Ligament laxity, which we think should be called Connective Tissue Laxity (CTL), is not a good thing. It can really cause problems. It is often an incidental finding during an examination, but is a really important finding.
So, firstly, what are these ligaments?
Ligaments are part of a group of tissues called your Connective Tissue (CT). CT supports, connects, and also separates, different types of tissues and organs in your body. Your ligaments, tendons and fascia are all part of this CT. Your ligaments are one of the structures that hold you together.
What’s the difference between ligaments, tendons and fascia?
Ligaments are similar to tendons and to fascia as they are all made of Connective Tissue. This CT is the material that binds you together. CT holds your bones in the right position; it controls the range of motion in most of your joints; it holds your organs in their correct place and protects most of your joint surfaces. If you want a fuller description here you go:
- A ligament is fibrous CT that connects bones to other bones. Skiers often know about the Anterior and Posterior Cruciate Ligament (ACL and PCL) in a knee joint. Why? because these are the ones they tear.
- A tendon is also fibrous CT. They connect muscle to bone and, in some rare cases, muscle of a bit of fascia. Most runners will know about the Achilles Tendon. Why? because this is the one they often sprain/strain.
- Fascia is the fibrous tissue that separates organs form other organs. It also connects muscles to other muscles.
Normally, your ligaments are just tight enough to stabilize your joints so that they are restricted only to ‘normal’ ranges of motion. This is really important because this creates stability and prevents joint injury. It is when your CT is too pliable, such as in CTL, that things start to go wrong.
What is Ligament Laxity (or better Connective Tissue Laxity)?
If your Connective Tissue is formed incorrectly the ligaments, tendons and fascia can all become more pliable than normal. They are then unable to handle loading correctly. This means that any structures in your body, which are usually stabilized by CT, are able to move further than normal. This can lead to joint injury.
Your joints are allowed to move through a wider range of motion than ‘designed’ and get damaged. This leads to compression and joint injury.
People with CTL are often categorized as having hypermobile joints or as being “double-jointed”. This hypermobility can appear in a variety of ways and levels of severity. However, CTL does not always affect the entire body. For example, it is perfectly possible, and pretty common, just to have lax ligaments of the feet.
Connective tissue laxity can also be as as result of an injury, such as a car accident. It can result from whiplash and can be overlooked for years, despite the chronic pain that often accompanies CTL and the associated spinal instability.
When this condition affects joints in the entire body, it is called generalized joint hypermobility, which occurs in about five percent of the population. It is almost certainly hereditary and we see it far more in females than males. So, if your mother can touch the floor with her hands, then you should be able to do so as well.
What are the problems we see as as result of having CTL?
CTL is usually something you would just be aware of, rather than it be a serious medical condition. There may even be some advantages in having CTL. You may be really good at gymnastics or dancing. You may also be able to withstand pain from hyperextension of a joint. However, there are some significant issues with having CTL. These are covered in the subsequent blog set out below. It can lead to a lack of perceived pain which can mean that you don’t remove the ligament from injury, leading to ligament and joint damage. CTL is important as it is a cause of chronic body pain.The short list is shown in this next blog, here: