Yoga Warning: Are You Putting Your Joints at Risk? with Lara Heimann

[00:36] Dr. Linda Bluestein: Welcome back, every bendy body, to the Bendy Bodies Podcast with your host and founder, Dr. Linda Bluestein, the Hypermobility MD. Today we'll be talking with Lara Heimann. Lara is a physical therapist and yoga instructor, and this is such an important conversation. I don't know if you're like me, but I tried yoga before and often found myself feeling more pain after taking a yoga class. It is really hard for people with joint hypermobility to know if yoga is something that they should try or not. So I think this is going to be a really important conversation.
Lara Heimann, physical therapist, yoga teacher, and creator of the LYT Method, received her education from Duke and Stanford universities. After noticing a void in the inclusion of anatomy in the conversations of yoga training, she began to refine the LYT Yoga Method, combining physiology, kinesiology, neurology, and functional movement patterns to yield a more cohesive movement philosophy. The LYT Yoga Method in-person and online teacher trainings have codified her technique that is now shared by hundreds of teachers around the world. Additionally, Lara teaches international retreats, workshops, and festivals, and shares her passion for movement and wellness on the award-winning podcast Redefining Movement with over 3 million downloads. I've been a guest on that podcast and can testify to what a great program it is. Lara is also a certified natural food chef and a certified holistic health coach.
[02:19] Many people with joint hypermobility wonder if yoga is a good idea. Some people have had positive experiences, whereas others have not. What is a bendy person to do? As always, this information is for educational purposes only and is not a substitute for personalized medical advice. Be sure to stick around until the very end so you don't miss any of our special hypermobility hacks. Here we go.
[02:44] All right. Well, super excited to chat with Lara Heimann and want to hear from you — why you created the LYT Yoga Method and what was lacking in yoga teaching?

[02:57] Lara Heimann: I try not to use the word lacking, although it was lacking. It's never a cut on anyone. It's really the fact that I just happen to have more education. Even with my education, when I was teaching yoga — I started teaching yoga almost 30 years ago — at the same time I had just graduated from graduate school for physical therapy. I really kind of kept parallel lanes, thinking that yoga was in this metaphorical box that I shouldn't really mess with. It felt like it had these kind of spiritual boundaries, like this is the way you do it. So I really taught like that and was kind of PT by day and then would come after the clinic and teach yoga. I did that for a number of years.
[03:42] After I got my postgraduate specialization in neurodevelopmental training — which is really about understanding how we can optimize our neuroplasticity when there's been an injury to the brain, whether via a stroke or a traumatic brain injury — I started working with patients who had experienced that, and noticed how, with intention, postural training, repetition, and lots of work on the floor, which mirrors our development, I noticed huge changes in them. And I thought, well, why don't I just apply that to able-bodied people who might have some kind of imbalance? Most of us have some kind of imbalance because life creates that. So I started merging those approaches.
[04:37] When I started doing that in my teaching, my clients were a little skeptical at first because it's like, wait, we're starting on the floor, we're doing all this stuff. And then within about a month, they were like, this is incredible, why isn't everybody teaching this way? Then probably about another year after that, they started telling me, please don't go away because we don't feel like we can go anywhere else without getting hurt. And these are seasoned yoga practitioners, strong. And I thought, hurt? Because I was kind of in my bubble doing my own thing.
Then I realized that during this time period, there was this explosion of yoga — anywhere between 1999 to 2005 — and when you look underneath the covers, the one monopoly of accrediting agencies was essentially just letting anyone conduct teacher training, and there really wasn't oversight. So the long answer is that there were a lot of people who were passionate about yoga, but they were not necessarily being trained in the how and why of biomechanics and functional anatomy, which is kind of essential if you're moving the body. You can only get away with teaching and mimicking and instructing without deeper layers of understanding for so long. Individual bodies differ. Not everybody can do the particular pose you're asking them to, and their endeavor to actually try and accomplish that might be injurious, not to mention frustrating.
[06:27] So that's really when I started to think, okay, maybe I just need to use my background and teach teachers more about functional anatomy. I had created this blueprint for the LYT Method and developed a teacher training. At this point it's been around for about 14 years. The last 5 years we've had it online, and just online alone we've had 1,000 people go through it. Of those people, I would say 70% are existing yoga teachers because they had gone through trainings and gotten to the point where it's like, I can't answer the questions, or I can't address individual bodies. And that's where I really wanted to get to — this needs to be available and accessible truly to as many people as possible. You can't really do that if you don't have the knowledge about biomechanics, functional anatomy, and how we need to move through space with this ultimate goal of sustainability.

[07:35] Dr. Linda Bluestein: I love that you're already commenting about the differences in bodies, because I think it's so important for people — even if they are hypermobile — to realize that all hypermobile bodies are not the same. They're very different. They're different at different points in time, and they're different from each other. There's such a huge amount of individual variation. So keeping all of that in mind, can you tell us some of the things that we should be thinking about? Should hypermobile people even consider practicing yoga in the first place?

