Postural disorientation and yoga

I recently had a question about a yoga series I post about often which prompted me to delve a little further into my practice. 

Problems with Yoga...

I have Orthostatic Hypotension (OH) and suspected POTS (Postural Orthostatic Tachycardia Syndrome) involvement, meaning I frequently lose vision upon standing (working out or not), this is largely due to the OI.  While this is the main component of my workout woes, I have experienced several episodes in the past after high intensity workouts, where my heart begins to beat fast, and or erratically to the point where I have had to lie down due to my pounding heart rate, disorientation and overwhelming weakness.  As you can see this has created hurdles in my wellness regimen.  Having hypermobile joints, stabilization is of utmost importance when trying to prevent injuries and rehabilitate from current injuries.  

Yoga had been a large part of my youth, and there is conflicting information among the EDS community, but I STRONGLY believe that when done properly yoga is one of the most beneficial exercises and maintenance regimens for those of us effected by hEDS, generalized joint hypermobility syndrome, and MANY other movement disorders.  That being said, my mobility issues and chronic fatigue generally keep me from committing to yoga classes and scheduled exercise activities outside of my home.  My husband has been supportive enough to help me turn our third bedroom into a yoga/pilates space so that I can have access to a body work space when I need.  



Getting on the right program...

Yoga helps reduce stress and anxiety, and build meaningful connections.  Notice my propped laptop in the back, that's where the home YouTube Yoga studio comes to life!

Yoga helps reduce stress and anxiety, and build meaningful connections.  Notice my propped laptop in the back, that's where the home YouTube Yoga studio comes to life!

Setting up a space is only half the battle.  Having done a lot of in-home yoga programs on VHS (yes VHS), and DVD's I found my body to adapt and crave change quickly.  If you aren't attending classes where you have the options to move up from basic to intermediate or advances techniques,  you won't get a change in programs from a few volumes of Yoga 101.  Enter the age of YouTube!  You can find almost anything, and so began my search.  My search also began with a lot of almost blacking out from poor instruction.  Let's be real, anyone can get on YouTube and upload a video, it does not mean they are trained instructors.  I found the main issue to be positional changes without proper instruction.  Example:  you're working through rounds of breathing in downward dog, and all of a sudden you look up and your YouTube instructor is in Warrior II and hasn't said a word yet.  You try to get up quickly and move into position and can't find your balance, or in my case you can't find your vision.  So how did I find a program that worked for me?

The search...

After many failed attempts at finding a yoga instructor or series  I felt comfortable with in English, I decided to check out videos in Portuguese.  I stumbled across a yoga institution who produced several series of videos at varying levels by multiple instructors, NAMU.  I have since found almost all of these videos to be at my pace, or adaptable to my pace.  I will reference these videos below for you, and they are in Portuguese which I hope that by happenstance, helps you immensely.  If you speak or understand Spanish it should be fairly easy to follow along.  If not, I recommend finding programs and videos made by educational institutions who release series on a semi-regular bases.  This should give you the options of choosing beginners/intermediate levels (always start with a beginner video no matter what your current lever-you never know where a program is going to lead and we don't want to start with injuries).  This should also give you videos hopefully led by practicing professionals.  Search YouTube, and keep looking until you find something that clicks with you.  



These standing positions , or sun salutations, are usually where I lose my vision.

These standing positions , or sun salutations, are usually where I lose my vision.

I found that I have a specific positional triggers to my disorientation- seated to standing movements.  These triggers may or may not be the same for you.  If they are not you should try to note when your specific triggers occur and proceed slower through these movements to maintain balance or abort all together if they induce pain.  If they are her triggers, pick a video that goes slow enough that she can go from seated or engaged positions to standing  (or whichever her triggering movements are) with her EYES CLOSED.  I found the eyes being closed through the movement to be KEY to me being able to focus on balance and muscle control rather than being disoriented by losing vision - your eyes are already closed.  

Start slow.  Sometimes you can only do 5 minutes and that's okay.  Endurance builds with repetition, so if you can go slow into a practice (stopping the moment you becomes disoriented) but every 2 days (or whatever your mobility/stamina will allow) to create a habit, 5 to 10 minutes will quickly turn into longer practices.  



The videos I have found to be most beneficial to me are released through NAMU, the  one I felt helped me get into good form and posture was Aula de yoga para iniciantes- vinyasa yoga | Fernanda Cunha (linked here-this is the first video I felt I could follow and repeat).   You can search through the NAMU library through the link as well. Now even if you do not speak Portugues/Spanish I highly encourage you to watch the first one to three minutes to get an idea of the speed at which she moves you through the movements and listen to how much she explains.  You want a video with an instructor who is constantly giving positional cues and muscle management techniques.  Our proprioceptive issues like a lot of cues to work together.   Disorientation can come from not being instructed through a position properly.  

Also, KEEP A BOTTLE OF WATER WITHIN ARMS REACH THROUGHOUT EXERCISE.  While this is merely a personal suggestion, I found marked improvement and ability to return to my exercise from drinking water as soon as I was overcome by disorientation during exercise.  Water helps cardiovascular function, and having water readily available allows her to at least distract part of the episode by focusing on drinking.  It definitely won't do any harm to have it available.

I went through MANY videos before I found a practice that worked for me.  You should never feel pressured to finish a practice that is not going at your pace or makes you uncomfortable.  Feel free to try 2 practices at a time to eliminate ones she knows will not work for you (you should feel fairly quickly if a video is going to work out).

If you are feeling good with a routine the most important part is to keep with it.  We are prone to a quicker rate of muscle deconditioning, so keeping a regular exercise schedule will eventually build muscle mass which improves posture, proprioception, and stability;   and the only way to retain all of this is to do it on a consistent basis.    I have personally found morning to be best, it helps set my balance for the day.  I cannot always make that goal though.

If you finds certain postures are exceptionally painful, always consult a physician.  I found a website that highlights which postures have injury contraindications.  You can use it as a guide to what he culprit may be.


  • Yoga not only improves stability (which is HUGE), with consistent practice.
  • It can help prevent injuries, and/or improve recovery time.  
  • Boosts mood by releasing endorphins (a benefit of all forms of exercise).
  • Improved mood can help alleviate depression and anxiety OVER TIME (this takes a while so don't be discouraged).
  • Allows you to feel more in control of your body (I know for me I feel like there is a huge disconnect between what I want my body to do and what actually ends up happening so another huge benefit for me).
  • Hot bod at the end of it all (fingers crossed!).

I hope this helps.

Do you have any tips/tricks that have helped you through your routines, please share below!