

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Maybe this isn't that big of a deal.

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And there's always that little bit of self doubt.

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And what's interesting is that I think that's even more common

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in people who have hypermobility because they have a hard time

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knowing how they feel and getting clear about like literally physiologically,

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how they feel and kind of creating,

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establishing a clear boundary about where their stuff ends and somebody

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else's stuff begins.

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So they're kind of impressionable,

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I have to say,

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and it's kind of weird,

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but there's an issue with boundaries there that's really more physiological

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than anything.

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I don't want to paint it as like a psychological defect,

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but it really is inherent in the difficulty with proprioception and

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interoception Well,

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that's a great segue cause that's,

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that's on that list of all these associated issues that go

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along with it.

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So there's difficulty with proprioception,

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meaning the,

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the actual mechanisms,

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the physical mechanisms,

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the mechanoreceptors that live in the connective tissue that deliver information

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to your nervous system about where your joints are in space

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are affected by this.

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And so you don't have that information being delivered to your

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nervous system.

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Exactly, exactly.

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Those mechanoreceptors aren't stimulated as easily because the connected tissue is

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floppy and it needs to sense tension for that stimulate or

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something. It's got a sense,

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some sort of mechanical event,

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some mechanical reality.

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That's what those sensors are looking for.

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And they don't get the information until you get to your

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end range.

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And that is,

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what's so tricky.

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A hypermobile person can't really feel anything without,

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you know,

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some training and then we can learn,

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but it's hard to feel anything about where we are in

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space, unless we're at an end range.

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And then those mechanical receptors,

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finally, there's tension across the tissue.

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Finally, they're stimulated.

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And they're like,

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ah, here we are.

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You have a body here it is.

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But before you get there,

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you're just like,

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ah, I don't know where I am and it's really hard

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to feel embodied,

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But that's,

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that's a catch 22,

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isn't it?

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Because to get that sense of where your joints are,

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you're actually putting yourself in a range of motion that's going

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to not help your problem and possibly make it worse because

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you're at your end range.

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Exactly. So especially for people who subluxate or dislocate and that's

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where it's going to happen,

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you know,

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and people who are,

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are, have strains and sprains,

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that's where it's going to happen.

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And so it is problematic and the trick is backing away

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up and learning how to sense.

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I mean,

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that's really the project with hypermobile people is teaching them how

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to sense their bodies in a new way.

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That is far more subtle than anything they've experienced.

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Yeah. And we're going to get to that,

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the actual clinical application of some of this information in the

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second half of our,

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of our talk,

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which by the way,

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will be available to subscribers to putting this.

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I see that's the,

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that's the little carrot at the end of the stick there.

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It's like,

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how do you put this in practice?

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And we're actually go to the mat and show some of

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this stuff,

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which is really important.

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And I just had to figure this out on my own

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without knowing this information years and years ago when I had

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hypermobile people in class and I was like,

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okay, so you can go there.

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Great. What happens if you pull back and work at something

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that doesn't feel like an end range,

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it's really,

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really difficult,

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you know?

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And actually I'm always,

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I was always telling the story about how well the stiff

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people like me have it easy.

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You see,

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you know,

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we're going to hit our end rings all the time.

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And it was like,

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okay, I'm going to develop some skills around dealing with that,

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like holding,

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releasing, breathing.

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And so the boundaries that I'm hitting up against are very

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clear. And then I developed skills of working with those boundaries,

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but establishing a boundary that your body isn't telling you should

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be there,

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that you're choosing to,

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to respect is much more difficult,

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both physically,

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because you're having,

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you're having to engage so much muscle effort to keep your

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joints from seeking that end range.

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But also it's emotionally challenging too,

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to say,

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okay, I'm just going to stop here because I'm choosing to

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stop here and work at this place.

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And it's,

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it's, it's tough.

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It's, I've seen people really struggle with it,

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but it's so,

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so necessary.

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So what else is on this rather long laundry list of

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difficulties that people have when they have now...by

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the way it's,

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can we add to this?

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To, to the Ehlers-Danlos hypermobility things like Marfan syndrome,

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which also affect connective tissue stability?

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It's, it's a,

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it's a somewhat related diagnosis,

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isn't it?

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Yeah. So there are a number of conditions that feature hypermobility

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as one of the aspects of Marfan syndrome is one of

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them and their osteogenesis imperfecta would be another one and Ehlers-Danlos

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are 14 types.

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So I would say the most common of the big umbrella

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of hypermobility syndromes would be the EDS syndrome,

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the Ehlers-Danlos syndromes,

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multiple of them.

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But the one that is most common within that is the

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hypermobile type.

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And it's confusing that it's called that because all the types

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of EDS generally feature joint hypermobility,

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but most of them are more rare.

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Some of them are ultra rare and the hyper mobile type

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is not rare,

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but it's prevalence as hard to determine because it's so often

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not diagnosed or it's misdiagnosed.

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And there's a sister diagnosis.

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I want to mention too,

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just to confuse things a little bit more,

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which is hypermobility spectrum disorder.

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Okay. So,

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so let's go back to that checklist.

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I was talking about with EDS,

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the hypermobile EDS diagnostic criteria,

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let's say somebody has what I call symptomatic hypermobility.

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They have joint hypermobility and they have symptoms related to it.

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They've got pain,

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joint pain,

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dislocations, subluxations,

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chronic fatigue.

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They've got all kinds of mental health,

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digestive, all the things we'll talk about in a second,

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but they don't meet those criteria.

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Well, that's when someone will be diagnosed with hypermobility spectrum disorder.

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And the thing is,

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is that that is not a less or lesser diagnosis than

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hypermobile EDS.

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It is simply a different diagnosis.

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And that's what I want to emphasize for people interested in

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this because that's not well understood by anyone even,

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you know,

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in the medical field or,

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or elsewhere that the hypermobile EDS diagnostic criteria really was developed

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to support genetic research.

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And so it wants to isolate and we're looking for the

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genetics here We are in our study are not based on

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these criteria.

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So then the genetics behind it Doesn't Mean that you're suffering

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less from it or that the treatment is necessarily going to

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be very different to help you.

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But it's,

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it's either you're,

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you're in this sort of genetic pool that we want to

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understand, or you're not Exactly.

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So it's sort of like genotype versus phenotype in a way

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here's the,

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the hypermoblie EDS.

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And here's something that looks just like it and experts in

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the field.

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They just put it all together.

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And that is one lump thing.

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And clinically we had treated exactly the same and those people

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are basically the,

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I don't differentiate between those two diagnoses clinically at all.

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And so that's something to be aware of because a lot

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of people say,

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well, I've just got hypermobility spectrum disorder.

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It's not like heavy EDS,

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you know?

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And, and so it's just assumed that it like EDS is

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really scary and really severe.

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And it,

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it isn't always,

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I mean,

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I have it,

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you know,

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and I'm pretty high functioning person.

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What about your kids?

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Are you,

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are you,

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you know,

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concerned about,

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are you testing their joints just to make sure they're,

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you know,

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not exhibiting the same ....oh,

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they definitely are.

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I mean,

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especially my younger child or she's super Gumby now there's no

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doubt about it.

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She was kind of,

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you know,

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she was never behind in motor development,

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but she got diagnosed with mild hypotonia as a baby,

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but it's,

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that's probably not the right diagnosis.

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She was just floppy.

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Cause her joints are floppy.

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You know,

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it wasn't a muscular problem.

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It was just,

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she was a little bit floppy,

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but she's,

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she's actually very athletic and very physical,

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but she definitely has what I have,

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you know,

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and the older daughter is hard to say she doesn't exhibit

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it as much so Well how,

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how fortunate that she'll be able to grow up,

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understanding this from the get-go,

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from your experience and avoid the pitfalls that you fell into.

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Yeah. And that's one of the motivating factors for me to

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get that diagnosis made official was so that,

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you know,

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if my kids have issues down there,

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they don't have to jump through hoops or wonder for 20

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plus years,

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you know,

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that I was seeking and wondering what is going on with

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my body.

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Why is it like this really?

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Since I was about 20.

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So I'm then I'm 45 now.

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So they won't have to do that.

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This is feel,

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skip that.

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That's, that's great.

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And that's why this is all about the education,

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you know,

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getting this information out there.

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And that is why I am so excited that your book

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is soon to hit the shelves.

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Isn't it?

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It is.

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So it'll be hitting the shelves of the very end of

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may or early June,

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2022. So it's in layout now.

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It's pretty much finished on its way.

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And it's got a nice blurb.

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I think that I wrote for it,

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It'll be on the back cover And,

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and, and the book is called "Yoga for Bendy People."

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Of course it is.

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And that's the perfect title.

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Yeah. Yeah.

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And so in the book,

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the first part is a bunch of background,

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all the stuff we're talking about laid out,

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you know,

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so that people really can understand what is hypermobility by itself.

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And then what is hypermobility syndrome?

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Because, you know,

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someone can be hyper mobile and be just fine.

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So it's not the case that if you see someone in

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your class and they're very,

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you know,

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they've got a lot of range of motion it's,

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we can't jump to a conclusion that there's something wrong with

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them. You know,

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they don't want to pathologize that,

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but because hypermobility can be caused by a number of things.

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But a lot of people who have hypermobility is,

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is caused by an underlying genetic difference that affects their connective

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tissue. And that's when it's more likely to be symptomatic.

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And so the book goes through all of that background even

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goes into a chapter on connective tissue nitty-gritty to get really

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understand tissue mechanics.

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And how is the bendy person's connective tissue different.

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It is different stuff.

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And to help understand what's underlying that and paint a big

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picture. And then of course I get into,

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you know,

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some suggestions for how to approach a yoga practice that is

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supportive for this person.

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Not only that avoids injury,

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is it something we want to do,

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but it's far more interesting to me to talk about how

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can yoga actually help them?

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Well, like the shift you experienced that the KYM all of

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a sudden there is,

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there's a way of thinking about what I'm doing in my

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practice, that on the one hand isn't going to exacerbate,

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you know,

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my situation,

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but will actually promote more health,

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more integration and,

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and overall,

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just more clarity on what I'm actually to accomplish with a,

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with a practice.

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Did you have,

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when you were writing,

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I'm curious,

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did you have mostly yoga practitioners in mind or yoga teachers

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or was it both?

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So is the audience pretty much both of those?

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Yep. Pretty much both of those.

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And that was early on.

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One of my editors was like,

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you have to choose an audience.

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You know,

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it's either you need to dumb it way down for the

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yoga practitioner or it's good as it is for the yoga

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teacher. And I was like,

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eh, I'm gonna go kind of go with it.

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I'm going to try to explain everything as accessible way as

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I can.

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But here's the thing about people with hypermobility syndrome,

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even if they're not yoga teachers,

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they need to become experts at their condition anyway.

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And so this is a particular population where I'm okay.

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Challenging them a little bit if,

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if they're challenged by it,

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because their doctor doesn't know what they will know after reading

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this book for the most part.

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Yeah. And that's,

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that's a pretty remarkable statement.

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Okay, let's get into some numbers.

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Now, what percentage of the general population is it estimated has

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this or these kinds of issues Up to 20%?

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It was like the highest estimate that I've seen.

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And again,

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the prevalence is very hard to pinpoint,

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but when you lump together hypermobile EDS with hypermobility spectrum disorder,

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it is thought to be,you

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know, 10 to 20% of,

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of people.

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And now that's general population.

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So let's take the yoga the practicing population.

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I was going to say that what percentage of people that

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show up to a yoga class are going to have this

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higher, Higher,

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and then what percentage of people are going to feel so

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successful at yoga that they decided to become yoga teachers?

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Yeah. Yeah.

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Just scan,

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scan through Instagram and make your estimate based on what you

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see there from the,

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you know,

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the yoga images who,

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who are actually getting,

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if not full-blown careers are,

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are getting a lot of positive feedback for the extreme things

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their bodies can do,

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who are always looking for the next,

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most extreme thing they can photograph and put up there and

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get more followers,

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you know,

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it's, it's like we're in this sort of echo chamber that,

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that really can exacerbate people's tendencies to push themselves in ways

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that are not necessarily healthy.

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It really can.

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And unfortunately it doesn't just do that,

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but it also intimidates all these would be practitioners,

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right? Like for whom yoga is awesome and could really be

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great for their life.

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And then they feel like they're not flexible enough because they

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see all this imagery.

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So it does both of those things,

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both of those are damaging.

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So yeah,

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the, the book is really,

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I would say primarily targeted to teachers,

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but absolutely appropriate for practitioners who think they might be bendy.