[08:07] Lara Heimann: Before hypermobility syndrome had a label to it, I remember watching — and I would say this in my teacher training long ago — the people that are really stiff, instruct them, but I wouldn't worry about them. They have tons of information. The ones in the corner that everybody is marveling over, like, look at them, they're bending — those people scared me because they are not getting any information from the brain, or very little delayed information, about where they are in space. And you, of course, know this to be true.
[08:43] So that decreased proprioception — where you get the feedback — means somebody like my husband, who is restricted, gets feedback pretty easily. He starts to lean over and it's like, ooh, my brain's telling me, hey, that's your end range. There are ways to work with him to override some of those very quick messages he's getting. Well, hypermobile people usually have the opposite issue. They don't have that information coming at all.
[09:13] So if people love yoga, they have to look at it carefully. I just actually had a private session yesterday with someone who has hypermobility syndrome. She's now not moving at all, which is terrible, and I told her to talk to you. But what I said is: you have to move, but you have to work on stability first and foremost. You have to use feedback, whether it's your own hands, the wall, the floor. That's why doing stuff on the floor is so great — because you're getting not only a lot of feedback, but a lot of support to the center of your mass and the center of gravity, which at that point is in your pelvis. If you can get some feedback into how to stabilize that, then you're more likely to have some continuity with that feedback coming up through the spine into the rib cage and shoulder girdle.
[10:11] But once you're bipedal and you're doing all the flowy stuff we do in yoga where you're only supporting yourself with your feet, and you've got this — for lack of a better word — Gumby-like body, it's really tricky to get enough feedback to stabilize in a meaningful way. And of course, many teachers are not going to pay attention to that person. They're like, oh, they've got this, they're moving fluidly, not realizing that's actually the lack of the motor response they need.
[10:47] So what I would say is, for anybody with hypermobility syndrome, you're likely not getting that feedback, whether it's lax connective tissue or proprioceptive diminishment or a combination. You need to pull in, minimize big ranges of motion, and use as much feedback as possible. Get on the floor and get a lot of feedback. For instance, something like a bridge — don't go all the way up and be thrusting your ribs, arching in. Stay really low, which actually is far superior.
We also have to reframe what is ideal in yoga. For so many years, what was glorified were these advanced flexibility moves. We have to reframe that. If you can hold yourself together, that is ideal — for anyone, but especially for somebody dealing with hypermobility issues.

[11:53] Dr. Linda Bluestein: Yeah. So it sounds like it's something that could benefit a lot of people, but you have to approach it in the right way. And trying to find an instructor who is going to take that kind of approach — of course it's different if you are doing a private — but if you are thinking of doing group lessons, what would you tell people to look for?

[12:18] Lara Heimann: When I teach, I teach online. I have some sessions by Zoom where I can see people. But even if I'm just filming a class, I already have in mind all the possibilities — somebody who might be trying to force end range, somebody who could go to end range with no problem. Say we're lying on our side doing some thoracic rotation. I will specifically say, move from your sternum. It's not about getting the arm all the way down. And if you know that you have hypermobility, you want to really find your scapula and stay there.
[12:55] So I would first look for somebody who is giving multiple cues in a movement pattern that addresses the different bodies and neurological environments. I learned that so early on in PT — everyone has different starting points. If you go to a class and they're just telling you, Warrior Two, reverse, lean as far as you can — if you're not getting some sense of how to hold yourself in the pose, that's a concern. We have gravitational forces on us. That's easy. And for hypermobile people, their joints and neurological system are just kind of letting go of that.
[13:51] I address as much about movement what shouldn't be moving, or what we don't want to be moving, as what we do want to be moving. So look for somebody who's giving a variety of cues and always has this awareness of what needs to be stabilizing for the parts that are moving.

[14:11] Dr. Linda Bluestein: Yeah, I love that. If you were to lump together people who don't have hypermobility and people who do, do you think both groups are going to benefit from yoga equally, or do you think people with hypermobility could actually benefit even more?

[14:35] Lara Heimann: It's hard to say who would benefit more, but they both can absolutely benefit if they're getting the right education. I had a retreat this spring with 40 people, and 2 would fall in the hypermobility camp. Fortunately, they were aware of that. But in a group setting, sometimes you just have to keep coming back to the reminders of what is vital for you.
In our LYT world, I think everyone feels very individualized and not competitive in terms of looking around the room, because we use blocks and props. It's like, these are amazing ways to better connect to your core. That's kind of what it comes down to. So instead of collapsing in the pelvis to reach the hand down in a lunge, put the block there and actually lift up. There's always this energy coming to center.
[15:37] What I will say is that people with hypermobility will absolutely benefit as much, if not more, but they will have to work three times harder. And sometimes that's a hard pill to swallow — but it is so much more repetition and finding those nuances than for somebody who is not hypermobile. But people with hypermobility need to know it takes time. It's going to take so much time and repetition, and it's worth it. It's challenging because you just feel noodly. But once you get that feedback more and more, it does pay off for sure.

[16:41] Dr. Linda Bluestein: That's really fascinating because, like you said, so many people think that the bendiest people are the best at yoga. It's really ironic. When I talk to my patients or clients, oftentimes they've told me of their incredible successes at yoga — they were considered the star students. Would you say that if a teacher is pointing to those students and holding them up for others to emulate, is that something where people should think, hmm, I wonder if this is the best environment for me?

[17:27] Lara Heimann: Absolutely. I want to cheer people on and encourage them and give them educational cues, but I can't remember a time where I was like, wow, look at this person. That kind of adoration for extremely bendy things — I think more people are starting to see it and think, okay, that person just naturally has some ability to do that. I stay away from ever suggesting that your goal is to fully extend your back in a wheel.
[18:26] I think it's a red flag if somebody doesn't speak to where you want to stabilize and the feeling you want to have. You want to feel like you're always in control of your body versus when you kind of flop into something. Because yes, you can go into these big ranges of motion, but how do you come out of it? Are you able to, without this feeling that you've become a wet noodle?
I would also look for flags around what some teachers call peak poses. I don't think there's anything wrong with that, but even the terminology always rubbed me the wrong way — like, we're going to go up to this peak pose, and by the way, 5% of you might be able to do it. It's so much more impactful to educate and empower people how to move their body through space so they can take that out into the world. It's not about individual poses and accomplishing them. Really good teachers, even if they don't have as much functional anatomy background, know that there are limitations on that approach — and it's never about the idealization of the look of a pose.

[19:48] Dr. Linda Bluestein: It's an amazing combination that you're a physical therapist and a yoga instructor. In what ways do you feel like that education and experience, including your postgraduate work, has informed your development of the LYT Method?

[20:19] Lara Heimann: It's really everything. I think we're all a little comfortable with bucketing things, and so people still to this day ask, oh, do you do physical therapy? To me, I have enhanced being a movement specialist by taking these different disciplines and combining them in a way that brings out the best of each.
[20:48] With physical therapy, it's amazing, but if you go into a clinic, you're very limited in what you can usually offer an individual based on insurance and whatnot. It's almost like, let's take the parts — here's your shoulder, you came for your shoulder, so I've got to address your shoulder. But I'm not necessarily going to be able to address your pelvis or your foot or your neck, which might actually be the cause of the shoulder issue. But there are so many amazing therapeutic modalities in physical therapy, whether it's joint mobility work, learning how to become more pliable in the tissues, core training, balance training, proprioceptive training, functional performance. Those are all terms that weren't really part of the yoga lexicon.
[21:48] By bringing them into yoga, what I describe LYT as is really bringing the mindfulness of yoga together with the intelligence of physical therapy. That isn't to say yoga lacks intelligence, but functional anatomy definitely wasn't its strongest feature. Yoga makes people feel like they're going inward, coming home to themselves. But what I wanted to say is, hey, I can teach you a deeper layer. This is information that you probably didn't get, and it's really unfortunate we didn't get it in school. Knowing about our body — it's the longest relationship we'll ever have — and unless you go to medical school or PT school, you're probably not getting that information. I'm going to let you in on it, and you don't have to have an advanced degree to have ownership over your own body.
[22:44] Being a physical therapist, one of the biggest things is being an educator, because our hope is that somebody comes with some kind of injury or issue, we help them, and then — whether from a rehab or outpatient setting — they take this information and apply it in their lives. I bring that sensibility absolutely into every class. It feels like a workshop in the sense that we're getting the movement practice in, but I'm layering the education. That's super vital because most people don't have the opportunity for that information to be relayed to them at any point in their life. So all of it informs LYT for sure.

[23:37] Dr. Linda Bluestein: I'm glad you brought up insurance because that is such a huge problem in our healthcare system. I was going to write a post about how healthcare is great unless you actually need it. And you're right about the limitations when you're working through insurance. I've been in and out of physical therapy since I was about 16 — probably more in than out. I was going to a physical therapist and they stopped taking my insurance, but I really liked her so I continued to go and pay cash. It's nice because now since we're not going through insurance, she can address my body in a more holistic way. Those are definite problems we encounter with the insurance system.

[24:34] Lara Heimann: Totally. Early on, working with so many neurologically impaired patients, I really learned how to write the things that the insurance company needed to hear — while being truthful about what I was doing. I was doing a lot more, and it's like, what's the function? How has their function improved? But I'm working on all these other elements. Even if I saw somebody in an outpatient clinic, I would do all the things and then make sure I measured whatever needed to be measured. But you're limited on time.
[25:13] I've worked for myself for probably about 20 years now, after about 10 years in a clinic. And that's because I can work with somebody one or two times and have way more impact than the 10 times they would get in a clinic, because I'm not limited by what insurance says or by how many other people I'm also seeing at the same time.

[25:38] Dr. Linda Bluestein: Right, right. I asked people to submit questions for this conversation, and I got some really great ones. One was: what do you recommend for people whose pain is poorly controlled?

[26:01] Lara Heimann: Meaning that they have pain and nothing can really take it away, or they do something and it provokes pain, but they don't really have a handle on what's controlling it — like what levers are being pulled?

[26:18] Dr. Linda Bluestein: Yeah, I think what the person was referring to is: if your pain is poorly controlled, what do you do in terms of movement specifically?

