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Ligament Laxity: A Missed Diagnosis from a Car Crash

Ligament laxity is also known as ligamentous instability. It is a condition that causes chronic pain and may affect any joint in the body. It is important to note that ligament laxity consists of those joints that extend beyond their normal range of motion.


Now, according to the American Academy of Orthopaedic Surgery, the commonest soft tissue injuries occur in or around the ligaments, tendons, and muscles.

Sudden trauma causes acute injuries. Sudden trauma includes a twist, fall, or sharp blow to any part of the body.

Examples of acute injuries include:

  • Contusions
  • Sprains
  • Strains

Photo Credit: Paolese


What are some other types of ligament laxity?

It is also important to note that there are other soft tissues in the body that are prone to injury. This includes the heart, lungs, brain, or other organs in the body. But medically, though, soft tissue injuries are usually limited to the tendons, ligaments, and muscles.

A closer examination of the structure of ligaments, tendons, and muscles shows that they’re basically connective tissues. The National Institute of Health defines connective tissues as “the material inside your body that supports many of its parts.” It shapes your tissues and keeps them strong.


What causes ligament laxity?

Ligament laxity results from extreme flexibility of the ligaments that surround your joints. The extreme flexibility of the ligaments allows these joints to move beyond their normal range of motion. Ligament laxity in most individuals is genetic and may start at a young age. At least one joint may be affected, and in some cases, the entire body (known as general joint hypermobility).

Ligament laxity also occurs after a ligament is damaged and fails to heal properly. The affected ligament loosens or becomes lax and does not support the joint as well as it should. In severe cases, joint damage may cause ligament laxity especially when the joint moves beyond its normal position. If ligament instability occurs in the region of the spine, the patient may suffer disc degeneration or osteoarthritis. Shoulder dislocations and sprained ankles are also common occurrences associated with ligament instability.

According to a 2013 study by Hauser and colleagues, the structure of an injured ligament is replaced with tissue that is similar to scar tissues biochemically, biomechanically, and grossly. Scar tissues that have been fully remodeled remain microscopically, grossly, and functionally different from normal tissues. Because the remodeled ligament tissue is inferior to normal ligaments, there’s a resulting laxity of the ligament, leading to disability of the affected joint, while other soft tissues surrounding the joints are predisposed to further damage.


Ligament laxity caused by automobile accidents

You see, most car crashes cause soft tissue damage. This soft tissue damage in turn causes ligament laxity.

Using whiplash as a case study, the torso and the head move in directions opposite to the impact force — this causes damage to the ligaments in the neck and spine.

Photo by C Joyfulon Unsplash

This may result in other injuries, as well as chronic pain. Secondary conditions experienced may include:

  • Numbness
  • Strains and sprains
  • Swollen joints
  • Pains in the neck and back
  • Discomfort when moving the torso or the neck

Diagnosis of ligament laxity is done via stress radiographs, joint mobility, and symptom evaluation. Treatment may vary but usually include Foundational Correction, anti-inflammatory medication, pain medication, braces, physical therapy, and/or movement, elevation traction, and heat (METH). In extreme cases, surgery of the neck or back may be recommended.


Can ligament laxity lead to permanent damage?

Ligament laxity can affect a person’s work-life or ability to carry out his/her activities of daily living.

Truth be told, ligament laxity is a costly condition, with expensive medical bills and even loss of one’s source of livelihood.

Also, ligamentous instability may lead to other injuries. The emotional distress resulting from the accident may trigger anxiety, depression, or mental health issues.

What’s more? Ligament laxity may have long-lasting physical effects if left uncorrected.


References

  • Ellis SJ. Tremor and other movement disorders after whiplash-type injuries
  • Journal of Neurology, Neurosurgery & Psychiatry1997;63:110–112.
  • Derrick, L J, and B M Chesworth. “Post-motor vehicle accident alar ligament laxity.”The Journal of orthopaedic and sports physical therapyvol. 16,1 (1992): 6–11. doi:10.2519/jospt.1992.16.1.6

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