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Yeah. Well,

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as I think I said in the blurb should be required

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reading for every teacher training program,

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for sure.

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Okay. So 20% of the population certainly higher than that in

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yoga environments.

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So some of the other thing I was fascinated to learn

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some of this,

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which I hadn't heard before in our previous conversation,

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let's just go through the list of difficulties people have,

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that are associated with this.

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And some certainly mechanical,

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physiological, emotional,

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you know,

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nervous system.

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So just kind of rattle it off for us so people

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can know what,

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what this affects.

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Yeah. So as far as the body goes,

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almost universally sacred iliac joint pain,

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that's the top of the list,

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joint dislocations,

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subluxations headaches,

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but beyond sort of the mechanical musculoskeletal we've got anxiety would

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be the biggest one anxiety and panic disorders.

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We've got some brain anatomy differences that have been documented that

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help explain the prevalence of anxiety and panic disorder and a

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hyper aroused sympathetic nervous system.

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So that is like probably the biggest one.

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And I think one of the most relevant for yoga practice,

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because yoga is so potentially so great at helping people learn

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to manage their nervous systems.

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So, so all the fallout that comes from a hyperactive sympathetic

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arousal, we've got smaller parietal cortex where the somatic sensory area

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is. So the body map that helps explain that lack of

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proprioception as well,

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not just from the mechanoreceptors side of things,

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but also from a actual brain body mapping perspective.

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We've got dysautonomia,

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that'd be another big umbrella.

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One dysautonomia just means dysfunction of the autonomic nervous system,

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which partially we could explain what that heightened sympathetic arousal.

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That's one expression of dysautonomia really,

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but then there's another common one that is just dizziness and

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people get dizzy really easily.

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They have low blood pressure,

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often low blood volume.

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And so what happens in the bendy body is that their

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vessels are saggy.

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If you think about the connective tissue in this body and

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just think of it as saggy,

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think of it as floppy.

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Well, the blood vessels are too cause and they're a little

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saggy. So blood pools in the lower body.

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And in order to get that blood pumped to keep it

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pumping, we have to turn up our sympathetic nervous system and

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the heart rate goes way up,

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right? And so there's this because otherwise it's just,

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you don't get cerebral blood flow literally,

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and you don't get good perfusion up here.

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And so you get all the brain fog and the chronic

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fatigue and all the things,

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and you don't even get good profusion into these muscles.

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They call it the coat hanger pain.

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Okay. The neck and upper traps.

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They're just like on fire for people so much.

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And they're literally not getting good blood flow because of this.

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Well, let's call it orthostatic intolerance.

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It's so hard to be upright because of that,

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the saggy vessels,

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the blood pooling,

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the low blood pressure.

Speaker:

And then that leads to the high heart rate and that's

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called orthostatic tachycardia.

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So P.O.T.S.

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(Postural Orthostatic Tachycardia Syndrome) is a really common one and that's

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relevant for yoga too,

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in terms of positioning,

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you know,

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in my yoga practice,

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I practically never stand up.

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Yeah. Well also,

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you know,

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it's interesting cause in this,

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the last couple of years in the age age of COVID,

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we were hearing,

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we're hearing a lot about this dysautonomia and the P.O.T.S.

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as being a by-product for many people of having had COVID

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and the long COVID effects.

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And I would imagine for someone with hypermobility who had COVID,

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who, you know,

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is getting hit with this double whammy,

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it's gotta be really,

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really disruptive to just about every aspect of life.

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Yep. Yeah,

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exactly. A lot of things that are coming out of long

Speaker:

COVID are very reminiscent of what people deal with with hypermobility

Speaker:

syndromes, chronic fatigue,

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P.O.T.S. dysautonomia,

Speaker:

and even,

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I don't know about mast cell dysfunction,

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that's a common one to mass cell activation disorder where your

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mast cells,

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MAST mass cells,

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they're part of your immune system and they release histamine and

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your response to allergens.

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Well, they just are releasing histamine all the time in people

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with mass cell activation problems.

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And so people break out in hives,

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they're itchy,

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they're allergic to adhesives,

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you know,

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and that's really common sometimes with heat and exercise will trigger

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that for people.

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And they're like,

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oh yeah,

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I am itchy all the time.

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You know?

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And they never knew that was part of it.

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So, so those are some things there's a higher prevalence of

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all kinds of other diagnoses.

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So for example,

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people who have fibromyalgia,

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some studies show that up to 70 or more percent of

Speaker:

people with fibromyalgia diagnosis have joint hypermobility.

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So that's like a real close correlation.

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And I think that speaks to the chronic fatigue and also

Speaker:

the muscle pain,

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the chronic muscle tension that is trying to compensate for joint

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laxity. And trying to hold you together.

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And also that's responding to that heightened sympathetic arousal.

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That's always in the background,

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it's just always in the background and it's just like that.

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So, so fibromyalgia is a really common one and then anxiety

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and panic disorder I mentioned,

Speaker:

but also neurodevelopmental disorders like autism,

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spectrum disorder,

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Tourette syndrome,

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even ADHD.

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Those are all very hypermobility is very overrepresented in those populations

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to Right.

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Well, the important thing to remember for brain development is that

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without certain kinds of stimulus,

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at certain key stages of development,

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certain brain centers don't develop well or fully know.

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And if you're not,

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and you said the parietal region,

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you know,

Speaker:

where you're processing proprioceptive information,

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whatever, if it's not being delivered,

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if you're not getting that stimulation.

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And, and as you said,

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you can see this as differences in actual brain structure.

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When you look at someone's adult brain,

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you're like,

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oh, you know,

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like if someone never got spoken to and didn't experience language,

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you see their language centers wouldn't develop,

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you know,

Speaker:

and it sounds like we've got a similar thing going on

Speaker:

with this lack of feedback that people are getting from your

Speaker:

joints. And also you mentioned interoceptive ....

Speaker:

as well,

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because it's not just your joints.

Speaker:

It's, it's the connective tissue that all of these sensors live

Speaker:

in, in your,

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in your guts,

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in, in the insides of your,

Speaker:

of your body.

Speaker:

And, and that leads me to something else.

Speaker:

You mentioned,

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talk a little bit about the,

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the, the historic kind of emotional relational tendencies that people with

Speaker:

hypermobility have in terms of they're over represented in,

Speaker:

in trauma.

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And you said,

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you mentioned boundaries briefly earlier and you know,

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how does that feed into it?

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Yeah, so it's just hard to establish boundaries.

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I mean,

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that's probably hard for anybody,

Speaker:

but it's literally so hard to establish physical movement boundaries in

Speaker:

this person.

Speaker:

And, and the thing about kind of more emotional and relational

Speaker:

stuff, I think it all points to interoception.

Speaker:

And so the funny thing about interoception,

Speaker:

which is the ability to sense physiological state sort of inner

Speaker:

sensations, and those signals are actually turned way up in the

Speaker:

hypermobile person.

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So they have it's louder.

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It's like the volume dial on interoception is really loud.

Speaker:

And they're bombarded with inner sensations all the time that they

Speaker:

have trouble understanding and differentiating and discerning and interpreting.

Speaker:

So they call that interoceptive sensitivity.

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And so they become,

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you know,

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it's like a lot,

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they're just very distracting.

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So they're just,

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they're the people who can very much feel their heartbeat very

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easily, loudly all the time.

Speaker:

And they're likely to be very empathetic.

Speaker:

I mean,

Speaker:

in fact,

Speaker:

there's actually some research that looks at people who can feel

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their heartbeat are more empathetic.

Speaker:

People like more generous and more caring,

Speaker:

things like that.

Speaker:

It's very interesting.

Speaker:

But when you think about interoceptive signals and you think that

Speaker:

emotions changing emotions are interoceptive signals,

Speaker:

they are inner sensations and we have a hard time understanding

Speaker:

them and interpreting them.

Speaker:

Then it actually is easier to describe why it's hard for

Speaker:

people to know how they feel.

Speaker:

It's like,

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how do you feel about this?

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And like,

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I don't know,

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it's just overwhelming.

Speaker:

I can't possibly,

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you know,

Speaker:

it's just hard to really tease through those sensations and that

Speaker:

comes into play in relational ways,

Speaker:

for sure.

Speaker:

Cause you need to really understand who you are in order

Speaker:

to understand how to communicate who you are to someone else

Speaker:

clearly and with kindness and,

Speaker:

and all of that.

Speaker:

So understanding who you are really is sort of the crux

Speaker:

of yoga,

Speaker:

I guess one of them.

Speaker:

And, and I think that's one of the big ways yoga

Speaker:

can be so wonderful for people with hypermobility syndromes is just

Speaker:

that helping you to go in,

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go in discern,

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discern, understand,

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interpret all the things so that you can be in the

Speaker:

world, be clear about who you are,

Speaker:

where you end,

Speaker:

and that person begins and then have that,

Speaker:

you know,

Speaker:

interaction that can be more meaningful and more fulfilling and less,

Speaker:

less likely to get sort of drug around by someone else's

Speaker:

agenda, basically That would never happen in a yoga situation.

Speaker:

Would it,

Speaker:

You see here's where here's where like even a philosophical grounding

Speaker:

in, in certain ideas becomes important because everything you're describing from

Speaker:

a, if you just look at it a little bit fuzzy,

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it's like,

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isn't that what we're aiming for?

Speaker:

Don't we want to just merge with the universe don't we

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want to just,

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you know,

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feel the boundaries dissolving between our own individual identity and the

Speaker:

rest of the universe.

Speaker:

I mean,

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you know,

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you, you know,

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the language that gets put out there with is these kind

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of fuzzy wuzzy understandings of some of the ancient philosophies and

Speaker:

you can see how easily someone can be drawn into a

Speaker:

very cultish kind of a situation where whatever abuse or lack

Speaker:

of boundaries they had in their,

Speaker:

in their background are just going to get retraumatized.

Speaker:

We see this happen,

Speaker:

those so much in these,

Speaker:

in these cultish situations that often develop around yoga traditions.

Speaker:

Exactly. So it was really,

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it, it always has to come back to developing an internal

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locus of control,

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which is totally antithetical to a cult situation.

Speaker:

And Let's just say a strong ego,

Speaker:

Right? That's true.

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Yep. Yeah.

Speaker:

And you know,

Speaker:

as far as the trauma goes,

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it's sometimes I heard someone say once that hyper mobile people

Speaker:

live as though they were raised in a war zone,

Speaker:

even if they weren't for that,

Speaker:

there didn't have a nervous system of someone who has experienced

Speaker:

a lot of trauma.

Speaker:

Maybe they have,

Speaker:

right. Maybe they haven't like,

Speaker:

but their nervous system is poised to respond much more strongly

Speaker:

to life events.

Speaker:

So, you know,

Speaker:

and it's all about threat detection.

Speaker:

They are very,

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very hypervigilant.

Speaker:

We're on step,

Speaker:

your knee cap flies off its tracks.

Speaker:

You have to be hypervigilant.

Speaker:

It is it's exhausting.

Speaker:

So there's this hyper-vigilance and this constant threat detection.

Speaker:

So whatever life events happen in the course of your life,

Speaker:

you're more likely to have a post-traumatic stress response to that,

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a stronger response to that.

Speaker:

Right. And,

Speaker:

and it really does.

Speaker:

I, if anyone is listening to this and your life is

Speaker:

starting to make a lot more sense from having this information

Speaker:

okay. And you want to find some help and some guidance,

Speaker:

obviously we'll give people your information,

Speaker:

how to reach out to you definitely read the book,

Speaker:

but where else can people find this sort of help?

Speaker:

And I think because it's so prevalent and it's so much

Speaker:

out there,

Speaker:

especially in our community,

Speaker:

what are,

Speaker:

what are we,

Speaker:

what are we doing about this?

Speaker:

Are you going to have a specialized training program or an

Speaker:

online course or something that you offer for educators?

Speaker:

Well, so I'm going to have an online course called well,

Speaker:

maybe called yoga for many people.

Speaker:

It's, I'm going to be filming it next month.

Speaker:

So it's got to happen soon,

Speaker:

but it'll go along with a book and it will be

Speaker:

for yoga teachers as well as practitioners.

Speaker:

And it will basically have a lot more practical applications,

Speaker:

demonstrations that I talk about in the book,

Speaker:

but also the same background information.

Speaker:

And there's a lot of exciting stuff going on out there

Speaker:

in the world.

Speaker:

If you start digging,

Speaker:

you will find so much research that's being published about hypermobility,

Speaker:

syndromes and organizations that are working on educating medical practitioners.