[26:30] Lara Heimann: That's really tricky. And I'm always fully transparent — that's why I recommend you a lot to my clients, because I can only tell you from my perspective of understanding it intellectually, but I haven't experienced it. And I know the experience of it is different for everyone. Hypermobility syndrome presents differently in different people. What phases, what stages, all kinds of things are still being discovered.
[26:51] What I typically tell people is, let's go towards stability, but don't stop moving — because we have to give your brain more input to have a different output. I think it's still not entirely known exactly why pain response is so much greater sometimes when you have a connective tissue or hypermobility disorder. My instinct, and this is what I've done when working with people, is that it's some kind of stress response on top of what's already there. The response to movement is not in the normal range, let's say.
[27:36] So some of it is: A, try not to be afraid of moving, because that's really hard when you have that anticipatory pain. I've seen it with complex regional pain syndrome — it's all part of that misfiring, so to speak. But also give yourself more tools. If you wake up with neck stiffness, we talk about pillow and positioning. Is there something they can wear throughout the day that helps — whether it's KT tape, some kind of splint, or some kind of extra support that gives them that sense of stability?
[28:23] And then learning, when you're in that mode of pain, what are some techniques that could redirect your brain? It's like there's a CEO up here, and how do we — I don't want to say manipulate — but how do we give it a different surface to work with so you're not sending everything into pain signaling? It could be rubbing or tapping or focusing on leaning against something. I had one woman where I just thought she needed more physical input. So I had her lean against a wall and try to breathe into her back, because she couldn't really find that 360 breath. And just that focus — okay, I'm on the wall, I have points of contact with the wall, now I'm just going to try and push my breath into the wall — it just gave her brain another avenue to go down.
[29:27] Those are some of the techniques that have seemingly worked when you just can't figure out where the pain is going to come from, when it's going to leave, and you're just trying to manage your nervous system response as much as you can.

[29:45] Dr. Linda Bluestein: It's fascinating that you picked that example because I have been struggling off and on — actually, it's really interesting that all of the examples you've used so far resonate with me, because I'm in physical therapy for my shoulders, but I'm also dealing with neck stuff. I woke up this morning with my neck. And sometimes you hear people talk about the "shneck," right — the shoulder and neck complex — because they are so closely related, like the hips and the spine. Having a more holistic approach is so beneficial.
[30:20] I want to take a quick break. When we come back, we are going to talk about stretching, because this is such an important topic and I know a lot of people had questions about it. We'll be right back.
[31:26] All right, we are back. We got so many questions about stretching for people with hypermobility. I would love to know if you have dos and don'ts for stretching and yoga for people with hypermobility.

[31:44] Lara Heimann: There are so many different varieties of hypermobility, but in general I think of taffy. If you pull taffy, it's going to stretch, but you have to have a hand that's holding it to actually get that pull. Your elasticity or viscosity — that taffy-like quality — is probably going to be pretty easy to pull. So counter it.
[32:14] Now, I know that so many people with hypermobility feel like they need to stretch because there's a lot of muscle tension — because your poor brain is like, wait, I need you to stabilize here more. And then you're like, oh, but I can stretch and it feels like relief. So give your brain the peace of mind that you're actually feeling. Whatever you're going to stretch, think of countering it as much as possible. For instance, if you're doing some kind of side bending where your arm is going up in shoulder flexion and you're moving in the ribs, instead of collapsing on the bottom side, can you lift into the top side and really hold that arm with a lot of tone? Get it al dente as opposed to floppy.
[33:04] And keep reminding yourself that the reason you feel tension is because you need more stability — it's not because you need to stretch the tissue. That doesn't mean stretching isn't going to feel good and be valuable, but your stretching is not the same as other people's stretching. You're going to focus on how to hold against a moving part. Also think of gravity as something to move against. Don't succumb to it. Whether it's hinging forward or side bending, you're always trying to move against gravity and not let it collapse you.
[33:48] Stretching — for anyone — is not about collapsing into joints. It's about having strong stability, an anchor from which you are trying to get the tissue to release if it is restricted. Keep reminding yourself that your feedback is not the same as others'. Even if it feels like something needs to be stretched, I'd rather you rub an area that feels tense than try to really stretch it.

[34:20] Dr. Linda Bluestein: Is it possible to have areas that are overly flexible and areas that are overly tight within the same body?

[34:29] Lara Heimann: Yes. The shoulders for some people can be hypermobile just by design — there's a lot of intrinsic mobility there. You've got a shallow, smaller socket and a big humeral head, and that allows for a lot of mobility. Anywhere you have a good amount of mobility, there is a trade-off for stability. So I can see people with too much mobility in their shoulders, and then their hips are much more restricted and tight. And they can even become more hypermobile in their shoulders by moving their ribs and their pelvis instead of actually moving in their hips.
[35:30] Similarly, someone might be really loosey-goosey in their hips and restricted in the thoracic spine. It depends on the person and what they've emphasized doing, but it is absolutely possible to have all of those at once.

[35:46] Dr. Linda Bluestein: Yeah. I went through a period in my life because I had so much pain in the backs of my legs, and I just completely stopped stretching my hamstrings or anything like that. Now I'm so incredibly tight. I do some nerve glides and things like that, but as a ballet dancer I used to be so incredibly flexible and hypermobile, and now it's incredible how tight certain parts of my body are. So if we don't stretch at all, are there consequences to that?

