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Author: Karen Robinson
Role: Senior Physiotherapist
Date written: January 2008
Last reviewed: July 2016
Review date: July 2019
Version: 2.0
Code: PI0031
Ligament Laxity (page 1 of
2)
What are ligaments?
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 preventing the joint moving in the wrong
direction and limiting the amount of movement in the right directions.
Some joints need to be more stable than others. You have less movement at
your hips and more in your shoulders, which enables your hip to support you
when walking and gives your shoulders the ability to move freely to reach up
high or throw a ball.
Why are ligaments lax (loose) and does it matter?
• the cause of ligament laxity is not known but it is often common within
families, and within the human population there is a wide variety of joint
flexibility
• frequently, lax ligaments are not considered a problem, in fact for
dancers and gymnasts being ‘stretchy’ is useful. Most people with
flexible joints do not experience pain or discomfort
• 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
• bendy ligaments in the wrist and hand can affect handwriting. Primary
school teachers have writing skills programmes or pencil grips which
help most children that this affects. If a child continues to experience
difficulties they can be referred to a children’s occupational therapist
• children with bendy joints can take longer to develop the strength
required for good balance (for example standing on one leg). They may
have flatter foot arches that can contribute to slower development of
motor skills
• children with bendy joints may be less aware of the position of their
joints (a sense called proprioception). This is because the nerve
endings that detect joints moving are inside the ligaments. Practicing
balance activities can help to improve this sense and prevent injury (for
example sprained ankle)
• children can sometimes look unco-ordinated when they walk or run due
to the increased range of movement they are working to control. This
can become more evident during growth spurts.
Children’s Physiotherapy
01722 336262 ext 4667/2280
© Salisbury NHS Foundation Trust
Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ
www.salisbury.nhs.uk
Ligament Laxity (2 of 2)
Physiotherapy for flexible / bendy joints
How physiotherapists can help:
• promoting exercise and increasing stamina
• increasing awareness of good posture
• managing muscle fatigue and aches
• provision of advice regarding footwear.
Top tips for exercise if your child has bendy joints
• choose activities that your child enjoys and is interested in. This will help to develop an
enjoyment of physical exercise that should last through childhood and into adult life
• sedentary/less active children may be more likely to experience joint pains associated
with excess flexibility
• it is usual to have mild muscular aches after exercise, especially as your child builds their
muscular strength. It is okay to ache on the day of exercise but if your child experiences
pain or discomfort into the following day they may require more time to build their
exercise routine (for example swim for 30 minutes rather than 40 minutes)
• if a specific activity causes discomfort then some sports are best avoided
• pace your child’s activities through the week. Completing too many activities one after
the other can result in discomfort or fatigue
• swimming is a whole body exercise with less impact on joints. Playing in water is
beneficial, this can include walking in the water, jumping and pushing off the sides. If
your child has any discomfort, it is best to avoid breaststroke and butterfly
• cycling places less impact on legs. Younger children can try balance bikes or trikes
• dancing and gymnastics can be appropriate. Tell your child’s instructor if they have
bendy joints or injuries
• competitive sports can be challenging but the skills needed for these sports can be fun,
for example Brazilian Soccer Schools
• older children can benefit from Pilates as it promotes good posture and core muscle
strength
• use your local play park or soft play
• find time for family walks
• make obstacle courses or play ball games in the garden
• activity ideas to complete at home can be found on www.nhs.uk/change4life.
This leaflet has been supplied to support the information provided during your physiotherapy
appointment. If you have any questions specific to your child please contact your
physiotherapist directly.
Children’s Physiotherapy
01722 336262 ext 4667/2280
© Salisbury NHS Foundation Trust
Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ
www.salisbury.nhs.uk