Speaker:

And one of the big organizations doing that is the Ehlers-Danlos

Speaker:

society and their website is just a wealth of information.

Speaker:

It's wonderful.

Speaker:

There are a couple of podcasts,

Speaker:

one in particular that is focused on hypermobility couple,

Speaker:

actually one's called the hypermobility happy hour and then another,

Speaker:

yeah. And then another called bendy bodies Podcast yet.

Speaker:

Not yet.

Speaker:

I hope to be.

Speaker:

Yeah. Yeah.

Speaker:

And, but I met both of them and in fact,

Speaker:

interviewed both of them for my book and the hyper mobile,

Speaker:

the bendy bodies is often geared towards dancers,

Speaker:

which that's another population where they're really dealing with this.

Speaker:

And the woman who hosts that podcast is Dr.

Speaker:

Linda Blustein.

Speaker:

And she calls herself the hypermobility MD.

Speaker:

And so she is another person.

Speaker:

Who's got a lot of information out and is doing a

Speaker:

lot to educate folks about this.

Speaker:

So I think we'll see more and more of it because

Speaker:

people are really coming to a bigger understanding of it.

Speaker:

And I'm really passionate about advocating for diagnosis so that it's

Speaker:

more visible in the medical community,

Speaker:

right? The more doctors who have patients with this diagnosis,

Speaker:

the more doctors are going to be motivated to learn about

Speaker:

this diagnosis.

Speaker:

And then that starts to change things.

Speaker:

So I really think too,

Speaker:

that diagnosis is freeing for a lot of people.

Speaker:

It certainly was for me,

Speaker:

I don't have to be afraid of this weird stuff I,

Speaker:

and now.

Speaker:

I get it.

Speaker:

My body's a little different and now I can just move

Speaker:

on with my life and learn how to manage it.

Speaker:

So I find that it,

Speaker:

it really is freeing in a lot of ways.

Speaker:

So anyway,

Speaker:

there are those resources out there.

Speaker:

Those are just a few that come to mind.

Speaker:

Well, we'll,

Speaker:

we'll get all those links and attach them to the podcast,

Speaker:

obviously. So people can easily track some of this down.

Speaker:

So yeah,

Speaker:

this is a,

Speaker:

it's a big topic and we've spoken about a lot of

Speaker:

stuff. We've,

Speaker:

we've been talking for almost an hour and we still have

Speaker:

some of the clinical practical stuff to go over.

Speaker:

So just to wrap up this first part of our discussion,

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what would be your,

Speaker:

your message?

Speaker:

I mean,

Speaker:

I've, I've,

Speaker:

I've read what you've written in the book.

Speaker:

And so a lot of it is,

Speaker:

is, is there a,

Speaker:

of what you really want people to know about this,

Speaker:

but if someone could have said something to you in your

Speaker:

twenties that would have saved you an enormous amount of suffering,

Speaker:

other than saying,

Speaker:

Hey, here's this thing called Ehlers-Danlos,

Speaker:

you know,

Speaker:

maybe you should look into it.

Speaker:

What would,

Speaker:

what would that message be for,

Speaker:

for, for young Libby or young,

Speaker:

whoever is hearing this to,

Speaker:

to help them?Oh

Speaker:

gosh. I mean,

Speaker:

that's just,

Speaker:

it was a little bit overwhelming to think about if I

Speaker:

had known this in my twenties,

Speaker:

how much it would have changed my life,

Speaker:

basically, if I had known that my body's ability to do

Speaker:

weird stuff was related to all the other weird stuff in

Speaker:

my life,

Speaker:

all the other,

Speaker:

the food sensitivities,

Speaker:

the constant search for like food allergies and all this stuff,

Speaker:

you know,

Speaker:

and that's so common and the anxiety,

Speaker:

and then just the feeling like I can't stand up,

Speaker:

it's exhausting to be upright.

Speaker:

You know,

Speaker:

my mom used to call it wilting.

Speaker:

I would just be wilting.

Speaker:

And you'd see me leaning on furniture all the time.

Speaker:

They just,

Speaker:

they can't stand to be upright.

Speaker:

And it's because of all this physiological stuff going on,

Speaker:

it's so uncomfortable.

Speaker:

And it would have just been so helpful to know that

Speaker:

it makes sense why you are so uncomfortable all the time.

Speaker:

And there are a lot of other people like you and

Speaker:

there's stuff you can do about it,

Speaker:

and you're not crazy or weak or wimpy,

Speaker:

you know,

Speaker:

and you don't,

Speaker:

even If you haven't done anything wrong.

Speaker:

Exactly. And you don't just need to do better alignment.

Speaker:

You know what I mean?

Speaker:

Like it's,

Speaker:

it's, this is a much bigger thing and it gives you

Speaker:

extra sort of super powers too some,

Speaker:

you know,

Speaker:

a lot of times just empathy,

Speaker:

that sensitivity that people have,

Speaker:

you know,

Speaker:

there's some really positive parts to it,

Speaker:

but you also have to learn to manage those too.

Speaker:

Okay. So super powers.

Speaker:

What are your super powers other than party tricks?

Speaker:

Yeah, so party tricks that I don't do it anymore.

Speaker:

I do think feeling like feeling in my body that that

Speaker:

interoceptive volume comes into play when there's empathy,

Speaker:

I feel what other people are feeling too.

Speaker:

And that is hard to differentiate what that person feeling and

Speaker:

what's my,

Speaker:

what am I feeling?

Speaker:

But it also plays in my ability to,

Speaker:

to empathize and to have connection,

Speaker:

you know,

Speaker:

that understanding of people.

Speaker:

I think that helps certainly clinically.

Speaker:

And I think just the mental processing,

Speaker:

my mental,

Speaker:

you know,

Speaker:

a lot of people with hypermobility syndromes have an ability to

Speaker:

get really hyper-focused and process a great deal of material in

Speaker:

their mental bodies and digest it and spit it out.

Speaker:

And so they tend to have sort of a high intellectual

Speaker:

sort of stuff and really love that.

Speaker:

And I can sit down and,

Speaker:

and really focus for a long time.

Speaker:

It's kind of like it,

Speaker:

you know,

Speaker:

there's ADHD,

Speaker:

but there's also this hyper-focus,

Speaker:

which actually might be a bit of a form of ADHD

Speaker:

in some ways.

Speaker:

Or it's a little spectrumy.

Speaker:

I mean,

Speaker:

you, you mentioned they have spectrum disorder diagnoses in higher percentage

Speaker:

when they have hypermobility.

Speaker:

Exactly. And so there's a little bit of a spectrumy,

Speaker:

mind power sort of thing,

Speaker:

going on with a lot of people.

Speaker:

So I would say that's where I am in the sensitivity.

Speaker:

So I try to see those things as,

Speaker:

as positive attributes,

Speaker:

but I also recognize that those things are exhausting and the

Speaker:

biggest thing,

Speaker:

you know,

Speaker:

another thing,

Speaker:

if someone had told me 20 years ago,

Speaker:

you don't have to work so hard.

Speaker:

This just doesn't have to be so hard.

Speaker:

And you have a special system,

Speaker:

a special body,

Speaker:

a unique system that takes in a lot of information and

Speaker:

that process a lot of information and it needs a lot

Speaker:

of rest.

Speaker:

It just needs so much rest and integration time and you

Speaker:

got to manage your energy or you're just going to burn

Speaker:

it out.

Speaker:

And that's what happens.

Speaker:

People just go,

Speaker:

go, go.

Speaker:

And they,

Speaker:

they literally hit such a wall they're laid out for days

Speaker:

in bed.

Speaker:

And so pacing and just bringing down the expectations of what's

Speaker:

possible in a day,

Speaker:

you know,

Speaker:

is so critical that concept of pacing.

Speaker:

Well, we'd like a,

Speaker:

high-performance a F1 car that just needs a lot of pit

Speaker:

stops. Yeah.

Speaker:

Lots of pit stops.

Speaker:

It's a great way to think of it.

Speaker:

Lots of refueling,

Speaker:

you know?

Speaker:

Yeah, yeah.

Speaker:

And the tires wear out real fast.

Speaker:

Yeah. Yeah.

Speaker:

So, so again,

Speaker:

there's that needle to thread,

Speaker:

which is,

Speaker:

we don't need to handle ourselves or others with hypermobility with

Speaker:

like fragility gloves.

Speaker:

But we do want to encourage wise management of energy wise

Speaker:

use of yoga practice so that you are left with the

Speaker:

best of yourself to bring to what actually matters in your

Speaker:

life. And again,

Speaker:

I think that's one of the cruxes of yoga in the

Speaker:

modern age is,

Speaker:

is just that exactly.

Speaker:

That is not to burn it out on the yoga mat,

Speaker:

but actually to leave yourself more integrated so that you can

Speaker:

meet your life even better,

Speaker:

you know?

Speaker:

And yeah,

Speaker:

Well, it's like that shift,

Speaker:

you described it,

Speaker:

the KYM,

Speaker:

you know,

Speaker:

doing less,

Speaker:

simpler tools,

Speaker:

working with the breath,

Speaker:

integrating, pulling things together.

Speaker:

Yep. Just do less.

Speaker:

That's a huge,

Speaker:

it's like one of the big banners do less.

Speaker:

I know I'm always talking to people.

Speaker:

It's a really hard work sometimes to not work so hard.

Speaker:

Yeah. It's the hardest work and,

Speaker:

and really hypermobile people tend to be kind of overachieving perfectionists.

Speaker:

It just tends to be a bit of a personality trait

Speaker:

there. That's pretty well-documented out there.

Speaker:

We probably just anecdotally,

Speaker:

but, but nonetheless,

Speaker:

it's very hard to do less and to pull back whether

Speaker:

it's range of motion or,

Speaker:

you know,

Speaker:

activity expectations.

Speaker:

And when it comes to yoga practice,

Speaker:

it's all about changing our whole idea of what is yoga

Speaker:

for and what is it for?

Speaker:

And if it's Personality type is,

Speaker:

is exactly what Dr.

Speaker:

Sarno describes in his criteria for,

Speaker:

you know,

Speaker:

TMS, you know,

Speaker:

the, the common sources of chronic back pain.

Speaker:

And he,

Speaker:

he has a whole theory about,

Speaker:

you know,

Speaker:

ischemia and,

Speaker:

and all of that.

Speaker:

And it seems like there's a big overlap in what we're

Speaker:

doing. That's really interesting actually,

Speaker:

because I ischemia there's something really to that with muscle tissue

Speaker:

and ischemia.

Speaker:

I mean,

Speaker:

that's what I was describing in that coat hanger scenario,

Speaker:

when muscles are like that,

Speaker:

they are ischemic and they hurt they're acidic,

Speaker:

and there's a painful soup that builds up.

Speaker:

And that's what some,

Speaker:

you can just plan on happening in the hypermobile body.

Speaker:

That's this,

Speaker:

that's what's going on all the time and it will be

Speaker:

going on all the time.

Speaker:

That's the other thing I would say to a young version

Speaker:

of myself,

Speaker:

is it,

Speaker:

this is your life.

Speaker:

This is not just getting over this little,

Speaker:

you know,

Speaker:

injury right now.

Speaker:

This is how are you going to live your entire life

Speaker:

and manage this,

Speaker:

this long-term,

Speaker:

this is,

Speaker:

we were going for a sustainability.

Speaker:

We want tools that we can use all the time from

Speaker:

now on forever.

Speaker:

Yeah. And 20 year olds are just developing their brains to

Speaker:

the point where they can do that kind of executive function

Speaker:

planning for the future sort of thinking.

Speaker:

It's true.

Speaker:

And if you told me that really at age 20,

Speaker:

I might've thought whatever,

Speaker:

That's what I'm saying.

Speaker:

It's like,

Speaker:

if you tell that to a 20 year old,

Speaker:

they're like what the rest of my life what does that

Speaker:

mean? Yeah.

Speaker:

And then I would have opted,

Speaker:

honestly, just to plant my face between my knees at Ashtanga

Speaker:

class anyway,

Speaker:

honestly, you know,

Speaker:

it's really that I that's just where I was.

Speaker:

I was really caught up in the performance of that.

Speaker:

Yeah. Yeah.

Speaker:

Well, maybe there's some 20 year olds out there.

Speaker:

They're going to hear this and,

Speaker:

you know,

Speaker:

save themselves some of the difficulties that,

Speaker:

that you discovered in your,

Speaker:

it was a your in your thirties when you figured this

Speaker:

out. Right.

