If you live with ME, Long COVID, fibromyalgia, EDS, hypermobility, POTS, or orthostatic symptoms, yoga can be supportive, but only when it is adapted to your body and your capacity. Many people have been taught that yoga should feel like a workout, a stretch, or a push. For complex chronic illness, the most helpful yoga often looks very different: slower, smaller, steadier, and far more resourced.

This post offers simple, practical guidance for building a yoga practice that is actually nourishing. Not draining. Not performative. Not something you have to recover from.

The foundation: smaller, slower, and supported

A supportive practice starts with one core idea: start smaller than you think. Rest and pacing are essential. Never push.

For many chronic illness bodies, the goal is not to get deeper into a pose. The goal is to stay regulated enough that your nervous system can learn safety and your body can feel supported. That means choosing stability over intensity, comfort over effort, and function over form.

Yoga can be done from bed, a couch, or a chair. Choose what feels supportive, not what it “should” look like. You do not need to be flexible, strong, or upright for it to count.

You are always in charge

One of the most important parts of an adapted practice is consent.

You are always in charge. You can pause, skip, or rest at any time, no explanation needed.

When your body has unpredictable symptoms, that permission is not a nice bonus. It is the whole container. A safe practice is one where your nervous system does not have to brace against pressure or expectations.

A simple symptom guided approach

Use your body’s feedback as data, not a verdict.

Pain, tingling, dizziness, nausea, shakiness, air hunger, or feeling worse later are signals to scale back, pause, or skip the movement. These are not signs of weakness. They are information that your system needs something different today.

A very helpful tool is the next day check in.

Practice with a next day check in. If you feel worse later or the next day, make it smaller and slower next time. If you feel okay, keep it the same or build very gently.

For many people with ME and post exertional malaise, this is essential. The goal is a practice that supports you today and does not steal from tomorrow.

Breathwork and guided rest are not optional extras

Breathwork and guided meditation support the nervous system, which is why they are in every class I teach and why they belong in your personal practice too.

Movement is only one piece. For many chronic illness bodies, the most regulating practices are the simplest ones: a steady exhale, a supported rest, a gentle body scan, a few minutes of guided downshifting.

If you do not know where to start or symptoms are severe, start with your breath and visualize the movements. It builds pathways in your brain and nervous system. Visualized movement counts. It can be a powerful bridge on low capacity days.

POTS and orthostatic symptoms: start low and transition slowly

If you have POTS or orthostatic symptoms, begin lying down and move very slowly between positions. Pause often.

A few practical ways to make this easier:

• Choose mostly reclined or side lying practices

• Take your time before sitting up, and pause before standing

• Keep a sip of water nearby

• Use pillows or a wedge to support a gradual incline

• When in doubt, return to the floor, bed, or couch

Often the most supportive class is one that does not require frequent position changes.

EDS and hypermobility: mid range stability over deep stretching

If you have EDS or hypermobility, stay in a gentle mid range and choose stability over depth. Avoid end range stretching, locking joints, or pulling on flexibility.

In practice, that can look like:

• Micro bends in elbows and knees

• Using props to reduce load and increase support

• Moving slowly enough to feel where you are in space

• Prioritizing strength and control more than stretch

• Avoiding long passive holds in deep ranges

Many hypermobile bodies are already flexible. What they often need is steadiness, muscle engagement, and a sense of joint safety.

The most helpful yoga is consistent, not intense

Consistency matters more than intensity.

For chronic illness, the best practice is the one you can return to without paying for it. That might be five minutes. That might be one pose with a pillow. That might be breathing with your hand on your belly.

A gentle rhythm helps your nervous system trust the practice. Small, repeatable inputs often create more change than occasional big efforts.

Choose the right kind of class

Not all yoga is designed for complex chronic illness. Look for teachers who understand pacing, post exertional symptom flares, orthostatic intolerance, hypermobility, chronic pain, and sensory sensitivity.

Find a teacher or practice that understands your conditions and feels like a good fit for you.

Signs a class is likely a good fit:

• Lots of permission and choice

• Clear options for bed, chair, and floor

• No pressure to keep up

• Emphasis on nervous system support

• Encouragement to stop before strain

• A pace that feels spacious, not rushed

If a class consistently leaves you more symptomatic later, it is okay to move on. Your body is allowed to be the authority.

A simple way to know you are in the right range

Here is an easy guideline you can use during any practice:

You should feel more settled as you go, not more depleted.

A supportive practice often feels like:

• calmer breath

• less gripping in the jaw, shoulders, belly

• a sense of warmth or heaviness

• steadier energy

• less internal urgency

If you notice bracing, strain, breath holding, or symptom escalation, that is your cue to make it smaller, make it slower, or rest.

What to do on flare days

Flare days deserve a plan that does not require decision making.

On low capacity days, try one of these:

• one to three minutes of slow exhale breathing

• a guided body scan with an eye pillow

• a hand on heart and belly with a gentle phrase, like “I can go slowly”

• visualization of one or two simple movements

• legs supported on pillows or a chair, if that is comfortable for you

This is still practice. This is still care.

A gentle invitation

If yoga has felt unsafe, inaccessible, or frustrating in the past, you are not alone. Many people with complex chronic illness have had experiences where yoga did not understand their reality.

A nourishing practice meets you where you are. It adapts. It respects your limits. It supports your nervous system. It helps you feel more at home in your body, even in small ways.

If you want to try a class, come exactly as you are. Start smaller than you think. Rest when you need to. Let it be gentle, low pressure, and truly supportive.