Ligament Laxity (1 of 2) - ICID - Salisbury NHS Foundation Trust

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Author: Karen Robinson
Date written: January 2008
Approved: July 2008
Review date: July 2011
Version: 1.0
Code: PI0031
What is a ligament?
Ligament Laxity (1 of 2)
• Ligaments are strong, flexible bands that hold bones together at
joints.
• Ligaments help to keep joints stable, although they are not the only
structures to do this. Muscles also help to stabilise the joint.
How do ligaments stabilise joints?
Ligaments help to stabilise joints by:
a. Preventing the joint moving in the wrong directions.
b. Limiting the amount of movement in the right directions.
The joints in our fingers, thumbs, knees, elbows and ankles are
particularly reliant on ligaments for stability.
Why are ligaments lax (loose) and does it matter?
The cause of ligament laxity is not known.
• It is often common within families.
• There is a wide variety of ligament tension that is within normal
range.
• Frequently, lax ligaments are not considered a problem, in fact for
dancers and gymnasts being “stretchy” is useful.
• Ligaments cannot be altered by exercise, but do naturally tighten
as children grow. General activities to help increase muscle
strength and stamina will help stabilise joints.
What problems does laxity cause?
1. Difficulty with tasks involving finger strength:
• Opening packets e.g. crisps.
• Turning taps on/off.
• Unscrewing lids, opening lunch boxes.
• Doing buttons, laces etc.
• Manipulation e.g. Lego.
2. Difficulties with writing:
• Gripping a pencil more tightly than usual, to compensate for poor
stability.
• Holding a pencil in an unusual way, e.g. with an overlapping thumb,
Children’s Physiotherapy
01722 336262 ext 4667/2280
© Salisbury NHS Foundation Trust
Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ
www.salisbury.nhs.uk

with joints of the fingers pushed back excessively and with more of the fingers in
contact with the pencil.
• Pressing excessively hard onto the paper.
Although these strategies seem to help stability they hinder fluency and cause poor
blood flow through the muscles, resulting in cramps and pain.
• Poor sitting position when writing.
3. Difficulties with activities that involve walking, standing on one leg or balancing generally.
Children who have underdeveloped foot arches due to ligament laxity often find it difficult
to stand on one leg and can find sport involving balancing on one leg difficult.
Where arches are well developed, the weight of the body is taken through the outer border
of the foot and the muscles and ligaments are correctly aligned to control balance. If the
weight is taken through the inner border of the foot because of ligament laxity, the muscles
and ligaments are poorly aligned, making it more difficult to balance. This can cause foot
and calf pain and minor repetitive injury.
What can be done to improve function?
Using insoles to correct the foot position may limit the pain and may help increase stability.
Activities that gently increase stamina and muscle strength should be incorporated into
everyday activities, such as:
Gross motor activities
1. Playing in the park and indoor soft play.
2. Swimming.
3. Walking.
4. Playing non-competitive ball games.
Ligament Laxity (2 of 2)
Fine Motor activities
1. Using different width pens to help improve hand position when writing and reduce pain
(you can use an elastic band to widen a pen or pencil). If the child is overusing certain
muscles, and this is causing pain, they can benefit from massage and stretching, which
improves blood flow. Short rests and stretching whilst working can help.
2. Playing with Lego, Play Dough, model making etc. will increase finger strength.
3. A sloped writing board and a sloped cushion to sit on can help improve a sitting
position.
4. When using computers; short rests and stretching whilst working helps.
If you have any specific concerns regarding the above information, please contact your
child’s therapist on telephone number below.
Many thanks to Sally Wright who allowed us to base this information sheet on one that she
had produced.
Children’s Physiotherapy
01722 336262 ext 4667/2280
© Salisbury NHS Foundation Trust
Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ
www.salisbury.nhs.uk