Speaker:

So when I finally got diagnosed,

Speaker:

I was in my forties,

Speaker:

early forties,

Speaker:

but, you know,

Speaker:

when I discovered KYM and the different way of practicing when

Speaker:

of my body started to feel better dramatically also starting to

Speaker:

strength training was in my thirties.

Speaker:

Yeah. All right.

Speaker:

Well, and you want to be able to still be moving

Speaker:

around in this planet when you're in your fifties and sixties

Speaker:

and seventies.

Speaker:

So, And there's no reason that we can't Exactly.

Speaker:

So speaking of that,

Speaker:

we're going to just make the segue here.

Speaker:

And I'm just going to remind our listeners that a,

Speaker:

the premium content is about to come and you'll see easy

Speaker:

ways to sign up for that on the rBreathing Project platform,

Speaker:

when we get all this uploaded.

Speaker:

So we're just going to sign off now for the first

Speaker:

part. And then here's where the premium stuff starts.

Speaker:

So Clinical Corner!,

Speaker:

You got a hyper mobile person on the mat.

Speaker:

What the hell do you do with them?

Speaker:

Well, you know,

Speaker:

I was thinking about this kind of,

Speaker:

what's a typical session.

Speaker:

Like a lot of my first session with people is us

Speaker:

talking. It's so much patient or client education.

Speaker:

It's a huge piece of it.

Speaker:

And so what I would say is,

Speaker:

you know,

Speaker:

don't skimp on that and it'll happen over time too progressively.

Speaker:

But usually in the first session,

Speaker:

people are just like,

Speaker:

Ooh, I had no idea,

Speaker:

you know,

Speaker:

and they're doing all the light bulbs and they're like,

Speaker:

oh my life,

Speaker:

it makes sense.

Speaker:

And, and even so many of them,

Speaker:

they tell me I've been digging and digging in therapy for

Speaker:

years, trying to figure out what must have happened to me

Speaker:

to make my nervous system like this.

Speaker:

And now I understand that it just is like this and

Speaker:

it doesn't No,

Speaker:

there's no trauma to recall.

Speaker:

It's just the trauma of being in this body all the

Speaker:

time and having to be hypervigilant.

Speaker:

Yeah, Exactly.

Speaker:

So there's lots of patient education and patient interviewing.

Speaker:

And I ask questions,

Speaker:

you got to ask questions for hypermobile people to help them

Speaker:

connect the dots because they may not realize at all that

Speaker:

their bendy body is related to some of these other aspects

Speaker:

of life.

Speaker:

And I want to get to those.

Speaker:

I want to ask about digestive issues.

Speaker:

And, you know,

Speaker:

as a,

Speaker:

if there's a yoga therapist working with people,

Speaker:

they're probably asking those wide ranging system kind of questions already.

Speaker:

But we want to ask about digestive stuff.

Speaker:

I'm going to ask about mental health and testified orthostatic vitals,

Speaker:

you know,

Speaker:

look for things like pots and decide to know me and

Speaker:

the dizziness and low blood pressure and things like that.

Speaker:

So that people have,

Speaker:

She will print out of the,

Speaker:

of the checklist.

Speaker:

I mean,

Speaker:

do you keep like soap notes that are specifically tailored towards

Speaker:

these kinds of questions?

Speaker:

I mean,

Speaker:

I just sort of have open-ended soap notes that I use,

Speaker:

but I do have that printout of the checklist and I'll

Speaker:

give it to people or I'll email it to them to

Speaker:

take to their primary care doctor often,

Speaker:

you know?

Speaker:

Cause I can take them through the checklist to look for

Speaker:

hypermobile Ehlers-Danlos I can tell them about these diagnoses,

Speaker:

but I can't make a medical diagnosis.

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I can suggest they go and take it to their doctor.

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Well, outside the scope of practice and physical therapists,

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your state in,

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in North Carolina,

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people can walk right in,

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right. They don't need a prescription,

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Right? Yeah.

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We have direct access.

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Now, if you want it paid for,

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that's a different question.

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Oftentimes if you want to paid for it,

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you need a referral if you have Medicare,

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but I don't really treat Medicare beneficiaries anyway.

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Cause I can't opt out of that either in North Carolina.

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So whatever,

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but yeah,

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you have direct access and we need to be screening for

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stuff like that.

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We're screening for everything.

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Cause we're the people often who spend the most time with

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these people and if something is any amount of a red

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flag, they need to be sent back to their doctor for

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further evaluation.

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And the problem is with hypermobility syndrome,

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it's very hard.

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If not impossible to find a doctor who can be helpful

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in this regard.

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And it's not because they're bad people it's because they just

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don't know about it.

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Right. And then people will know about it through nemesis.

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They're not clinicians,

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usually they're researchers.

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Correct. And I'll tell you an interesting story in my town,

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in Asheville,

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the genetic center here last year stopped taking referrals for hypermobility

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syndrome. You know why they can't,

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they couldn't keep up with the volume.

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They were just being overwhelmed.

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They were being overwhelmed by it.

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And because hypermobile EDS is a clinical diagnosis that literally any

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physician should be able to make.

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They were like,

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we don't need to see these people.

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You all handle it Again.

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They're kicking it back to the front-line MDs saying,

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Hey, get your other because you know,

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you should know this stuff.

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Exactly. And they sent materials to try to help and you

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know, but I,

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it's a really huge limiting factor right now.

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And it is in every area I know of.

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I don't know of any doctor in the state of North

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Carolina that I could refer anyone to.

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So one of the things,

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it is crazy.

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I have patients who traveled in New York and patients who

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traveled to around,

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you know,

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Maryland area.

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There's a percent of the general population having a significant diagnosable

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issue that affects every dimension of their wellbeing.

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And there's not a single person in your state practicing medicine

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that you can refer someone to for their diagnosis so they

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can come back and get reimbursed for your services.

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Yeah. Well,

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at least that I know of and I'd love to find

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One. Exactly,

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exactly. There was one here and she actually has EDS.

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And of course she's retired because you know,

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there's also this issue of practitioner wellness and sustainability,

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and that's a whole different topic.

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But if you're an actual physician working,

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you know,

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on the front lines,

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treating that volume of patients and you have one of these

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conditions, forget it.

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You're not gonna,

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that's not going to work.

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So a lot of things to it,

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but, but I do have some other resources.

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I know some mental health providers that are very knowledgeable.

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I have a colleague who's an acupuncturist and she does functional

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medicine, kind of functional nutrition consultation with people.

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And she's an expert on hypermobility syndrome.

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So I send people to her almost all the time.

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I've worked with a personal trainer who is my personal personal

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trainer trainer.

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And she and I are working on developing kind of a

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program for bendy people with strength training.

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So Out of pocket,

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to me,

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It is,

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it is,

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it is Getting it covered is,

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is, is what I was sort of pointing out.

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It's like,

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you got to get that diagnosis and it's gotta be something

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that you're gonna get reimbursed for.

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You do.

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And exactly.

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And when you get that diagnosis and the doctor refers you

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to PT,

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which is going to be the most common referral,

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you've got to actually land with a PT who also understands

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these conditions.

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And like I was saying before,

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I didn't learn adequately about it anywhere near about in PT

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school. And so what happens is the hypermobile person in PT

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doesn't respond as expected.

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They respond more slowly.

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PT makes it worse sometimes,

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you know,

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they don't respond to exercise.

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Normally they have massive delayed onset muscle soreness,

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there a lot,

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a lot of different problems that kind of in the context

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of a traditional PT setting,

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which I used to work in for years,

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seeing 15 people a day,

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it's like,

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it's not going to go that well.

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Right. Especially if it's an environment,

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right. Well,

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you know,

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it's in an environment that's really overstimulating already.

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And so everyone's just like,

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ah, you know,

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yeah. So this sounds like a crusade is in order to,

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to, I feel like a crusade is coming on and then

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I'm like,

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oh yeah,

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I have to manage my energy.

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Well, no,

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but it's not,

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it shouldn't be just you advocating for yourself and people like

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you. This is,

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you know,

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if there was any other syndrome that affected 20% of the

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general population that had such a wide range of,

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you know,

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connected dysfunctions for people,

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there'd be huge foundations,

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you know,

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there'd be,

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there'd be like telephones for it.

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Yeah, you're right.

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It's true.

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And it,

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yeah, it comes down to,

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you know,

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who are the people most effected by this type of syndrome?

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It's usually more prevalent in women who we know aren't heard

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in the same way by medical professionals,

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you know,

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where there's research,

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that documents that.

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And again,

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it's not an intentional bias,

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but a female patient versus a male patient reporting on the

Speaker:

same symptoms are going to be heard differently by Women are

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a little hysterical about their symptoms.

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Aren't there Always hysterical.

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Yeah, yeah.

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Yeah. The root of that word hysterical is actually very interesting.

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Right. So getting down to a,

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a S a session focus here,

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so you're educated,

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you're, you're patient,

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you call your,

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your people,

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patients or clients or students,

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what I call them patients Because you're a PT,

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you're medical professional.

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So you've got,

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you've taken your notes.

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You've, you've answered their questions,

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you know,

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and it's about,

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it's about that relationship fundamentally about establishing that connection,

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that relationship.

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And I remember so clearly watching Jessica char do this with

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people when he would demonstrate his one-on-one work,

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you know,

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which he would often do it in some of these seminars

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and he'd be up there and he'd be sitting in chair

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and the person would be sitting in a chair,

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they'd be looking at each other and talking as if they're

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the only two people in the world,

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you know,

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and within 10 or 15 minutes of just talking,

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he's become like the best friend this person has ever had

Speaker:

and the best listener that they've ever been talking to.

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And I'm there like going,

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whoa, I'm just like so locked in and fascinated by every

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choice he's making and every gesture and you know,

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all of it.

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And I'm just like in trance and there's someone sitting next

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to me,

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who's like,

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where's the damn yoga boring.

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What the hell is going on here?

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Like the way you first felt when you went to the

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I, right.

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And then you realize,

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oh, this is the yoga.

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It was the yoga.

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He just told us 20 times yoga is relationship.

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Yeah. And so all of that's been established.

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So do you have,

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then at that point,

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some standard tools for assessment in terms of checking people's range

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of motion,

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can, can you show us what,

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what P what you're going to ask people's bodies to do?

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Yeah. So I always do the bite and scale.

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The bite and scale is kind of that most common,

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hyper ability,

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quick screen.

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And it's not perfect at all.

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It's, it's actually quite limited,

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but I'll take people through that,

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that nine point scale.

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I can show it to you if you'd like to That's

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that's, that's the,

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that's the,

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the, the meat on the plate here.

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We want to do this stuff,

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And then I'll show you why it's a little limited too,

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but at least that's something to start with.

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Okay. The bite and scale,

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total of nine points gives you a point for each one

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of these things.

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So the first one is forward.

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Fold with me straight.

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If you could touch the paws to the floor,

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that's a point that blew my mind to think that that's

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not a normal human thing to do,

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because you know,

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like, No,

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I need to bend my knees to touch the floor.

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So, yeah.

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It's not,

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well, I noticed you're not hyperextending your knees there,

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although you probably could.

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I don't so much anymore.

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My knees aren't that hyperextending.

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So, so for me,

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you can see it more this way.

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Okay. So we'll look at the knees in a little bit

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there. It's Not bad.

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Here's my other knee.

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See it more when I sit down and I straightened out

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my knees fully,

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my heels kind of weigh up off the floor.

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Okay. Yes.

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That's, that's definitely beyond just straight.

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It's a little further.

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Yeah. A little further,

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but that's not bad.

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Okay. And technically,

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you're supposed to go about 10 degrees past zero to get

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a point for,

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and you get one for each knee.

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So you might have one for your left knee,

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but not the right.

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And here's an interesting thing.

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Some people have really different sides of the body and one

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side is more hypermobile than the other,

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So, okay.

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So you got one point for palms touching knees straight One

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point for each knee,

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one point for each elbow.

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My right elbow.

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Not so much my left elbow more,

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And this is just visual.

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It's not like you're sticking,

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goniometers on people.

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You get visual assessment.

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Exactly. That's how I do it.

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And then one point,

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if you can touch your son to your forearm,

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I can.

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But I actually really wrecked my thumbs,

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demonstrating this for a long time.

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And he's demonstrating big source of injury.

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We talked about that Actually do it anymore.

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But you know,

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if you pull your thumb down to your forum,

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you get a point for each thumb,

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if it can touch.

