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Ligament laxity: The downside of flexibility
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Ligament laxity: The downside of flexibility

Excessive flexibility of ligaments increases the risk of instability and injuries, making it all the more important to differentiate it from the normal flexibility range

Ligament laxity refers to the looseness or excessive flexibility of the ligaments that can make people vulnerable to injuries

Many of us would have attempted this childhood challenge — to bend the thumb backward and make it touch the forearm. Some would have succeeded too. The ability to flex certain joints varies from person to person — some can easily do it, while others cannot. While excessive flexibility comes easy for some, it is still considered atypical due to several factors, including the fact that it elevates the risk of instability and injuries.

Ligament laxity refers to the looseness or excessive flexibility of ligaments, the connective tissues that stabilize and attach bones to joints. “Differentiating between normal and abnormal flexibility might be challenging at times,” says Dr Vaibhav Bagaria, orthopedic surgeon and director, department of orthopedics, Sir HN Reliance Foundation Hospital, Mumbai. “While some people think that they are inherently very flexible, there is a fine line separating natural variation from abnormality, which calls for medical intervention.”

If you are capable of particular movements, such as bending your thumb and touching your forearm with its tip, it may indicate that you are naturally flexible. However, it could be a sign of abnormality as well, and it is important to differentiate that.

Normal joint flexibility vs ligament laxity

Ligaments not only provide stability but also some degree of flexibility within the normal physiological range. This is needed to perform regular activities. “The ligament provides a degree of laxity needed to carry out certain tasks [for instance, kicking a football] and recoils to its original shape after the movement,” says Dr Bagaria.

“Ligaments typically have a laxity of two to four millimeters. However, it can range from three to five millimeters in individuals who are hyperflexible, which is still considered a normal variation from what the majority have,” he adds. The laxity is considered excessive when it goes beyond that range and interferes with your daily activities to the point where your joint gives way or you experience joint instability. “If it is happening in more than one joint and you feel that your joint is giving way or you experience instability when performing daily activities like walking or running, you should seek evaluation from a healthcare professional,” explains Dr Bagaria.

A loss of stability is indicated by abnormal mobility. Ligament laxity can also be caused by injuries to the ligament, ranging from minor damage to complete tears. According to Dr Bagaria, the anterior cruciate ligament (ACL) is injured most often, especially in sportspersons.

Consequences of ligament laxity

The exact area of laxity determines the detrimental effects. “For instance, if it is on the knee, people are more likely to fall while walking on uneven surfaces. It may also affect their self-confidence when playing sports. They can become reluctant to participate because they’re constantly worried about their unstable knee,” says Dr Bagaria.

Excessive laxity increases the possibility of frequent instability episodes. There’s an elevated chance of joint surfaces rubbing against one another, raising the risk of arthritis. Although arthritis is a common phenomenon among older adults, inadequate ligaments can cause the condition to develop early.

Treating ligament laxity

The initial phase of treatment involves making slight modifications to daily activities, such as limiting motions that result in the affected joints bending excessively. This is followed by strengthening the muscles that surround the affected joint. “Strengthening exercises, balance and proprioception training, taping the affected joint, etc., are a few steps involved in treating ligament laxity with the help of a physiotherapist,” says Dr Bagaria. “We recommend braces in certain situations to maintain proper support and avoid injuries, especially during activities like trekking, which need more leniency.”

Surgery is the only option in severe cases of ligament laxity, where it restricts one from performing a lot of everyday activities. “Arthroscopic or keyhole surgery is mostly performed, where a portion of their tendon is used to form a new ligament. It is referred to as ligament reconstruction or repair,” says Dr Bagaria.

Takeaways

  • Ligament laxity refers to the looseness or excessive flexibility of ligaments, the connective tissues that stabilize and attach bones to joints.
  • Although the ligament allows for a certain amount of laxity when performing regular tasks, too much of it can cause the joint to give way, resulting in instability.
  • Ligament laxity can make people vulnerable to injuries and prevent them from participating in sports and other physical activities. It can also raise the risk of developing arthritis at an early age.
  • The condition can be treated through strengthening and balance exercises, minor variations in daily activities and wearing a brace. Severe cases require surgical intervention.

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