We recently had Libby Hinsley join us again to lead yet another webinar for us, this time we explored posture. Libby is a Doctor of Physical Therapy and Certified Yoga Therapist specializing in the treatment of chronic pain, hypermobility disorders, and yoga-related injuries. She has taught yoga for 17 years and has trained yoga teachers for over a decade. Watch the full webinar to learn more about:

• What “good posture” is and whether or not it matters.
• What is hypermobility?
• And how we should cue posture.

What is "good posture," and why does it matter for people with hypermobility?

Posture is a hotly debated concept, and plenty of people will get in the ring to argue their specific beliefs about what “good posture” is and whether or not it matters. 

Posture is how we hold our bodies in gravity. While “good posture” is a slippery concept, there are more or less efficient ways for people to be with gravity. Optimizing the way our bones can support us in gravity can save some energy for bendy people in particular, and may even be more comfortable!

While “good posture” hasn’t been shown to be well correlated with pain and function in normal healthy subjects, it may be more important to consider for someone with a hypermobility syndrome.

We talk about some key points to optimizing our relationship with gravity for more ease and comfort in a bendy body.

What even is good posture?

Obviously answers change depending who you ask. Generally includes an emphasis on pelvic position, ribcage position, ears and shoulders, and not slouching

Does Posture Matter? 

Current research questions how much posture contributes to trouble for the general population for l ow back pain and neck/shoulder pain. However, there are several reasons why posture matters for bendy people. 

What Is Hypermobility?

This is actually a descriptive term which mean the ability of a joint to move more than normal. If you have 5 or more "bendy" joints you are considered to have generalized hypermobility. 

Hypermobility by itself isn’t a pathology. Some people even have hypermobility with no symptoms!

What causes Hypermobility?

There are quite a few things that "cause" Hypermobility such as:

• Bone shape
• Muscle tone
• Due to a genetic difference in collagen the connective tissue laxity is increased
• Ligaments, tendons, joint capsules, fascia
• Laxity, floppiness, and decreased stability
  from passive support structures
• Musculoskeletal symptoms
• Wide ranging comorbidities

Types of Hypermobility Syndromes

There are many syndromes associates with Hypermobility. Hopefully talking through them will help you with the unfamiliar names. 

The first is Hypermobile Ehlers-Danlos syndrome (hEDS)

This is the most common of the 14 subtypes and can be diagnosed by clinical checklist. However this is the only subtype without a clear genetic marker. Some other symptoms are a defect in collagen and/or fibroblast behavior

Hypermobility Spectrum Disorder (HSD)

This is a Symptomatic hypermobility however is does not meet criteria for hEDS. Let's be clean though, this is not a “lesser” diagnosis.

HSD/hEDS taken together represent the most common hypermobility syndromes. 

Hypermobility Symptoms

There are wide-ranging symptoms across many systems of the body such as:

• Musculoskeletal
• Mental health
• Autonomic dysfunction
• Immune and digestive dysfunction

And the two most relevant symptoms for our posture discussion are muscle pain and fatigue & Dysautonomia

MUSCLE PAIN AND FATIGUE

There is decreased support from passive structures with Hypermobility. In addition people who have it usually have quicker connective tissue creep and slower connective tissue recoil.

Due to this issue there is increased compensation from muscular systems such as:

• Chronic muscle contraction
• Decreased blood flow
• Muscle pain and fatigue

• Baseline muscular function of bendy
  people is decreased

AUTONOMIC DYSFUNCTION

Dysautonomia is a dysfunction of the nerves that regulate nonvoluntary body functions, such as heart rate, blood pressure, and sweating. Some symptoms include

• Dysregulated heart rate and blood pressure
• Low blood pressure and volume
• Blood pooling in lower body (saggy vessels)
• Increased sympathetic arousal
• Postural orthostatic tachycardia syndrome
  (POTS) = Dizziness, brain fog, anxiety, sleep
  disturbance
• Orthostatic intolerance
  • Being upright is taxing for bendy people!
  • We can use all the help we can get

Why Posture Matters For Bendies

Focusing on posture helps optimize how we handle gravity which can help in a decrease of muscle pain and fatigue, and increase stability, comfort, and awareness. If you are a teacher make sure you understand that different bodies have different needs. Next time you are offering yoga adjustments make sure to offer safe and effective options. 

Just remember the main cue for posture: back it up and stack it up!

Her new book — Yoga for Bendy People: Optimizing the benefits of yoga for hypermobility — explores how people with joint hypermobility can avoid injury and instead, use the tools of yoga to support their thriving. The book is for all yoga teachers as well as bendy practitioners. Libby is also the co-founder of Anatomy Bites, a monthly membership for yoga teachers who want to learn anatomy in a fun, supportive, and highly relevant way.

Additional resources from Libby!

• Bi-weekly yoga anatomy tips and updates from Libby’s Anatomy Bites membership
• A free monthly hypermobility-friendly yoga practice plus updates on the hypermobility hub coming soon