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Yeah. And then you get a point for each pinky finger

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that extends beyond 90 degrees.

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So There's one,

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that's pretty.

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Okay. I can,

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I'm not even at 90.

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Yeah. Okay.

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Don't wreck your pinkies.

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We take your word for it.

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So you get one for each.

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So the pinkies sums elbows,

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knees pumps to the ground.

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And that's your total nine points.

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Now it could be considered having a generalized joint hypermobility.

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You need to have four or five out of nine,

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depending on the study,

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depending on who you ask four or five,

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the tricky thing is that it doesn't take into account your

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history. So let's say you're in your sixties,

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but when you were in your twenties,

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you could do all those things that still counts.

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Okay. So historical perspective is going to be relevant when you're

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assessing someone for hypermobility.

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Okay. And so people may have had surgeries and things that

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have changed their range of motion as well.

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But that's the bite and scale.

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Now I will tell you,

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I had a patient once who was a yoga teacher,

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as many of them are.

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And she was very clearly just,

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you know,

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hyper mobile,

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especially in her shoulders,

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but the bite and scale doesn't look any at your shoulders.

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Yeah. I was,

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you, you got a bunch of joints in the extremities,

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but there's actually nothing.

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Well, there's no shoulders in that assessment and there's really no

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spine. Yeah.

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Except for the forward fold,

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which is kind of like,

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I think of it as more lumbosacral than We'll cycle and

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hips and hamstrings and all that.

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But yeah.

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Yeah. But we don't see hip rotation.

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We don't see any shoulders.

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And that's where she was really hypermobile.

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I think she scored a one or a two on the

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scale, but that's okay.

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So the scale is something,

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but it's not everything and scale.

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So don't pin everything on that.

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If someone scores low,

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it doesn't mean they don't have it generalized mobility.

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If they score high,

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it doesn't mean they're going to fall apart,

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But you do to test someone's shoulders.

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Oh, I would just,

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you know,

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have them go up and touch back here.

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I'll have them do this.

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Yeah. That's a lot,

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that's a lot here.

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And, and just watch them generally move around.

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So, but especially the Goma class and the kinds of movements

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that, that easy people can class really easily like sense of

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kind of out of the ordinary to be able to really

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class very easily or easy binding,

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you know,

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the people who just boom,

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they just,

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because they ask,

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right. Like why would anyone ever do that?

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And it's such a,

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it's such an extreme movement,

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but that would be exactly.

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Yeah. Yeah.

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And the other thing is long arms make binding a little

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easier. And the long arms,

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that's actually one of the criteria for hypermobile EDS is wingspan

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to height ratio.

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Yeah. You measure fingertip to fingertip and compare that to your

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height. There's a certain ratio that,

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that, that is normal to have and longer arms throw that

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ratio off.

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And that's one of the diagnostic criteria.

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So I have really long arms,

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I mean,

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Your wizard jumped through.

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So I never thought of myself as having really long arms,

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but apparently I do compared to my height and it's called

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the ape index,

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which is kind of a weird way to describe it.

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Yeah. It's the long arms.

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So I'm,

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I'll do those things and kind of get a sense of

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someone moving around actively and then I'll have them get on

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the table and I'll do passive range of motion.

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So especially well,

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their hips and their shoulders,

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especially so,

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and, and it becomes more specific to what is their primary

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complaint, of course.

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But along the way,

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I want to look at their balance.

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I do a lot of quick screens for strength and balance.

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Like I'll have them stand on one leg as long as

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I can on one side.

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And then the other I'll have him do a squat,

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almost always,

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you know,

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if they can and see what they're,

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I kind of get a sense of sort of what part

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of their body does their brain recruit to try to get

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a task like that done?

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Because what we're dealing with a lot of times in hypermobility

Speaker:

is compensation habits.

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So show me,

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give me an example of some compensation habit that you would

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see if you asked someone to squat.

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So I might see something like,

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you know,

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or just like,

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well, I mean,

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I can't really,

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I just never went SWAT all the way down to the

Speaker:

floor type of squat,

Speaker:

but coming up,

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you know,

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is going to be,

Speaker:

do they really,

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oh, like,

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are they,

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their back is really involved or can they really just use

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their, the power of their legs to just stand up?

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That's a big one that I'm looking for where my steady

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here and my legs are the powerful thing.

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Or am I like,

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Right. They're just looking to prop prop themselves into a position

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rather than muscularly engage into the solution Or they might bounce

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out of it.

Speaker:

Right? Yeah.

Speaker:

So my mentum will be a big one.

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And then I'll always look at strength,

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I'll assess their bridge.

Speaker:

Honestly, I use bridge pose a lot to assess left and

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right. Leg strength.

Speaker:

So I'll show ya,

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I'll find someone do,

Speaker:

and this is something I've always done.

Speaker:

I think one of my early PT mentors did this and

Speaker:

it was so easy to do and it's been some useful,

Speaker:

I just use it anyway.

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I'll have him just hold the light up,

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do eight or 10 bridges on that side slowly and steadily.

Speaker:

And I'm going to look at like momentum,

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cause that's happening a lot,

Speaker:

you know,

Speaker:

or this will happen a lot.

Speaker:

Oh yeah.

Speaker:

Swing. Yeah.

Speaker:

Use the leg to,

Speaker:

So I'm always looking for a momentum versus control number one

Speaker:

And also,

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right. It's just,

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it's not this coming up.

Speaker:

It's coming down.

Speaker:

Yeah. Badly.

Speaker:

So we kind of get a sense of,

Speaker:

so the concentrate and east centric control of the movement,

Speaker:

and then I want to compare the sides for strength imbalances.

Speaker:

And it's really,

Speaker:

sometimes it's visual,

Speaker:

but it's also just the perception of the patient,

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which side is harder.

Speaker:

And more importantly,

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who's tired afterwards.

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Where do you feel that fatigue when you,

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after you do the movement a bunch of times,

Speaker:

and that's sometimes the most important information,

Speaker:

especially when there is low back hip sacral pain.

Speaker:

'cause if you're completely exhausted after doing that,

Speaker:

what's it like to stand and walk around for quality,

Speaker:

you know,

Speaker:

endurance wise and fatigue wise,

Speaker:

and then what gets recruited when all of that fatigues That's

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true. Yeah,

Speaker:

exactly. And so sometimes it may be an early muscle fatigue

Speaker:

situation that kind of shows you some of the compensations.

Speaker:

Cause we'll have those in fatigue,

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anytime or table we'll drop into those.

Speaker:

But so if someone does a single leg bridge for eight

Speaker:

or 10 times and their hamstrings are cramping,

Speaker:

then that gives me a lot of information about who's being

Speaker:

recruited. Right.

Speaker:

You know,

Speaker:

which muscles are being recruited for hip extension and Their glutes

Speaker:

may not be firing up enough to Exactly.

Speaker:

Yeah. And so,

Speaker:

so hamstring fatigue,

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hamstring cramping is common for,

Speaker:

I would say hamstring dominance on hip extension.

Speaker:

So how I characterize that and,

Speaker:

or their low back hurts.

Speaker:

Well actually,

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you know,

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we didn't mention this in the first half,

Speaker:

but I think we discussed it previously.

Speaker:

There's a higher prevalence of scoliosis that you're seeing.

Speaker:

Yeah. I think there is.

Speaker:

And I haven't seen any research on that,

Speaker:

but I see it all the time.

Speaker:

Mild scoliosis with hypermobility.

Speaker:

Yeah. Well that makes sense.

Speaker:

Cause you know,

Speaker:

just you lose the ligamentous integrity of the spine and then

Speaker:

the bodies naturally kind of take over.

Speaker:

Yeah, exactly.

Speaker:

So, so I almost always look for hip extension recruitment patterns,

Speaker:

especially if there's hip low back sacral pain.

Speaker:

Do you,

Speaker:

do you put them prone and have them do like a

Speaker:

shell of Boston type stuff?

Speaker:

Yeah. I'll put them pros because that shows me,

Speaker:

I mean the bridge is cool because it shows you from

Speaker:

flection to neutral what's happening in hip extension.

Speaker:

We have different,

Speaker:

different parts of the range being represented here to neutral.

Speaker:

And then we go over now we get to find out

Speaker:

what happens from neutral into extension.

Speaker:

Right? And so I will just pal page hamstrings,

Speaker:

glutes and contralateral lumbar to try to discern,

Speaker:

you know,

Speaker:

what the firing pattern is.

Speaker:

There's a lot of debate about how much that matters or

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doesn't matter.

Speaker:

But I think that in general,

Speaker:

what I'll say is when there's debate about does this or

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that actually matter,

Speaker:

like out there in the world,

Speaker:

there's firing patterns,

Speaker:

there's gluteal amnesia.

Speaker:

There's just posture there.

Speaker:

There's debate about all those things,

Speaker:

how much relevance to those things have clinically.

Speaker:

And I would say it depends on who you're dealing with

Speaker:

clinically and the bendy person.

Speaker:

Those things have more relevance For Matter more.

Speaker:

That's the,

Speaker:

that's the thing,

Speaker:

blue to yellow amnesia.

Speaker:

It is a thing.

Speaker:

Yeah. It's a thing.

Speaker:

And again,

Speaker:

you know,

Speaker:

it's, it's a bit debated about whether it's really relevant.

Speaker:

I find it highly relevant clinically.

Speaker:

You know,

Speaker:

when people have poor gluteal firing,

Speaker:

they can't connect to it.

Speaker:

They can't feel it.

Speaker:

Their hamsters are dominant.

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Their low back gets achy when they're doing hip extension or

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I don't feel it contract or contracts after the hamstrings,

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instead of before the hamstrings,

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that type of thing,

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it usually is clinically relevant.

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And I work on gluteal activation.

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Yeah. We need to work on some of the queuing language

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we use in yoga when people are actually encouraged to disengage

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their glutes in actions that would naturally require them.

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And that's,

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that's how I recall Diane Bruni describing that.

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That's the sort of thing that actually got her to,

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to basically tear her hip and gluteal region to shreds when

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she was doing her practice.

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Yeah. Yeah.

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It's a huge problem.

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And it,

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it underscores the need for yoga teachers to understand basic muscular

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anatomy. So they know if this movement is hip extension,

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the prime mover for hip extension is gluteus Maximus.

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And we better have that muscle on board.

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And if we don't,

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if we actually queue to not use that captain of the

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hip extension team,

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we are creating a problem for our students.

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We are building a neuromuscular pattern that is dysfunctional and we

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pray we're teaching them to practice it year after year after

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year and Going into it again.

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And again,

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it's like,

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people can't find their butts anymore if they ever could,

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you know?

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Yeah. Yeah.

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And they will have sacred joint pain if they don't already.

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So you're creating a situation for that.

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So, so that's,

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that's often a big focus now sometimes,

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you know,

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we go from assessing sort of gluteal function that way through,

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I look at that with a squat,

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a little bit to it.

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Does someone have more of a quad dominant squat?

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This one had more of a glute dominant squat.

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So what is the quad dominant squat looked like?

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It's just more anterior knees.

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Okay. These are forward.

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And of course that's okay.

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Knees forward is okay.

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But it does.

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Oh you mean your knee?

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Won't explode if you send it in front of your ankle

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joint? No,

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there's a guy that has a whole internet presence.

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Like his brand is like his handle is knee over ankle

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guy. Have you seen him?

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It's great.

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It's great.

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It is great.

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But it gives me information about how the body is figuring

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out how to do the squat.

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That's all it's telling me.

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Right. And so the knees forward is a quad dominant squat,

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like burning up here.

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And, but back is a more glute dominant.

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It's flat.

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It's still,

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I mean,

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quads and glutes are always going to be a team when

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it comes to a squat.

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But if someone seems that gluteal at Nisha and they show

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me a quad dominant type of squatting strategy,

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I'm just making note of that as part of the whole

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picture. And we're going to eventually work on chair pose or

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some form of squat trying to get the glutes a bit

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more active throughout their whole range.

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Well, sometimes that's also a compensation.

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If you ha if for whatever reason,

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the person has a really tight soleus,

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they're just not able to get that.

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You know,

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that degree of Dorsa flection out of their ankle because of

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it. That's true.

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They're gonna,

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they're gonna keep their center of gravity going forward rather than

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fall on their ass.

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Right? Yeah,

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yeah, absolutely.

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So it may reveal that as well.

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It also going to reveal if you have long femurs,

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you just proportionately,

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Unfortunately you're you,

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your Senator rallies and yeah,

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Yeah, yeah.