[36:26] Lara Heimann: I would say, again, this is where understanding some principles of biomechanics comes in, and they may have some neurological differentiation in people with hypermobility. But the hamstrings — I would much rather have somebody who feels tight in their hamstrings but works on strengthening and stabilizing their pelvis than someone who's constantly stretching them. Because the hamstrings feeling tight versus actually being restricted are different things. I don't ever sit down and statically stretch my hamstrings, but dynamically I'm moving them. These are spring muscles, just like our calves. They need length, but they have a lot of coil to them. Because of the way the muscle fibers run in the sagittal plane, if you pull them too much, they lose the spring that helps us bend the knee and project us forward.
[37:25] But if you're tight in your back fascia, that can be really problematic because it can pitch your pelvis forward, restrict your shoulder, and it doesn't feel great. It's also important to know that muscles themselves may not be what's making you feel tight — it's the fascia overlying them that makes them feel tight or not. It's like Saran Wrap. If you chronically feel a lot of back tension, what is happening that makes that Saran Wrap cling versus be able to glide around? Fascia has this gliding principle — you want to feel like your skin could slide over the underlying structures. If it doesn't feel like that's happening, that's probably because there's stickiness in the fascia.
[38:15] More and more, the research is showing that static stretching isn't changing that. What changes it is the biomechanics. The fascial restriction has gotten that way from postural imbalances. You take those postural imbalances, and then you move — and you're just moving in those imbalances. That's one reason I created LYT. I saw in yoga classes, you come in off the street with whatever imbalances you have, and then you start moving and you're just kind of moving in those imbalances, maybe freeing them up but also exacerbating the alignment because the muscles that are already clinging and ready to fire are in a more shortened position.
[38:58] So we start in LYT by resetting the whole environment from which you can start to change long term. Stretching means you need to reestablish your most optimal posture — which is a spectrum — and then move the joints without compensating, whether that's thrusting your ribs or rounding your back or whatever it is. Those little changes are what will actually change that long-term feeling of being tight.

[39:41] Dr. Linda Bluestein: I love that you start out that way in LYT. How do you do that?

[39:47] Lara Heimann: This really comes back to my specialty in neurodevelopmental training. If you think of a child's development, you know there are developmental stages. The baby comes out super floppy, and then they start to develop really the muscles closest to the bones to start stabilizing, and then they activate muscles to lift their head, roll on their back, come around onto all fours. Those developmental stages are when your brain is growing dramatically. There is so much growth between 0 and 2 years old because of movement. Movement is actually growing the brain — the exploration. And that movement is also growing your connection to motor coordination and muscle firing. When kids aren't hitting those developmental stages, there's always a concern because the brain-body coordination is really important.
[40:52] So we just go back through that again. Why? Because it's hardwired in our brain. It's a way of resetting our movement pattern and our posture. We do it on the floor because, as I said earlier, the floor gives so much feedback. You've got gravitational forces and then you've got the responsive ground reaction force. These energies are coming through our body and we have a lot of support for our center of mass at the pelvis. So we can get that feedback.
[41:26] For instance, if somebody's coming into a low bridge, and I know they're really inclined to thrust their ribs — hands on your front ribs, anchor them down so that your back ribs are broadening, and then lift your hips. People are like, oh, those are my glutes. They're so used to their ribs thrusting in all of their activities — squat, hip hinge, lunge, anything — that they're just using their back. The back gets really tight. And then where do they feel it? They feel it in the hamstrings, but it's actually because their glutes are underperforming. The back stays really restricted and the hamstrings are like, help, I'm trying to help the pelvis — but the glutes are the best thing to stabilize the pelvis.
[42:14] So we get on the ground because we want to immediately recruit the deep abdominals, the ones that support the low back from inside. We want to get the glutes working. They not only extend the hip and externally rotate it, but they stabilize the pelvis. And people don't stabilize the pelvis well. That's when you run into the loosey-goosey shifting — can you stand on one leg without shifting your pelvis? That's all the gluteal complex.
[42:51] We do that on the ground because you have a lot of support, a lot of feedback, and then you are changing what's called the motor recruitment and coordination. Because when you've been on this track, it's like listening to the same song every day your entire life. It's really hard to get off that track. Well, you change the song. You change the recruitment by giving yourself a fighting chance and setting yourself up for success. We start there, and then we go into bigger movement patterns, building from the ground up.

[43:39] Dr. Linda Bluestein: I really love that, because we all know what our own body feels like and we don't necessarily know what we're doing that is not helping us. As you said, we don't come with an owner's manual, unfortunately. No matter how much education we have, if you go to look in the mirror, as soon as you do that you've already changed the way you're standing or moving. So I think that's so important, because otherwise we keep reinforcing those suboptimal patterns.

[44:15] Lara Heimann: Yes. You need different input into the brain. For anyone — but especially people with hypermobility syndrome — if you're wanting to work on posture, you need more feedback mechanisms. Using the ground, using blocks, using the wall. We do a lot of work where — you can try this right now — you stand next to the wall, your right shoulder close to the wall, you extend your right hand so it's pressing into the wall, you grow your spine tall, and you try to lift your right knee in hip flexion. Even in people who feel the least connected, they feel it. But you have to do those things because it's like you've got to burn those signals in. They just don't come on right away.

