Yoga Peeps – Do You Know Your Beighton Score?
A newly popular, highly recommended teacher was coming to town for a workshop so I thought, “What the hey?” and signed up.
She began the first practice from seated by bending her right knee, externally rotating her leg, and then, somewhat magically, placing her foot into her armpit while casually reaching her left hand out into a mudra (it’s sometimes called “Yogi Dandasana”).
Then she told us with a bright twinkle that we could get there too, if we just followed her instructions exactly.
My stomach lurched and my hips and knees informed me that they would not be participating.
Then she started the class, which quickly transformed into something of a game that I like to call “Last Man Standing Yoga” (I’ve seen this many times in “advanced” workshops). The poses get harder and harder, more and more folks drop out and sit down on their mat to watch the rest of the spectacle, and eventually you have just one person left, who gets lots of applause both for the performance and for following exactly.
Except mostly, that person is dangerously hypermobile and probably should’ve dropped out with the rest of us.
What You Need to Know About Hypermobility
What the teacher did not share, and what is typically not talked about in workshops (or teacher trainings unfortunately) is that:
- Joint mobility is primarily genetic and secondarily use dependent (that means you can get a bit more flexible if you work it, but if you weren’t a gymnast as a kid, there’s a reason why). So those with more typical ranges can easily hurt themselves attempting this stuff; and
- Frequent, repeated performance of hypermobile poses may exacerbate problems for those with hypermobile joint issues because these folks need to focus on stability rather than mobility.
So, how do you know if you’re hypermobile?
The Beighton Score
English medical geneticist Peter Beighton created a test in 1969 (The Beighton Test and Score) to determine if patients have a genetic predisposition to hypermobility. It’s simple and quick. And there’s a range from 0 being your dad to 9 being most definitely Gumby. It can be helpful to take the test with a partner.
Hypermobility affects something like 4 – 13% of the population – and they all tend to be yoga teachers (just kidding…not really).
In some cases, hypermobility is associated with Ehlers-Danlos syndrome, a group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. In addition to biomechanical instability, symptoms may include:
- Anxiety disorders and attention disorders
- Low blood pressure
- Leaky gut and chronic GI issues, food sensitivities
- Chronic fatigue
- Poor exercise tolerance
- Decreased proprioception
- Decreased interoception
- Decreased motor control
Even when Ehlers Danlos syndrome is not present, exploiting hypermobility, while it’s long been encouraged in yoga circles, can result in destabilized joints and chronic pain.
My suggestions is that yoga people – teachers and students alike – test themselves. Then you can make an informed choice about whether or not you want to play the Last Man Standing Yoga game.
Being Okay with Less Stretch
Ah, and one more thing I almost forgot to mention – people with hypermobility tell me that they have to push a lot harder to “feel something” in their poses – they need to go to end range. I always feel kinda bad bursting this bubble, but it’s necessary. So this is what I tell them:
Hypermobility is often accompanied by decreased proprioception (where is my body in space) and decreased interoception (how do I feel). It means that the volume on your ability to feel a stretch is most likely turned way down. The unfortunate answer is teaching yourself to be happy with less sensation. Also the tension you’re feeling is most likely fascia rather than muscle fibers – but I’ll leave that for another blog!
And what you didn’t mention is that people with hypermobility need support rather than mobility. And ALSO, if you self-assess a high Beighton score, you should get advice from a Physical Therapist about what the beset exercise is for YOU. Ehlers-Danlos is Waaaay out on the spectrum of herpermobility. I’ve treated one patient with this and she was severely limited with lots of pain in every joint along with limitations from erratic BP.
OK, so I’m a PT that also teaches lots of yoga. I love your posts but I get a little twitchy when musculoskeletal “conditions” or physical diagnoses are addressed. Though I love to hear from you about mental health as I know this is your specialty.