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So it's,

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but it just gives you a sort of paints,

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a bit of a picture there.

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And when it comes to hypermobility,

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the recruitment patterns are super important.

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And so that's,

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you know,

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when you're assessing someone's movement asking questions,

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like where do you feel this?

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Or yeah.

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Where do you feel this?

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And really moving slowly,

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letting something fatigue so that they can tell you,

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where do I feel fatigue.

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That's why I don't just do one single leg bridge.

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I do like 10 of them.

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So it gives them time to get some muscle fatigue so

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they can feel it because you know,

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the hypermobile Trouble with proprioception And they may not feel anything.

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And they may be like,

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I don't know.

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And that tells you something too.

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And so what helps people feel something when you want to

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teach them,

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okay, what muscle should be working here and how do we

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find it?

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Let's say I have a hard time finding my glutes.

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How do I learn is I need resistance and,

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or I need a tactile cue,

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The tactile cue being,

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just reach over and touch it.

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Either them doing it or you touching it,

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just cuing that way.

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I have people smack themselves on the rear end.

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Yeah. I won't,

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I won't be the one that does it,

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but you know,

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just literally,

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and they think it's funny,

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you know,

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cause they're smacking themselves in the rear end,

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but It Isn't about you.

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You know?

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And the other thing is I'll often use tape as a

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tactile cue cause this is Easier taper.

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Yeah. And so depending on,

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you know,

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what sort of setting you're in that may or may not

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be relevant,

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but it is such a great tool for bending people with

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the caveat that so many bendy people's skin is sensitive to

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the Heat.

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And that's the problem is that they're classically,

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you know,

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can't tolerate it.

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There are some brands that produce a gentle form of their

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tape that is more tolerable.

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I've just recently tested it out on a client with EDS,

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a patient with DDS.

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And it did not go that well.

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I mean,

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it wasn't horrible,

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but we can't we've now I know we can't use tape

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The photos,

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the rap,

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those rappy strappy things that,

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that you use The body braid.

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Yeah. That's what it's called.

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I'm calling it the rappy strappy thing.

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I can show you that.

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Yes, because that,

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that fascinates me.

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This has to be an image of that.

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Yeah. This is actually a new little fun thing I have,

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but let me just show you some other before we get

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to the body brain,

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other ways to give resistance and to give proprioceptive input because

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resistance really is proprioceptive input in a way,

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right? When you contract against resistance,

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you're going to get your mechanical receptors stimulated when you tap

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or, you know,

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give the tape,

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it's a neurosensory input.

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It's helps your body,

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your brain say,

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oh, there's my body.

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Okay. I think other than hitting your end range in the

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joint structures Exactly contain the movement,

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but give it some resistance.

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So one way I often do that is with a strap.

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So like if I want to find my glutes,

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then I can press out into the strap into abduction.

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I'm going to get these medius contracting,

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but that's going to give me some neurological overflow in terms

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of nerve roots,

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you know,

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into gluteus Maximus is going to help me recruit my glutes

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better in a bridge,

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for example,

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Or the opposite where you can squeeze a ball with your

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knees to get the doctors fired up Super useful.

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Yeah. The other way I like to use resistance,

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I use the strap is around the ribs because breathing is

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huge for bendy people,

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breathing mechanics and,

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and posture.

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So it kinda throw breathing mechanics and postural awareness in here.

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Cause that would be the sort of second thing that I

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find myself working on most.

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If the first thing is the lumbosacral hip recruitment stuff,

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the second thing is the rib cage position.

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So, so often in bending people,

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you'll find their posture is like this.

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They have a sway back.

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And if we can build awareness about the rib cage position

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and get some fullness back here in the ribs and the

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back ribs that can really help to bring the diaphragm down

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over the pelvis instead of being like that.

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Well, a lot of people,

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even who aren't hydro mobile,

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they exploit that T 11 T 12 mobility.

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The mobility that we have at that joint.

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Yeah, Exactly.

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And the problem is a lot of things.

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It puts the shoulder blade at a weird position.

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So then you've got shoulder issues.

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Cause it's not at a good mechanical advantage with,

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but when we can fill out the back of the rib

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cage here,

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the shoulder blade gets to sit where it wants a little

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bit more easily.

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And then we get to have better contact with our respiratory

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diaphragm. And what's below is And the backs of the lungs

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where you have 60% of your lung capacity.

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Yeah. So,

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so using that almost like resisted breathing,

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you know,

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breathing to expand into the straps.

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I use that a lot and now might be better that

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works in less than two tight.

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And then it just restricts the movement of the ribs.

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Right. So you don't want to tighten it too much.

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And that's just another example of using kind of a tactile

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Q and a little bit of resistance to teach people what

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it feels like to do a thing to help them find

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their body in space because they do not know where it

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is. And especially when you give postural cues,

Speaker:

they will overshoot the target every time they just go right

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past where you're trying to get them to because they just,

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there's no guideposts to say here's where it was.

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Whereas if you're,

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if you're queuing someone to do a standing backpack Yeah.

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They'll just keep going spatially.

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Yeah. Get to the point where it feels like they're in

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a backbend.

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Exactly. They'll just go,

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they'll get to an end range somewhere.

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And if it's about just standing posture,

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let's say to dossena kind of thing.

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If you just say something like stand up straight,

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they're going to stand up and go into a backbend there

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at the thoraco lumbar junction.

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Like you said,

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they're going to get that end-range somewhere.

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Cause then they'll be like,

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ah, I've arrived somewhere.

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I'm somewhere.

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But I've The sensation of arriving at a position.

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Exactly. That's why we want to give people when you give

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them the sensation of arriving at a position before they get

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to their end range.

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And that's what I was saying early.

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It's like,

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that's really hard for someone that,

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that has been relying on end range,

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degenerate sensation,

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their whole lives.

Speaker:

Yup. Yup.

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Yup. It's so hard.

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And it's almost like they have to relearn what it feels

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like to move and stretch because they equate the feeling of

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stretch with the feeling at end range.

Speaker:

But there,

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there is something before they get there,

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they just haven't ever slowed down enough to notice it.

Speaker:

And they've never been directed to notice it.

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They've always been directed to go somewhere like that.

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This was always the goal,

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you know?

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Cause that's what Language and queuing is so important because like

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at a certain point when Amy and I were working on

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the book in the Austin analysis section,

Speaker:

when we realized we don't want the word stretch in here,

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stretches the description of a sensation.

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Exactly. We're talking about this muscle lengthens.

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Yes. This muscle has to lengthen in order for this shape

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to happen.

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Lengthen is fine.

Speaker:

But whether you feel a sensation of stretch when that muscle

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lengthens or not,

Speaker:

that's a whole other conversation and we didn't want to confuse

Speaker:

those, those words with each other.

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Right. Yeah.

Speaker:

And exactly it's really tricky.

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Language is so tricky because a lot of people,

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whenever they reach that feeling,

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that sensory experience of tension stress,

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they always will feel tight.

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Right? So someone either feels tight.

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They feel that tension of stretch here,

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or they feel it ear or they feel it here.

Speaker:

But the sensation of the stretch is similar,

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no matter where you are in your range of motion that

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gets, you know,

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wherever you are,

Speaker:

your end range will always give you that similar sensory.

Speaker:

Yeah, exactly.

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But so it's about subtle listening and noticing and it's tedious

Speaker:

and it's hard,

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you know,

Speaker:

to back up.

Speaker:

And what does it feel like?

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Is there a signal that my body gives me before then

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that I never really noticed that I never really valued or

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I never considered it useful information,

Speaker:

but maybe it was there.

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It's not what I expect,

Speaker:

but maybe it's that this,

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the subtle sensation has moved to a different part.

Speaker:

Maybe it's,

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it's not in the belly of the muscle,

Speaker:

but it's towards a joint.

Speaker:

Now. Maybe that's a little bit of an indicator that I

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could look for,

Speaker:

you know,

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just gotta be something we're not used to looking for.

Speaker:

Yeah. How long did it take you to like literally reprogram

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yourself along those lines?

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Probably some years,

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probably a few years.

Speaker:

I remember really toying with that.

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It was hard.

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I felt so embarrassed when I first started doing that,

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you know,

Speaker:

as a yoga practitioner and as a yoga teacher,

Speaker:

this was a long time ago,

Speaker:

but starting to pull back my range of motion,

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I was very aware,

Speaker:

what are people gonna think about me?

Speaker:

Am I not going to be as good at yoga anymore?

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Because it's not like,

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you know,

Speaker:

contortion ism anymore.

Speaker:

I'm not,

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I'm not exhibiting the obvious visual marks of accomplishment in this

Speaker:

environment. Yeah.

Speaker:

And I had to be okay with not feeling sensation for

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awhile, but just feeling stable and like,

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it wasn't a sensation of stretch.

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It was like,

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ah, I get to make a choice to stop here.

Speaker:

The boundary as a choice instead of the thing that chooses

Speaker:

to stop you.

Speaker:

Yeah. And the boundary as a choice started to be really

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intriguing for me.

Speaker:

And I started to really like that.

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Oh, I'm in charge of my body.

Speaker:

That's kind of cool.

Speaker:

Yeah. There's a whole other level of agency where you're Chu,

Speaker:

you're making a choice to stop here.

Speaker:

Not through anything that mechanically is stopping you,

Speaker:

but because you chose to and respecting that that's,

Speaker:

that's, it's intense on a lot of levels to think of

Speaker:

that. Yeah.

Speaker:

It really is.

Speaker:

And it was really powerful.

Speaker:

It's hard to describe,

Speaker:

but what then happened?

Speaker:

I remember the thing I write about it in the book

Speaker:

I was in a class and I was practicing this,

Speaker:

choosing my boundaries.

Speaker:

And, and then of course the teacher comes up and pushes

Speaker:

me past my boundaries with,

Speaker:

you know,

Speaker:

the hands on assists thing.

Speaker:

And I'm just like,

Speaker:

you know,

Speaker:

that's frustrating because oh,

Speaker:

hands on assist is a whole topic,

Speaker:

but it's,

Speaker:

it's so disempowering when someone is working so hard to establish

Speaker:

a boundary and they get pushed it Without,

Speaker:

without consent.

Speaker:

Yeah. Yeah.

Speaker:

Well that,

Speaker:

yeah, that's a big conversation.

Speaker:

This was,

Speaker:

this was before that became a huge hot topic.

Speaker:

And in our community,

Speaker:

when you had your little consent coin,

Speaker:

you could flip.

Speaker:

Yeah. So you're aware you're wearing the device now And here's

Speaker:

the body braid and it's a really neat product.

Speaker:

Again, it's new for me.

Speaker:

So there are a couple of ways you can wear it

Speaker:

and you can look it up,

Speaker:

body braid.com.

Speaker:

You can wear it just for sit sitting,

Speaker:

posture support.

Speaker:

And that's not how I have it set up.

Speaker:

Now I have it set up to wind around my legs

Speaker:

to get me more of a whole body proprioception.

Speaker:

But if you can imagine this loop being shorter,

Speaker:

it would wrap around the knee like so,

Speaker:

and when I would sit down,

Speaker:

it gives me some joint compression into my pelvis and it

Speaker:

gives me this postural support.

Speaker:

And it's really pretty amazing,

Speaker:

but I'm going to show it to you standing.

Speaker:

So I'm going to wind it up here.

Speaker:

Okay. Let's see.

Speaker:

Let me see if I can do this.

Speaker:

Here we go.

Speaker:

Okay. And then outside and there are video tutorials that you

Speaker:

have to watch to figure out how to do this,

Speaker:

but once you get it,

Speaker:

it's a little easier.

Speaker:

You wrap it around and then you put it under your

Speaker:

foot like that.

Speaker:

There we go.

Speaker:

All right.

Speaker:

So here it is on one leg.

Speaker:

The other leg here.

Speaker:

Yeah. All of the Tom Myers people are gonna look at

Speaker:

this and go,

Speaker:

okay. I,

Speaker:

I, these look like some of those spiral lines that we

Speaker:

talked about Exactly.

Speaker:

Does that get through and you can even do more wrappings.

Speaker:

You can,

Speaker:

you can really turn this up or down.

Speaker:

I'm pretty new to it.

Speaker:

So this is kind of the basic wrapping that would be,

Speaker:

you know,

Speaker:

I could go walking,

Speaker:

Can you show us the back?

Speaker:

Cause there's,

Speaker:

there's a,

Speaker:

it crossed the crisscrosses in the back.

Speaker:

There you go.

Speaker:

Yeah. Yeah.