[45:09] Dr. Linda Bluestein: I think that's fascinating, because there are probably certain exercises you could give people who feel like they are very fit, but you could give them some pretty simple exercises that they really struggle with.

[45:23] Lara Heimann: Yes. I was just teaching a corporate class yesterday — a lot of men, actually all men, relatively fit. I had them in quadruped, just taking one arm off the floor almost like a bird dog, and I said, don't move anything else. And it was quivering. I say that quivering is awakening. Don't think of it as being weak — it's like, oh, because we have muscles that are close to the bones, the proximal muscles, postural muscles, core muscles. There's some crossover between all of that. And then in the other layers, we get into the big mover muscles.
[46:05] I work with professional athletes and they have the same thing. It's the balance between being able to stabilize in the proximal and being able to move with those mover muscles. If that balance isn't there in a way the body feels comfortable with, you create imbalance, and that's when things feel restricted, or even become injurious. But you go into those proximal muscles and you're not even doing that much — you just add a longer lever, gravity on that longer lever, and tell someone not to move anything. And all of a sudden it's like, whoa, all those muscles close to the bones are like, we're coming on. Because there are a lot of ways to execute a movement. If I just say lift one arm in quadruped versus I want you to reach that arm forward and not have anything else move, really draw everything to the spine — it's very different.

[47:06] Dr. Linda Bluestein: Yeah, that makes sense. And I'm so glad you've mentioned the pelvis several times, because a lot of hypermobile people do have pelvic pain, low back pain, hip pain. I know one of the interesting things to discuss is the SI joint. We're taught that there's almost no movement in the SI joint, but we know there is some, and in people who are hypermobile, there's more than just some. What are your thoughts about yoga or the LYT program for people with a hypermobile SI joint?

[47:43] Lara Heimann: For anyone — and really especially for anyone with hypermobility — I think the key is keeping the pelvis in a stable neutral position most of the time. The only time I think of purposely moving the pelvis is when I have more support, like in quadruped for cat-cow, because I've got support for the center of mass and I'm tipping it and feeling it move. It should be able to move. But my general intention is to keep it neutral.
[48:22] Neutral means the joint surfaces between two bones are at maximal congruency. The energy efficiency is there, and it puts less strain and stress on the surrounding tissues. When somebody has SI joint pain, the first thing I look at is whether they're tipping their pelvis — and that's often the case.
[48:51] This is where it doesn't matter if you are hypermobile or not, but you need to be more vigilant when you are hypermobile, because the sacrum and ilium come together at the SI joint in a way that's really not the same as other bones. Its stability comes through dense overlying and connecting fascia and ligaments that keep it really stable. But when you don't have that same inherent stability in those ligaments and surrounding fascia, you're going to get more movement there. So it is even more incumbent that you stabilize the pelvis.
[49:38] One cue I give a lot: take your fingers one inch above the pubic bone in front, second and third finger pressed in toward the body, and imagine a string pulling straight back while firming. It's almost like an elastic band that you're trying to cinch together. It's not sucking the belly in. It's really deep, going inside the bowl of the pelvis and getting at the very bottom of the sacrum. Stabilizing there helps prevent the pitching of the pelvis. If you do that, it's really hard to let anterior tilt happen because you're getting at it from deep within and below. It's a way to connect using your hands as a feedback mechanism.
[50:27] I would say, especially in yoga or any movement practice — even walking around and standing — where is your weight distributed through your feet? That will often tell you about where your pelvis is. If your pelvis is tipped in either direction, it's going to impact your SI joint more than it would for someone without hypermobility, because the SI joint is really quite dynamically stable unless it's not. It's also an area of shock absorption. We need that stability there to take the energy from the floor up through into the core. If it's moving around, that's not effective shock absorption — the energy gets leaked, and all the tissues around it are not going to be happy. So it's not simple, but if you repeat this vigilance over and over again, it can help a lot.

[51:35] Dr. Linda Bluestein: I love that because so many people have pelvic pain. A lot of times they'll try pelvic floor PT, which can be really beneficial, but some people cannot access it in their area. With the programs you have, you have a lot of online resources. Is your program appropriate for somebody who has pelvic pain?

[52:02] Lara Heimann: Yes. We actually have on our platform several pelvic PTs who have created programs for pelvic instability, pelvic pain, the whole gamut. And anything inside the pelvis is impacted by the position of the pelvis. It's as simple as thinking about a bowl that's tilted — where is the pressure going? Where are the contents going? There's an imbalance there. When that imbalance is repeated over and over again, something has to take up the slack.
[52:45] So if you're pitching forward, your spinal extensors are overworking, and that's going to put a different load down through not only the pelvic floor, but the pelvic wall muscles. You get some of those deep external rotators, like obturator internus — these become very restricted and tight because they are constantly trying to give feedback to keep everything in check. Whenever you get into those muscles near the bottom of the pelvis, the pelvic floor can be impacted. That can affect pelvic pain at any time, but also pain during sexual intercourse, urination, leaking, and tightening. When you have tightening in the pelvic floor, it's often correlated to clenching in the jaw. But all of that is coming from imbalance. So we go to the root and ask, what is the imbalance and how do we address it so that what's happening downstream isn't being impacted in the same way.

