Can yoga help with hypermobility?

DEAR DR. ROACH: You recently wrote about some of the benefits and risks of yoga. Would you suggest yoga to someone diagnosed with hypermobility?

I’d like to try, but I worry about creating more problems. How do I know if an instructor has enough relevant experience to protect my joints?

ANSWER: Joint hypermobility syndrome is a hereditary disorder of connective tissue seen in as much as 10 to 20 per cent of the population, to some degree.

It is related to Marfan syndrome and Ehlers-Danlos syndrome, but unlike those other conditions, the exact mechanism is not understood.

People with JHS (often called “double-jointed,” though this is not accurate) routinely get joint sprains and other soft-tissue injuries.

Joint dislocations are common, and many people with JHS have stretchy skin that bruises easily. Hernias, flat feet and irritable bowel syndrome are other, more common associated conditions.

Pelvic floor weakness — with attendant urinary urgency, frequency and stress incontinence — also is common. About 60 per cent of people with JHS have chronic pain; 90 per cent have chronic fatigue; and 15 to 20 per cent have anxiety.

I am sure many readers are seeing themselves in at least parts of this description but have not been diagnosed. This is common: The diagnosis of JHS is often missed. Some authorities have recommended against yoga, as stretching can damage joints, and many people with JHS do not realize that they may be injuring themselves due to abnormalities in pain processing.

However, I think that with proper precautions, yoga may still be a valuable treatment to improve strength and stability, both important parts of treating this disease.

Rather than relying entirely on your yoga teacher, I would recommend that you seek out a physical and/or occupational therapist with experience in JHS, and learn yourself how to avoid overstretching in yoga class. You certainly should explain your concerns to your instructor.

Some other activities you could try include tai chi, a form of movement that is particularly recommended for people with JHS.

Another is Pilates exercise, which was shown in one survey of JHS patients to be one of the most effective treatments for the symptoms of this common but often undiagnosed condition.

DEAR DR. ROACH: What are some healthy desserts to bring to a potluck dinner?

ANSWER: I’m fond of desserts using mostly (or all) fresh fruit, but nuts and dark chocolate are other good options for dessert. I’d also say to make them small: Eating a lot after a full meal isn’t necessary.