Speaker:

Yeah. So that just is like,

Speaker:

now I have this on and I can just feel my

Speaker:

body. It's just a hug.

Speaker:

It's just a hug to the body.

Speaker:

It's like appropriate step to pug and pretty amazing.

Speaker:

This is,

Speaker:

this has reminded me so much of a temple Grandin.

Speaker:

You know,

Speaker:

she, she invented that hug machine autism.

Speaker:

Yeah. Oh my gosh.

Speaker:

I just,

Speaker:

it, again,

Speaker:

it feels amazing.

Speaker:

Yeah. I can,

Speaker:

I, I bet this would be like a transformational sensation for

Speaker:

somebody because now the elasticity that's missing from your fascia,

Speaker:

from your connective tissue is all of a sudden being applied

Speaker:

externally. And it's like,

Speaker:

wow. Yeah.

Speaker:

It's basically like having your whole body taped with Kinesio tape.

Speaker:

You know,

Speaker:

it's the same idea.

Speaker:

It really,

Speaker:

you, that neurosensory input that helps your body know where it

Speaker:

is. It helps your brain know where you are.

Speaker:

And the other thing I love to use is this head

Speaker:

cushion. Have you ever seen this?

Speaker:

This was developed by Esther,

Speaker:

go clay,

Speaker:

Esther, go clay.

Speaker:

The go clay method.

Speaker:

She wrote the fuck eight steps to a pain-free back,

Speaker:

But I just loved the head cushion.

Speaker:

So I know I don't have actually read the whole book,

Speaker:

but this is amazing because why I was at a friend's

Speaker:

office once my acupuncturist friend,

Speaker:

I mentioned earlier,

Speaker:

she put this on my head and the moment that I

Speaker:

put this on my head,

Speaker:

I had this aha moment of like,

Speaker:

oh my gosh,

Speaker:

I just landed in my body in a way that I

Speaker:

had never experienced anything when I get,

Speaker:

so this,

Speaker:

I don't remember how much exactly it ways I can find

Speaker:

out you put it on your head and it just shows

Speaker:

your, your,

Speaker:

your boundary,

Speaker:

Your face just lit up when you did.

Speaker:

That Feels so good.

Speaker:

It's so hard to,

Speaker:

it's so hard to explain,

Speaker:

especially if you already kind of always know that you have

Speaker:

a body,

Speaker:

but those of us who were like untethered it's,

Speaker:

it's just containment.

Speaker:

And that's really the feeling.

Speaker:

The feeling is containment,

Speaker:

boundaries, Swaddled.

Speaker:

There's a swaddling.

Speaker:

That's going.

Speaker:

Yeah. And so if you're working kind of on a postural

Speaker:

awareness, let's say standing there and you're wanting to feel like

Speaker:

you're kind of growing tall.

Speaker:

You know,

Speaker:

I can push into this.

Speaker:

I can push this up towards the sky in a way

Speaker:

it's giving me that resistance.

Speaker:

That helps me where I am.

Speaker:

It's that resistance.

Speaker:

So whenever you can provide something to push into for your

Speaker:

Bindi people,

Speaker:

oh, it just,

Speaker:

it feels good,

Speaker:

but it also is teaching them how to know where they

Speaker:

are, you know,

Speaker:

in a new way,

Speaker:

then you take it away.

Speaker:

I can still feel that on my head right now.

Speaker:

Interesting. It feels,

Speaker:

it leaves an echo.

Speaker:

You know,

Speaker:

there's an echo.

Speaker:

Now there's an echo on my body from that.

Speaker:

So I have better proprioception now for some time,

Speaker:

even after wearing that.

Speaker:

Cool. So w what I'm thinking of now is to what

Speaker:

extent does the training that many folks have had in restorative

Speaker:

and use of props kind of coincide or intersect with some

Speaker:

of the ways that you're helping people get this,

Speaker:

this feedback in their bodies A lot.

Speaker:

So I think the use of props is huge because props

Speaker:

are, what's going to help you put constraints on the movement

Speaker:

to the little bit.

Speaker:

So think smaller movements,

Speaker:

smaller movements.

Speaker:

Cause if you got your hypermobile person and you ask them

Speaker:

to do,

Speaker:

you know,

Speaker:

even the locust or something,

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they're going to be like,

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way up here.

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There's going to go as far as they possibly can.

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And I always tell them,

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just do half that amount,

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whatever it is,

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do half of it.

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I'm now halfway just get low.

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But so you have to constrain the movement somehow and props

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are one way to help you do that.

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To limit the movement.

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It's like,

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you know,

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putting your hand on the blocks or the chair instead of

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the floor to get out of a posture a little bit.

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I'm always asking people to like,

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you know,

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in triangle or whatever,

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don't let that hand go further than halfway down your shin.

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I know you can put your Palm on the floor,

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you know,

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great. And you suspend yourself without letting the floor become part

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of your base of support and going all the way to

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that end range and just kind of hang out there.

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And then they start tell me,

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tell me about some of the things you see when you

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know, people are doing the work that's useful.

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Cause I see tremors,

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I see the nervous system,

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the whole neuromuscular system,

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like trying to reset itself sometimes.

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And that can look like shaking or tremors or,

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or mentioned fatigue.

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But you know,

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sometimes I had a woman tell me,

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I interviewed her for my book.

Speaker:

Hyperverbal practitioner say,

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when she backs out of a pose,

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she works harder.

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She feels more fatigue,

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feels more muscular engagement.

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She just feels it more because she's giving herself the resistance,

Speaker:

you know,

Speaker:

with just engaging her muscles in a posture versus flopping into

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it. She said not number one,

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it's fatiguing,

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but number two,

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it feels safe.

Speaker:

And that would be maybe the biggest theme of working with

Speaker:

hypermobility is feeling safe.

Speaker:

This person has got to feel safe,

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not just consciously,

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but like their nervous system has to feel safe.

Speaker:

Like it doesn't have to be in,

Speaker:

in hyper-vigilance all the time.

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Yeah, yeah.

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Yeah. So to kind of even learn what that feels,

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what feeling safe feels like is one of the goals really

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to cultivate that experience of feeling contained and feeling safe and

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building control in a smaller range.

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And then later once you have that control and a smaller

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range, you can start to explore the range a bit more

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in a way that is functionally useful.

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So like when you do triangle now,

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you know,

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what does that look like?

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Do you,

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do you use a block for your hand or you just

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sort of suspended in the air?

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Do you actually go for the floor now that you can

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do that safely or So triangle pose?

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I'm glad you brought it up because it's probably,

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if I had to choose one posture that is problematic for

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hypermobile people,

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that's the posture.

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They have a hate relationship with it.

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They love it because they can feel it,

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feel it in their sacrum secretly enjoy.

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They hate it cause they hurt worse afterwards.

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And that was me.

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That was me for 10 years.

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So the way that I do triangle pose,

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it really changed when I was at the K Y M

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because the way they taught triangle pose just blew my mind.

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So I thought it was crazy.

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This, this doesn't look like anything.

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This is,

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this is going to be,

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this is like a super easy beginner's triangle pose.

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And then you try it.

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Yeah. It was just,

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it was just so different and it,

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but it didn't hurt,

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you know?

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And so I don't do the big hip thing,

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you know,

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there's that hip thing that people do that.

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And it becomes problematic if people have a suspected labral tear

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too, which is common.

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And because it puts this front leg,

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you know,

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in this really extreme flection abduction,

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external rotation,

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and now we've got some femoral acetabular Going on there for

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a lot of people.

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Yeah. A lot of people.

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Yeah. But not only that,

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but now my SSI joints got some sheering going on that

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it just like it doesn't Well,

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the problem is when you put these,

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these really long leavers at that distance and brings them against

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the floor and then upon those brace leavers start twerking your

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pelvic joints around.

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It's Just a recipe for disaster.

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Yeah. It's along leavers.

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So my triangle pose is very know I could go here

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and this is what's so visually confusing for people like I

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can, this looks really deep,

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right. Blah,

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blah, blah.

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But when I,

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when I stabilized here and I just,

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I just sideways bend,

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this is where I am actually,

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because now I'm revealing,

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Well, that's the lateral flection for your spine before it was

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all pelvis.

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Oh, what's that pelvis,

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hip, nothing going on in my spine.

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Now I'm just side bending.

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And I see how limited that actually is,

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especially on my left side because of my scoliosis.

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And so very often I'll have my arm here.

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Right. So I might be in a side angle and I'm

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just gonna keep this tucked in.

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I'm not going to swing it out,

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but I just put it here and my triangle or hand

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on a chair,

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honestly, you know,

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maybe I could stack up some blocks,

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but this is where I usually stay.

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I just really enjoy it.

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I may even take my arm over.

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Cause I love sign bits.

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So you're getting tons of sensation along that top side now.

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Right? Yeah.

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Because I've just sort of like,

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I've put the constraints on the movement to isolate the stretch

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where it's actually useful for me.

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Okay. Libby,

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don't just demonstrate on the one side.

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Don't do that thing with Jews,

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yoga teachers come on now.

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Well, and this might be interesting to see,

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let's do it again here just to see if,

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if there's a notable difference between the two sides that you

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can, that you can notice they do have,

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this feels so good.

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I mean,

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it's just feels so good.

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I just love it and it doesn't hurt my safe room.

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It's amazing.

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And so my,

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my stance also isn't very wide.

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I can be any,

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any distance.

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Right. But I just narrow stance.

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It's not going to do this swing.

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I'm just going to get inside.

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Oh, I do go farther on the side.

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Do you see that it might just be a sensory?

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What are you going with your scoliosis at this point?

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Is that yeah.

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Yeah. And it feels very different.

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And so Are you feeling more compression on the downside then

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stretch on the top side with that one or No,

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I would just say,

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I feel it's easier to go pull farther.

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Like I can bring in my hand a little down,

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I, it still feels comfortable for my pelvis,

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but this side feels so restricted.

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I'm on my left.

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If you're countering your scoliosis pattern,

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you're probably yeah.

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And even the second time that feel starting to feel different,

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but it feels more,

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it feels really useful.

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I would even wrap the top,

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top arm back and not,

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and take that out of the equation and maybe even,

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you know,

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turn the head down toward that front foot just to protect

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the neck.

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Right. So you're getting the essence of it without the bells

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and whistles.

Speaker:

Sometimes it's,

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you know,

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better to pull in the extremity somewhat.

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So Some of the pieces and so that you can focus

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on what it is you want out of it.

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I mean,

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that's always the question,

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what is it you want out of the pose,

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then that'll determine how to do it.

Speaker:

But what I don't want out of triangle pose for people

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who well,

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for any people,

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but many people is the moral acetabular impingement.

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And as I joined pain.

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Yeah. And,

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and I'm glad I brought that up and I'm glad,

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you're glad I brought it up because if I had to

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pick one pose,

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that's like the hip shredder,

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it would probably be triangle warrior two,

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you know,

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very similar in terms of the stance and the pelvic movements

Speaker:

and so on.

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Yeah, Yeah.

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Yeah. So that's usually how I teach it in a normal,

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like weekly class.

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I usually don't even teach that because I don't have our

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use for it in that I teach them back care class.

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And then when they have a use for it in that

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class, but you know,

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when I'm working with other teachers and things like that,

Speaker:

I've just present them some different ways of exploring triangle pose

Speaker:

to see what they get out of it and to see

Speaker:

how it feels.

Speaker:

Especially if they have a history of SSI,

Speaker:

joint pain.

Speaker:

And in the end for some people it's still too much

Speaker:

of a lever that is still uncomfortable and it may take

Speaker:

a while or it just may not be a posture they

Speaker:

want to practice.

Speaker:

And that's okay too,

Speaker:

For sure.

Speaker:

Exactly. It's a waste to side bend.

Speaker:

It doesn't have to be triangle pose.

Speaker:

Are there any other just red flags that you,

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you generally have in terms of,

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you know,

Speaker:

this Austin plus hypermobility just for most people seems to not

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be a great idea.

Speaker:

Yeah. Yeah.

Speaker:

A couple extended.

Speaker:

We're going to think about problem.

Speaker:

Awesome. As we've already talked about one and the other one

Speaker:

is flipping your dog.

Speaker:

Oh yeah.

Speaker:

We went through a whole thing about that.

Speaker:

Amy wrote a great piece about that a while ago,

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you know,

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about the shoulder joint.