“Frequent, repeated performance of hypermobile poses may exacerbate problems for those with hypermobile joint issues because these folks need to focus on stability rather than mobility.” 🙂
Actually I did say that people with hypermobility need support. “2. Frequent, repeated performance of hypermobile poses may exacerbate problems for those with hypermobile joint issues because these folks need to focus on stability rather than mobility.” And if you self-assess anything, yes, you should definitely get a professional opinion – the Beighton score is useful for yoga teachers to understand. I can see how it can be frustrating for a PT to hear a yoga teacher talk about biomechanics, even if we have a fairly good grasp of the (growing and evolving) subject, because there are quite a few yoga teachers who know very little about it. Nevertheless, it’s a part of the yoga profession and I think it’s important to be well educated. One thing I would add is that there is an important emotional component to Ehlers Danlos and the folks I’ve worked with who have it deal with mental emotional symptoms as well as physical ones. Some health professionals like myself are holistic generalists, others are specialists – optimally, we complement each other. I’m sure some MH professionals get twitchy when I talk about yoga and mental health.
Kristine did emphasize stabilizing joints for hyper mobility. Perhaps you skimmed past that point but it is definitely addressed. And has been in other blogs and teachings.
She said people with hypermobility need stability. To me, that’s pretty much the same as support as they go hand in hand.
Stabilizing joints for hyper mobility was emphasized here.
I agree. Let’s just stick with addressing hypermobility as it applies to asana. Otherwise many good points made here..
Oh gosh I love reading your blog:) awesome article and very timely- was just explaining to my class this morning about hypermobility not being a good or bad thing. But whether you are or not (and most think they are but arnt:) ) its just something to be mindful off.
🙂 your awesome explanation will have to be shared though:)
yes, it’s so important for folks to know Kali – thanks for teaching about it!!
Thanks so much for this Kristine. I have a very hyper mobile student coming back to class soon and when I watch her I get the feeling that she is just hanging out in her joints with a floppy body attached. I need to spend some thinking time planning what I could say to redirect where she naturally wants to go with the shape of her asanas. ( her body) I notice though that strength in something like a plank pose is very challenging for her and my 60 and 70 plus yoginis are kicking her butt ( if I could be so crass and competitive). She’s probably in her late 20’s. I’d appreciate any suggestions from your yoga science mind and your informative teaching language?
Hey Mary, it’s tough, but at least she comes to class which says a lot about her willingness! Strengthening can help her feel a lot more stable in her body and the relaxation part of yoga can help if she has any accompanying anxiety – which btw, doesn’t mean she has EDS – but as we know from yoga, hypermobility is a vata issue and the mental correlate is often anxiety. hope this helps!
I have slightly hypermobile joints, caught by a physical therapist. I was warned off yoga for the reasons you state, by a different PT.
Glad you were assessed. Hate that the PT was ignorant enough to ward you off the practice.
A good PT would have found you a style and a taught you body cues to use where ever you move and what to ask for in interview of a good teacher. – signed A Good Physioyogi 🙂
yes you are!!
I think the strengthening part of yoga asanas, as well as the relaxation and nervous system resilience building practices can be great! It’s just the uber flexibility stuff that you need to watch out for
Love love love your stuff. You really are a gem to the yoga world. Thank you for being amazing!
Awwww thanks so much Diana! 🤗
Yes, those Gumbies are the hardest to teach. I frequently tell them to think strength & structure rather than stretch, and to take the depth of the pose that they can support sustainably. In a triangle I might have them bend their forward leg consciously so that they can feel the work of the quads.
I always enjoy your approach to hatha yoga and your knowledge of all the limbs of yoga. Yoga is not just the physical body.
Wow I love this! Being hypermobile myself and a yoga teacher this taught me to strengthen strengthen strengthen! Also I was just talking about it in my classes today. Love your explanation and I tell students it’s really not a bad thing to be on the inflexible side, less chance of injury. Bringing more awareness to this is so important! Thank you!
Thanks so much Wendi! I love that you are aware that hyper mobility can be a challenge and should be addressed compassionately rather than exploited! You are a great role model for your students!
