Connective tissue laxity – what problems does this cause?

We have talked about ligament laxity, hypermobility and connective tissue laxity previously:

What is the best term to describe this problem: ligament laxity, hypermobility or connective tissue laxity?

As this previous posts suggests, the term connective tissue laxity (CTL) is the preferable description of the problem.  The advantage of CTL over the others is that the description includes the ligaments, tendons and fascia.  It does not focus only on the ligaments.  So, what does CTL change?  Well, nearly all the relationships between your bones will be compromised to a degree.  Even your stiff joints, such as your sacroiliac joint, will be more mobile than normal.  Your more mobile joints, such as your shoulders, will be able to move too freely and in an uncontrolled way at times leading to injury

What are the problems we see that are associated with connective tissue laxity:

Over our time treating patients we have found that CTL leads to the following problems:

A collapse of arch in the feet as the stretchable ligaments of the foot can’t maintain the arch.  At the same time, the tendon from the Tibialis anterior is also able to stretch too far and can’t support the arch.

The mechanism for toe-ing off when walking is compromised by flat feet.  This leads to joint injury in the 1st toe and may lead to bunion development.

The ankle joint is compressed leading to joint pain.

The ankles are also unstable as a result of the ankle ligaments being too lax.  This increases the occurrences of sprained ankles and further joint damage.

The knees are liable to hyper-extend leading to cartilage compression at the front of the knee and compromised tracking of the kneecap.Knee hyperextension

The sacroiliac joints are normally held together by a band of really taught ligaments.  Someone with CTL will often present with a functional leg-length inequality because their SI joints have moved.

This leg-length inequality leads to trigger points in the medius and min Gluteal muscles.  This can cause associated leg pain that is misdiagnosed as ‘sciatica’ and treated as such.  This may also lead to the development of scoliosis in some people.

Leg-length inequality also means the unstable low-lumbar spine sits on an uneven base.  This leads to low-back pain and lumbar joint compression and then on to posterior facet syndrome.

The mid-thoracic joints will move in strange ways leading to joint injury.  This is particularly so if you have to spend time working in front of a computer and an anterior curve can then develop.

Your anterior head carriage may be worse than that of your peers because your ligaments allow greater movement.  This will lead to neck pain, shoulder and neck muscle trigger points and possibly neck generated headaches.

Your temporomandibular joint will move in unusual ways leading to injury and pain.

And all your joints will click which will annoy you and others and you will be one of those people who cracks their knuckles.

This is far from the full list of the possible impacts of connective tissue laxity.  However, I think you have to agree, it’s a pretty impressive list.

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