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Yeah. It looks like a shoulder dislocation waiting to happen to

Speaker:

me because the shoulder dislocation is what's most likely to happen

Speaker:

as far as like a bigger injury that is,

Speaker:

we really don't want our Bindi people to dislocate and that's

Speaker:

going to be the shoulder and it's going to Oh,

Speaker:

a wild thing by the way,

Speaker:

people, you know,

Speaker:

flipping the dog wild thing.

Speaker:

I think they gave a Sanskrit name to it too,

Speaker:

but I can't remember,

Speaker:

but this was an honor Saraj thing.

Speaker:

Actually this is a man.

Speaker:

And then you go into wheel.

Speaker:

Yeah, Exactly.

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So, but the thing is an anterior dislocation is going to

Speaker:

happen with the arm and abduction and external rotation loaded.

Speaker:

We're talking about hyper mobile people.

Speaker:

I mean,

Speaker:

it is possible to do that safely.

Speaker:

If you can keep your scapula congruent with your,

Speaker:

with your humerus and you know,

Speaker:

not put all of that into that one place.

Speaker:

If you can distribute the movement in a healthy way,

Speaker:

it's not impossible to do it without hurting your shoulder,

Speaker:

but for a hypermobile person.

Speaker:

Exactly. That's who I'm talking about.

Speaker:

And especially if they have subluxation or any history of dislocation.

Speaker:

Absolutely. I would not go anywhere near that post,

Speaker:

but you're right.

Speaker:

It's, it's not categorically dangerous per se.

Speaker:

It's just,

Speaker:

it's always about who's practicing.

Speaker:

Yeah. And similarly,

Speaker:

you know,

Speaker:

this thing,

Speaker:

I don't know if you see it where you put your

Speaker:

arm out to the side and then you start to roll

Speaker:

over. Oh,

Speaker:

just, you're just using the floor to brace the arm and

Speaker:

get a stretch across the PEX or something.

Speaker:

Yeah. Oh,

Speaker:

the shoulder,

Speaker:

I can't stand.

Speaker:

I can't watch that one either.

Speaker:

So those would be just the position,

Speaker:

you know,

Speaker:

that's what I always teaching my patients who go to regular

Speaker:

yoga classes.

Speaker:

You want to watch out for the position of dislocation.

Speaker:

What about Lupa Vista?

Speaker:

things like that.

Speaker:

Oh, just like crazy,

Speaker:

extreme, Crazy splits.

Speaker:

That sort of stuff.

Speaker:

Yeah. I mean,

Speaker:

I don't recommend that at all.

Speaker:

I mean,

Speaker:

that's so not even in my realm of anymore,

Speaker:

you know,

Speaker:

and I realize it is for a lot of people,

Speaker:

but not just tricks.

Speaker:

I just don't do those.

Speaker:

They're not going to serve you there.

Speaker:

There needs to be a functional reason.

Speaker:

You're doing a posture.

Speaker:

There's a,

Speaker:

they have a purpose as you know,

Speaker:

I mean,

Speaker:

they're not just cool to do.

Speaker:

They're just,

Speaker:

they have a,

Speaker:

they have a role to play in your practice.

Speaker:

And if there's not a good reason for it,

Speaker:

it's like,

Speaker:

well, Well that's what I guess the guitar would always say

Speaker:

the form of the practice needs to serve the function.

Speaker:

Exactly. And that requires you to know what you're trying to

Speaker:

accomplish. Yeah.

Speaker:

And that requires you think about it and you get to

Speaker:

know who you are and what it is you want out

Speaker:

of your practice.

Speaker:

And those are hard questions.

Speaker:

So Harder than,

Speaker:

oh, if I do the form of the practice correctly,

Speaker:

the function will just come to me.

Speaker:

Exactly. It's,

Speaker:

they're harder.

Speaker:

It's, they're more self study questions than that.

Speaker:

Exactly. Yes.

Speaker:

And so the other one,

Speaker:

the other kind of category of caution would be for inversions.

Speaker:

Well, mostly not,

Speaker:

I don't want to say inversions,

Speaker:

I'm going to say headstand and shoulder stand.

Speaker:

So a lot of bendy people,

Speaker:

or more,

Speaker:

more bendy people than not have craniocervical instability,

Speaker:

which is lax ligaments where the head meets the neck and

Speaker:

that can lead to more serious problems like subluxations in the

Speaker:

cervical spine and even a Chiari malformation,

Speaker:

which is a herniation of the brainstem through the foramen Magnum,

Speaker:

which is,

Speaker:

we don't want that.

Speaker:

Right. Very bad outcome,

Speaker:

Very bad.

Speaker:

And you know,

Speaker:

it's not to say that I don't even know There's a

Speaker:

cerebral artery dissections that got a lot of years ago.

Speaker:

Yeah. Well,

Speaker:

and, and we know,

Speaker:

you know,

Speaker:

if you think about saggy vessels and sort of different connective

Speaker:

tissue, it's like this becomes more relevant for the bendy practitioner.

Speaker:

It really does.

Speaker:

So I would really urge caution when there's sacro mobility for

Speaker:

those extreme,

Speaker:

the headstand shoulder stance.

Speaker:

Now Putting weight bearing loads on the,

Speaker:

on the head and neck are just generally discouraged these days.

Speaker:

And rightly so,

Speaker:

but especially for the hyper mobile.

Speaker:

Yeah. You know,

Speaker:

my motto is when in doubt,

Speaker:

just leave it out.

Speaker:

You know,

Speaker:

why risk it,

Speaker:

it just isn't worth it.

Speaker:

Because again,

Speaker:

what is this about for you?

Speaker:

But you know,

Speaker:

a really modified shoulder stand like a supported bridge or something

Speaker:

like that.

Speaker:

I think if that's my shoulder stand these days,

Speaker:

you know,

Speaker:

I still was going upside down a little bit,

Speaker:

but I'm not going to really wreck my neck,

Speaker:

A block of blankets,

Speaker:

a bolster legs up the wall.

Speaker:

Oh, that is great stuff.

Speaker:

You know,

Speaker:

somebody, somebody wants to ask desk a good chart.

Speaker:

I remember about props.

Speaker:

If his father taught with the use of props and they

Speaker:

said, did he ever use blankets when he was teaching shoulder

Speaker:

standard plow?

Speaker:

And Derek said,

Speaker:

yeah, he said,

Speaker:

my father would put the blanket under your head to,

Speaker:

to make your,

Speaker:

your Joel and daughter under stronger.

Speaker:

That was not the answer that we were kind of expecting.

Speaker:

It's like,

Speaker:

wait, don't they go under the shoulders to take pressure off.

Speaker:

And he was like,

Speaker:

no, no,

Speaker:

he wanted it more intense,

Speaker:

but yeah,

Speaker:

Well, exactly.

Speaker:

And if that's where you just have to continue to ask,

Speaker:

who's practicing what,

Speaker:

what's our goal here.

Speaker:

And in current times and all of that,

Speaker:

the other thing I would say as far as,

Speaker:

you know,

Speaker:

the therapy or clinical is to really encourage more symmetry.

Speaker:

That's another thing.

Speaker:

If I have a patient who's going to a regular class

Speaker:

or I'm designing a home practice for them,

Speaker:

or with them,

Speaker:

it'll have a lot of symmetry in it,

Speaker:

symmetrical postures and a lot of frequent symmetry that compensates for

Speaker:

asymmetry. So like asymmetrical postures followed by a symmetrical posture.

Speaker:

Okay. So we're talking about sequencing here in terms of when

Speaker:

you're working in a,

Speaker:

in a range of motion,

Speaker:

that's unilateral,

Speaker:

finish it off or reference it at least with something symmetrical

Speaker:

and, and quite frequently,

Speaker:

I'll put this in a symmetrical thing in between the instances

Speaker:

of the asymmetry.

Speaker:

Cause that gives more information to your nervous system.

Speaker:

You Can compare what you have a reference pose,

Speaker:

like say you do something with split legs and warrior,

Speaker:

whatever, come back to it within ASA,

Speaker:

you're going to register the changes that have just happened more

Speaker:

to same thing,

Speaker:

comparing, comparing the reference posts from,

Speaker:

from before to after and then so on.

Speaker:

So that's,

Speaker:

that's a definite value,

Speaker:

I think for the neuromuscular reeducation aspect of it,

Speaker:

as much as any kind of structural balancing as well.

Speaker:

Yeah. I agree.

Speaker:

It's helps in training the person to feel the sensations feel

Speaker:

the effect of the posture.

Speaker:

Yeah. I can talk shop with you all day long living.

Speaker:

We've already been on for more than two hours.

Speaker:

Can you believe that?

Speaker:

No, because I feel like we just barely got started,

Speaker:

But A lot of the things are there.

Speaker:

I just,

Speaker:

I do want to throw in the absolute goldmine that is

Speaker:

self massage for these,

Speaker:

this population,

Speaker:

just to feed for people.

Speaker:

And I want to give,

Speaker:

you know,

Speaker:

two things,

Speaker:

that's a PTI do a lot of manual therapy,

Speaker:

you know,

Speaker:

with my hands.

Speaker:

But when it comes to bendy people,

Speaker:

the active modalities are going to be the most important,

Speaker:

you know,

Speaker:

teaching them to move differently and to treat themselves is really,

Speaker:

really important.

Speaker:

So self-massage is huge.

Speaker:

'cause again,

Speaker:

it's, it's just the,

Speaker:

the feed that So many things,

Speaker:

it's the feedback.

Speaker:

It's proprioceptive training.

Speaker:

It's relieving.

Speaker:

It's calming for so many people love it,

Speaker:

her self-care.

Speaker:

Exactly. And it's,

Speaker:

it's turning that constant external seeking inward and just say,

Speaker:

I have a resource,

Speaker:

I have a tool that can give me relief right now

Speaker:

and every single day.

Speaker:

And that's so it's just part of shifting that whole paradigm

Speaker:

to an internal locus of control.

Speaker:

Yeah. So the act of modalities So important.

Speaker:

Yeah. Yeah.

Speaker:

Wow. This has been so much fun.

Speaker:

I'm so glad we did this.

Speaker:

Me too.

Speaker:

It was fun.

Speaker:

I hope it was helpful.

Speaker:

And kind of what you had in mind,

Speaker:

A hundred percent,

Speaker:

a hundred percent and yeah,

Speaker:

I'm, I'm actually going to be doing another interview with Robin

Speaker:

Rothenberg tomorrow.

Speaker:

Who's well-known in our yoga therapy circles.

Speaker:

And when I emailed her similar to what I emailed you,

Speaker:

that like,

Speaker:

we're doing the opposite of dumbing it down.

Speaker:

She wrote back saying that is such really,

Speaker:

I am so tired of giving 20 minute interviews where I

Speaker:

have to dumb things down to the lowest common denominator.

Speaker:

Right. It's like,

Speaker:

let's talk shop.

Speaker:

Yeah. Good.

Speaker:

Well, I'm so excited to see what comes out of your

Speaker:

podcast. Me too,

Speaker:

me too.

Speaker:

We're still working out the details of the platform that we're

Speaker:

putting it on and all of that.

Speaker:

But yeah,

Speaker:

the first part is going to be audio only for,

Speaker:

for free,

Speaker:

for general public and all of that.

Speaker:

And then we're going to invite them into the,

Speaker:

the premium content and of just,

Speaker:

you know,

Speaker:

promoting your book and everything else that you're doing.

Speaker:

So any,

Speaker:

any links,

Speaker:

anything at all,

Speaker:

any references that you want to send over that you want

Speaker:

to have attached to this?

Speaker:

We'll just put her all up there.

Speaker:

And I want people to know about the book.

Speaker:

I want people to buy this book and read the book

Speaker:

and put it in their teacher trainings.

Speaker:

And you know,

Speaker:

a lot of doctors,

Speaker:

I think,

Speaker:

need to need to read this too,

Speaker:

because it's not just about yoga.

Speaker:

It's about this diagnosis.

Speaker:

It's about Educating about this thing that affects 20% of the

Speaker:

general populace.

Speaker:

I agree.

Speaker:

I agree.

Speaker:

So, absolutely.

Speaker:

So I'll send all that.

Speaker:

Thank you so much for having me.

Speaker:

This was great fun.

Speaker:

Oh yeah,

Speaker:

me too.

Speaker:

Absolutely. So I'll I'll well,

Speaker:

we'll be in touch on the details and let's get this

Speaker:

out there right around when the book is due out in

Speaker:

may, right Early June.

Speaker:

Yep. Cool.

Speaker:

Alrighty, take good care.

Speaker:

So good to see you again.

Speaker:

All right.

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