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What Is Ligamentous Laxity?

Medically Reviewed by Dan Brennan, MD on May 11, 2021

Ligamentous laxity, or ligament laxity, means that you have hypermobile joints that are very flexible and have a wider range of motion than most people.

For many people, having loose joints is not a medical issue. It can even be advantageous to some, such as dancers, gymnasts, and musicians. But for others, it can cause pain and other problems.

What Are Ligaments?

Ligaments are bands of tough tissue that hold your bones together at the joints. They provide support and stability. Your ligaments prevent your bones from moving too far apart or twisting too much. 

Some of your ligaments aren’t connected to bones. Some ligaments hold internal organs, such as the womb, in place. Others may connect two or more organs together. For instance, ligaments hold your intestines, liver, and stomach in place. 

Symptoms of Ligamentous Laxity

Some of the symptoms that come with hypermobile joints include:

Causes of Ligamentous Laxity

An estimated 5% to 12% of adults have some form of flexible joints associated with ligamentous laxity.

Children tend to be more hypermobile than adults. It can be hard to tell if a child’s hypermobility is associated with an underlying disorder. 

There are some conditions that are associated with loose joints. These include:

Marfan syndrome. This is a rare inherited disease that affects your connective tissue. It affects about 1 in 5,000 people. Marfan syndrome can affect your heart, eyes, skin, blood vessels, lungs, and bones. Some of the complications can be very serious. An aortic aneurysm can cause the walls of your aorta to tear and blood to leak out.

People with Marfan syndrome tend to be thin and tall, with very long arms, fingers, legs, and toes.

Ehlers-Danlos syndrome. This is a group of connective tissue disorders. People with this syndrome usually have very stretchy skin and flexible joints. A more severe form called vascular Ehlers-Danlos syndrome can weaken your aorta and other arteries. It can also cause the walls of your large intestines, blood vessels, or uterus to rupture.

Ligamentous Laxity and Injuries

Ligamentous laxity can cause joint instability. When the ligaments around a joint become loose, torn, or weak, they may not be able to hold the bones in place. This is when dislocation or misalignment of the joint (subluxation) can happen.

Several studies have found links between injuries and ligamentous laxity. 

One study found that men with shoulder dislocation were 6.8 times more likely to have loose joints.

In a study of 51 male rugby players, researchers found that those who had high scores on the Beighton assessment, which is a way to test for hypermobility, had significantly more injuries than those who were not hypermobile. Both groups of players had similar strength, which means that strength doesn’t protect those who are hypermobile from injury.

Diagnosis of Ligamentous Laxity

There isn’t a formal standard for defining ligamentous laxity. But the Beighton test is the most widely used system for assessing hypermobility.

These are the joints that are tested:

  • Knuckles of your little fingers
  • Base of your thumbs
  • Knees
  • Spine
  • Elbows

When you take the Beighton test, your doctor will ask you to perform a series of movements. These include:

  • Bending forward and placing your palms on the ground with your legs straight
  • Bending your thumbs backwards
  • Bending your little fingers backwards

If you have a high Beighton score, it doesn’t necessarily mean that you have a hypermobility syndrome. Your doctor will also examine you and test you for other symptoms and signs of these syndromes.

The Beighton test does have a few drawbacks. It only tests a few joints, and it doesn’t tell you the degree of hypermobility.

Treatment of Ligamentous Laxity

You might not need treatment for ligamentous laxity, especially if it doesn’t cause any pain. See your doctor if your loose joints cause pain.

You can try physiotherapy exercises to help you strengthen your joints and make them more stable.

Before starting any physical activities that may cause injuries, splinting or taping your affected joints can be beneficial.

Prolotherapy. Some researchers have studied the effect of prolotherapy on those with pain and ligament laxity. Prolotherapy involves injecting an irritant solution into your ligaments. The irritant is usually a solution with a form of sugar called dextrose. It’s thought to help kickstart growth in the connective tissue, and this process will reduce pain.

But some studies have shown mixed results. Researchers also haven’t been able to prove this effect in lab studies. This has led some experts to think that prolotherapy provides a placebo effect.

WebMD Medical Reference

Sources

SOURCES:

AAP News: “When to refer a child with hypermobility for further evaluation.”

Anatomy, Posture, Prevalence, Pain, Treatment and Interventions of Musculoskeletal Disorders: “Joint Instability as the Cause of Chronic Musculoskeletal Pain and Its Successful Treatment with Prolotherapy.”

American Journal of Medicine: “Joint Hypermobility Syndrome: Recognizing a Commonly Overlooked Cause of Chronic Pain.”

Arthritis Foundation: “Prolotherapy for Osteoarthritis.”

British Journal of Sports Medicine: “Does generalised ligamentous laxity increase seasonal incidence of injuries in male first division club rugby players?”

BMC Musculoskeletal Disorders: “Arthralgias, fatigue, paresthesias and visceral pain: can joint hypermobility solve the puzzle? A case report.”

Centers for Disease Control and Prevention: “Marfan Syndrome.”

Cincinnati Children’s Hospital Medical Center: “Identification and Management of Pediatric Joint Hypermobility.”

Ehlers-Danlos Society: “ASSESSING JOINT HYPERMOBILITY.”

Hypermobility Syndromes Association: “What is the Beighton Score?”

InformedHealth.org: “What are ligaments?”

Iranian Red Crescent Medical Journal: “Generalized Ligamentous Laxity: An Important Predisposing Factor for Shoulder Injuries in Athletes.”

Medscape: “Ligamentous Laxity.”

Mayo Clinic: “Ehlers-Danlos syndrome,” “Marfan syndrome,” “Prolotherapy: Solution to low back pain?”

The Pediatric Upper Extremity: “Multi-ligament Laxity.”

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