There was a time when I would have rejoiced at being told I was hypermobile. I have some of those other things that aren’t so desirable.
Yoga is so much more than a physical practice. I am flexible enough for my age, but just need to be able to accomplish life goals. Hatha practice helps with this, but it is Raja Yoga that I take with me into my life. I like that I can bring yoga to a bed bound hospital patient, the Visually impaired community and an amputee. They are grateful for and find benefit that does not necessarily come from a physical practice
So true Karen!
Yet another dollop of unique Kaoverii wisdom! Love your blog articles and your voice in this (often) crazy world of modern yoga. Thank you. What is your view on the subject of advanced postures? Not necessary? Part of a long-term asana journey?
Thanks Sarah – I think “advanced” postures can be great for some folks – for giving a sense of accomplishment, confidence, and focus. And I think we have to examine what “advanced” means. I met a yogic nun in India once who told me she did lots of asanas when she was young because she needed them to calm her mind, but as a mature yogi, her practice had turned to meditation and devotion. So what is advanced? I think that’s an interesting question.
I am a Yoga teacher. I was diagnosed with Ehlers Danlos at the age of 51, after a lifetime of dance, gymnastics and yoga…all the things that i was applauded for. I am now 61.
Ehlers Danlos has at least 8 different types that express int he body in different ways, and of course there is lots of cross over, for instance i am hypermobile in my joints but also have vasular issues, Pots, autonomic nervous system dysfunction- among other things. Some of my joints literally dislocate and I can pop them back in with mindful effort, strategic movement and self manipulation. Some of my joints sublux. and I feel torked and crooked, my proprioception gets fogggy and my interoception shuts down. The cool thing is, I know when this is the state I am in. it is especially important to have the space and time to breathe pause and get centered in order to discern what is the next best thing to do, or not to do.
We are made up of connective tissue so this syndrome is systemic and can be debilitating. Feldenkrais, Alexander and yes, the yoga i practice now all are vital for my well being and wellness. I have developed a practice that is inpired by my training with Jillian Pransky Krisitine Weber, my PT Kevin Muldowney and the system of stabilizing movement, and many other intelligent modalities and practices. Balancing the nervous system is a bottom line prerequisite for any physical practice. EDS has been my most powerful teacher, and my self study continues to inform my movement, self care and practices. I never stop learning, and i am fascinated by this human body and all the healing that we can access.
BTW a person who is Hypermobile cannot develop EDS, EDS is genetic, you are born with it.
Thank you so much for sharing your story and for the info about Ehlers Danlos Claudia. I love that you have found a way to practice that works for you! The nervous system is key.
Thanks Kristine! Hyper mobility is something I have and it caused great confusion for me on my yoga journey. Thanks for the science, compassion and advice.
Yoga teacher for over twenty years now. advised 10 years ago to stop practicing due to EDS diagnosis, with risk of dislocation, stretch injury of nerves and vessels as well as ligaments, tendons and muscles. I’ve instead modified my practice greatly, retired many poses (headstand, shoulderstand and others emphasizing end range. I use strap, physioball, blocks, bolsters etc in the iyengar method to strengthen and restorative via meditation, pranayama and visualization for pain management. Yoga teachers should refer their excessively hypermobile students to physicians for complete evaluation.
This is so amazing Catherine! I love that you have found a way to practice – and yes, I totally agree if you are on that end range, you do need a diagnosis.
Your wisdom and subtle nature is brilliant! Thank you for your teaching and inspiration. Long live the art of slow!
Thanks so much Narelle! viva la slow!
Thank you for sharing your stories and knowledge, Kaoverii! I’m not sure I could have stomached staying in that class, but it’s always interesting to see where teachers are going. I learn something in every class I attend!
I like to say to my yoga students, with great flexibility comes great responsibility…..
I love the Oprah image. That’s exactly what I would be thinking if I was in that class. I have never seen that Yogi Dandasana pose before. Glad I haven’t! I agree with you wholeheartedly and appreciate you spreading accurate information!