[54:03] Dr. Linda Bluestein: I've actually worked with quite a few young people who are experiencing some significant complications related to hypermobility. You talked a little earlier about fear of movement and kinesiophobia. When I first learned that term, I realized, oh my gosh, that's what's happened to me. It helped me understand that I needed to start to move better and then move more, doing it in a way that my brain felt safe. What would you say to people who are — some of them so young — spending more and more time in bed or just not very active? Because they're getting these signals that feel like they're coming from the body, and it's like, well, maybe if I move less, this will be better. But we know that's not really the case. Do you have any thoughts about people in that kind of situation?

[55:12] Lara Heimann: I think first of all, you're not alone. There are many people whose brain is having that conversation — whether it's anxiety, depression, or fear of movement, something is spinning out and it results in a very real story. It's not that it's not real, because there can be evidence to it. There can be evidence to having anxiety, or to having pain when you move. So some of it is saying, let me befriend this and realize we're working together. Movement is medicinal. But not all movement is going to be equal, especially in these cases.
[56:09] Let's figure out movement that is going to help your brain understand that we're trying to stay balanced, healthy, and energized — because not moving is stagnant, and every system in our body benefits from movement, including the mental. We need to get the neurotransmitters working for us, knowing that there is going to be that part of the brain that is speaking, and we're just trying to get it to speak not as loudly.
Whatever we have on a loop in our heads — we put in other things, and eventually we'll actually believe it. I tell people: your thoughts right now aren't going to believe this to be true. But find this part of you that is new, that needs to move, and speak to it kindly. Try not to let the other stuff drown it out, and then move again in a way that feels safe.
[57:33] It could be, hey, how about taking a walk? And when you're walking, how much can you lift up and not let gravity sink you down, giving yourself even those little things? When I tell somebody to try and make their spine taller, just the thinking in the brain is going to in some way connect into those muscles. And then you can always tap more, or use a corset or supportive garments that give you that experience. Start with something like that, because you need to get moving so that you feel the benefit — even if you also feel some pain — because that pain is not necessarily tissue-damage pain. It's the perception of it. We have to work within that comfort zone. But I think it's important just to say: everybody can have different elements of this. You're not alone. This is your expression of this imbalance and what your brain is telling you. We just need to give your brain something else to think about.

[58:34] Dr. Linda Bluestein: Yeah, definitely. And I talk a lot about hurt versus harm. Okay, this might hurt, but is it actually harmful?

[58:41] Lara Heimann: Not exactly the same thing.

[58:42] Dr. Linda Bluestein: Definitely not always. And paying attention to, okay, that time I really overdid it — that was a lesson. And rather than beating yourself up, because I think people beat themselves up: oh, I should do this, I should do that. That can be really challenging as well.

[59:02] Lara Heimann: Yeah, trying to be really tender with yourself, because at the end of the day, you're listening to your own thoughts more than anyone else. So let's try and be gentle and encouraging.

[59:14] Dr. Linda Bluestein: And we like to end every episode with a hypermobility hack. Do you have a hypermobility hack for us?

[59:25] Lara Heimann: One that has worked quite well, besides the stuff on the floor. Definitely get on the floor — a modified side plank is an example. I have several people with a lot of hypermobility in their shoulders that translates into a lot of neck issues. And actually giving them a one-pound weight, or a can, or something that provides feedback — think of it not as I'm trying to get strong, but as a lightweight tool to give you more proprioception — that has been really great. It can certainly be more weight over time, but start there.
[1:00:05] Try this today for your neck: if you have a hand on the floor — you don't even have to be on the floor, you could do this at your desk — hold just something like a one-pound weight or a can, and do some small circles where the shoulder is creating the spinning. There's not any moving forward or back, and there's a little bit of support with the hand on the ground.
That hack is one I fell into honestly, because I was working with somebody who was so scared to move, so scared to do anything, and everything was, oh, but that hurts. I just needed to override some of it. So I said, let's try this — grab that thing. And she just literally did a small movement. She now does that every single day, only for a minute or two. But why? Because something a little different that you're holding as a lever is going to light up some proprioceptors, which we know are either really delayed in firing or on very low volume. We just need to turn up the volume. And then your brain starts responding to that.
[1:01:25] So doing things on the floor and having a little bit of weight in your hand can be amazing. And not down — because a lot of hypermobile people have those slopey shoulders — you want the arm out at 90 degrees or up at a diagonal, doing small circles there. You're actually taking what's called the lengthened strain out of the neck. What we're trying to turn on is all the muscles that help cuff the shoulder — the rotator cuff muscles — and also some of the muscles within the scapula itself.

[1:02:03] Dr. Linda Bluestein: That's fascinating. So the arm is just feeling enough different to change the input?

[1:02:12] Lara Heimann: Yeah. So, Linda, like you're rubbing your right side — if you took your right arm out to the side, right now it has a long strain to it, and you lifted it up — I just have a coffee cup — and you're trying to think of getting really tall and doing some small circles, really small. Can you get it up to 90 degrees, like straight out to the side?

[1:02:16] Dr. Linda Bluestein: Yeah.

[1:02:40] Lara Heimann: And then do small circles.

[1:02:42] Dr. Linda Bluestein: Oh, interesting. Yeah.

[1:02:45] Lara Heimann: It can be a coffee cup. It's just something of density and a tiny load that changes that awareness. And then we want all of this to register as, okay, this isn't going to be strained, we're going to work on the shoulder. So that is a hack that I've taught because the shoulders get really slopey and the neck gets involved, and then it becomes this whole thing. Just trying to bypass that a little bit.

[1:03:14] Dr. Linda Bluestein: That is a hypermobility hack that I am going to start working on immediately. Thank you.

[1:03:21] Lara Heimann: And report back and let me know.

[1:03:23] Dr. Linda Bluestein: I will for sure. So thank you so much, Lara, for joining me today. I really have just enjoyed so much learning from you. Before we go, I would love to know what you're up to — if you have any special projects you're working on, and also where people can learn more about you.

[1:03:43] Lara Heimann: The best place to find out all of the above is our website. If you type in LYT Yoga or LYTMethod.com, either one of those will get you there. My Instagram is Lara Heimann. We are constantly looking at where we can extend our reach — there are so many areas beyond just the yoga world. We're helping other movement professionals, getting into corporate settings, and we always have teacher trainings. We now have both a guided and a self-guided online teacher training, and we're also doing mini courses for all movement professionals.
[1:04:20] The one that's out right now is called the Triple S — it's called Improve Your Posture. It covers what the Triple S is and why it's so important. There's a lecture and a lab, and it's really dialed down — I always say my 10-year-old niece could listen and understand. I always use anatomical material, but make it accessible. We also have a retreat in Greece focused on longevity, working on all of these elements — that's October 9th through the 15th or 16th, about a week. I'm doing that with another physical therapist, so we'll be doing all the LYT yoga stuff, but also bringing in some myofascial and mobility work. So it's for all types.

[1:05:08] Dr. Linda Bluestein: And LYT is L-Y-T, correct?

[1:05:12] Lara Heimann: L-Y-T. It's an acronym — it stands for Lara's Yoga Technique, but I didn't want my name in the branding. I always talk about how when we feel really aligned and we're moving well, we feel lit up. That's really what we're going for — this energy of light that we all have. We know when we feel dim and we know when we feel really bright in our spirit, and that's very much linked with our body and how we move, because it's all holistic. We don't have a separate mind, brain, and body — they're all interwoven. When they're functioning well together, we feel really lit up.

[1:05:55] Dr. Linda Bluestein: That's great. And you mentioned a while back about young children and babies, and how movement informs the brain and the brain informs the movement. But that's lifelong, right?

[1:06:08] Lara Heimann: Lifelong.

[1:06:09] Dr. Linda Bluestein: Yes.

[1:06:11] Lara Heimann: And what people really need to understand is that we are very curious with our movement as children, and then after we get to school and start not moving as much and having less movement variability, we have to purposely bring that back for neuroplasticity to continue throughout our life. There has to be intention and effort behind it, because it's not like when we were kids where we were just going everywhere and exploring.

[1:06:44] Dr. Linda Bluestein: And thank God for neuroplasticity. The ability of the nervous system to change throughout our lives is so important, because we used to think that essentially stopped around age 25.

[1:06:45] Lara Heimann: Right.

[1:06:57] Dr. Linda Bluestein: And now we know that's not true.

[1:06:58] Lara Heimann: Not true at all. Intention behind it, but it's always available to us, which is incredible.

[1:07:07] Dr. Linda Bluestein: Well, thank you again so very much, Lara. I really just enjoyed chatting with you, and I know everyone's going to really enjoy listening to this episode.

[1:07:17] Lara Heimann: Thank you so much, Linda. It's always wonderful to see you and hear from you, and I love what you're doing. It's an honor to be on here.

[1:07:29] Dr. Linda Bluestein: Wow, that was such a great conversation with Lara Heimann. I hope you enjoyed it as much as I did. I know that yoga is such an interesting topic for people with hypermobility. As she said, we can be so good at it, but we have to work even harder at it in order to be doing it correctly.
[1:07:47] Thank you so much for listening to this week's episode of the Bendy Bodies with the Hypermobility MD Podcast. You can help us spread the word about joint hypermobility and related conditions by sharing this podcast and leaving us a review. This really helps to raise awareness about these complex and frequently missed conditions. You can also find me, Dr. Linda Bluestein, on Instagram, Facebook, TikTok, and LinkedIn @HypermobilityMD. You can find Human Content, my producing team, @HumanContentPods on TikTok and Instagram. You can find full video episodes up every week on YouTube at Bendy Bodies Podcast. To learn about the Bendy Bodies Program disclaimer and ethics policy, submission verification and licensing terms, and HIPAA release terms, or to leave us a question, please visit bendybodiespodcast.com. Bendy Bodies Podcast is a Human Content production. Thank you for being a part of the Bendy Bodies community, and we'll catch you next time on the Bendy Bodies Podcast.