Ligament laxity, or as I prefer to call it Connective Tissue Laxity (CTL), can really cause problems. Although it is often and incidental finding during an examination, is a really important finding.
So, what are ligaments?
Ligaments are part of a group of tissues called your connective tissue (CT). CT is a term used to describe the biological tissue that supports, connects or separates different types of other tissues and organs in your body. Therefore, your ligaments, tendons and fascia are part of your CT.
What’s the difference between ligaments, tendons and fascia?
- A ligament is the fibrous CT that connects bones to other bones. Skiers knows about the Anterior and Posterior Cruciate Ligament (ACL and PCL) in a knee joint.
- A tendon is the fibrous CT that connects a muscle to a bone and in some cases to a muscle of a bit of fascia. Most runners will know about the Achilles Tendon.
- Fascia is the fibrous tissue that connects muscles to other muscles.
Ligaments are similar to tendons and to fasciae as they are all made of connective tissue. This connective tissue is the material that holds you together. It 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 it protects most of your joint surfaces.
Normally, your ligaments are naturally just tight enough to stabilize your joints so that they are restricted only to ‘normal’ ranges of motion. This is really important because it creates stability and prevents joint injury. It is when your CT is too pliable that things start to go wrong.
What is Ligament Laxity – or better Connective Tissue Laxity?
If your CT’s matrix is formed incorrectly the ligaments, tendons and fascia can all become more pliable than normal and are unable to handle loading. This means that any structures in your body, which are usually stabilized by your CT, are able to move further than normal. As a result of this, people with this CTL problem are often categorized as having hypermobile joints or are “double-jointed”. This hypermobility can appear in a variety of ways and levels of severity. It 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 by doctors who are not looking for it, 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. Connective tissue laxity is almost certainly hereditary and possibly sex-linked, as 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 if you’re female, but perhaps not if you are male.
Connective tissue laxity is usually something you would just be aware of, rather than it be a serious medical condition. There may even be some advantages – you may be able to withstand pain from hyperextension of a joint. However, this is also a significant disadvantage as a lack of perceived pain can prevent you from removing the ligament from injury, leading to ligament and joint damage. CT laxity is important as it a cause of chronic body pain characterized by loose ligaments.
What are these problems we see as as result of having CTL?
The short list is shown in this next blog, here: