Psoas and hypermobility Liz Koch

This is an insightful article and one so necessary for the Yoga community to understand. As the author of The Psoas Book and Core Awareness: Enhancing Yoga, Pilates, Exercise & Dance and I am writing because the Psoas plays a major role in joint hyper-mobility. When a person does not receive proprioceptive information within their joints the Psoas becomes involved. According to Chinese Five Element Theory ligaments are housed in the liver/ gallbladder and by nature define a range of motion. They are boundary markers. When a person does not have this information they over-reach. Over extending involves over doing which can eventually effect the kidney or Chi - life force, depleting their life force (i.e. exhausted adrenals). The Kidneys literally float on the Psoas tissue, which grows directly out of the midline (central nervous system) and so the two communicate and influence each other. The Psoas I call the messenger of the midline, it tell us whether we are moving from our core or compensating in some manner. The Psoas is involuntary tissue, what I refer to as bio-intelligent tissue that signals us when we are not moving from core integrity.   liz koch

.....ANUARY 11, 2016    BY BERNADETTE BIRNEY  in Yoga International

People with JHS often suffer from musculoskeletal and joint pain and soft tissue injuries like strains, sprains, tendonitis, and dislocations. Because our ligaments are unstable, we have an increased tendency to have scoliosis, TMJ, spinal disc problems, flat feet, and headaches.

Dr. Alan Pocinki, an MD who practices in Washington D.C.’s metro area, and who has written what is in my opinion a groundbreaking article about JHS, explains: “Because…the ligaments [are]…too loose and therefore cannot do their job well, the muscles…are forced to do more of the work…than they are meant to do, so they become strained.” 1

“We don’t really understand this condition yet,” my neurologist told me. “It may be caused by a mutation in collagen genes.”

People with JHS are prone to fibromyalgia, osteoarthritis (which occurs more rapidly in loose joints), and neuropathic pain or numbness.1 We often bruise easily, and have unusually elastic and velvety skin. We may be markedly uncomfortable standing for prolonged periods of time.

Our nervous systems tend to be overly responsive. Dr. Pocinki writes that “In recent years, [JHS] has been associated with a variety of autonomic nervous system problems. (The autonomic nervous system regulates all body processes, such as heart rate, blood pressure, breathing, digestion, and immunity.)” 1 So we may have circulatory problems (for example, low blood pressure, light-headedness upon standing, cold hands and feet, heart palpitations, varicose veins, and in extreme cases blood vessels can even rupture. And we’re prone to digestive issues like acid reflux and irritable bowel disease. 1

According to Pocinki, “To compensate for stretchy blood vessels…most people with hypermobility appear to make extra adrenaline...”1 Over time, excessive adrenaline production can exhaust our adrenal glands, leading to fatigue, difficulty sleeping, anxiety, and depression. 2 Speaking from personal experience, being chronically achy and exhausted takes a major toll. 

My neurologist continued on to tell me that autoimmunity is also associated with the condition. That likely explains my Hashimoto’s disease, which is an autoimmune disease of the thyroid. Hashimoto’s made me more likely to develop the thyroid cancer that resulted in surgical removal of my thyroid last February, hence meeting my insurance deductible, which is how I wound up in the neurologist’s office to begin with.

JHS and its similar but more severe sister condition, Ehlers-Danlos Syndrome, are thought to be genetic. Women are around three times more likely than men to have JHS. As children our extreme flexibility may have been considered cute and encouraged—especially if we were involved in activities like gymnastics and ballet.1

Obviously a conversation about JHS is relevant to yoga, yet I’ve never heard the condition referred to in any yoga class or publication. I have a hypothesis that, because flexibility is generally positively reinforced in yoga classes, there’s a good chance if we looked we’d find higher incidences of JHS among yogis than in the population at large.........

Yoga can still be great for people with JHS. Stabilizing the muscles around our joints by strengthening through light resistance is helpful.

It’s imperative, though, that we use good alignment when we practice asana and that we refrain from hyperextending our joints. Heavy lifting isn’t good for our joints either, so we may have to modify poses to decrease weight-bearing. For example, bringing our knees to the floor in chaturanga dandasana, or skipping chaturanga entirely. We might need to move more slowly if we become light-headed.

Obviously, restorative yoga, pranayama, and meditation are great support for our nervous systems.

At this time there is no cure for JHS. Right now we can treat the symptoms but not the underlying cause. That said, the confirmation a diagnosis brings could be a huge relief. It was for me.

When you’re tired, achy, and stressed for long enough, it’s easy to dismiss yourself as a complainer or hypochondriac. Understanding there are real physical reasons at play affirms I’m not nuts, emotionally frail, or crazy—at least, no more so than anyone else.

References:

1. Alan G. Pocinki, MD, PLLC, Joint Hypermobility and
Joint Hypermobility Syndrome, (2010).
2. William C. Sheil Jr., MD, FACP, FACR, Hypermobility Syndrome
(Joint Hypermobility Syndrome), (4/29/2015)