In this article, we will discuss joint laxity and postural control.
Have you ever been told that you have loose joints?
Joint laxity is a condition that is generally beyond the range of motion, and is said to be related to women, family history, young age, and athletic characteristics.
How it is used in clinical practice is up to your imagination, but I found an interesting study that I would like to share with you.
The study
The study aimed to investigate the potential relationship between joint relaxation and postural balance using the Tetraataximetric Postural Recording Method (Tetrax®).
A total of 69 participants were included and were classified into three groups based on hypermobility severity as determined by the Beighton-Horan Hypermobility Index score.
Of those, 29 participants were found to be non-hypermobile, 13 participants were found to be mildly hypermobile, and the remaining 27 patients were found to be severely hypermobile.
The participants' postural control was assessed using the Tetrax® device in eight different positions.The stability index, Fourier index, weight distribution index, and synchronization index scores were recorded for each participant.
Results showed that participants with severe hypermobility had significantly higher stability index scores while extending their head position and rotating to the right.
The weight distribution index of the elastic surface was impaired in non-hyper-mobile and severely hypermobile participants.
Fourier index scores were observed to be higher at higher medium frequencies (0.5 to 1 Hz) in participants with severe hypermobility.
There was no difference between the groups in terms of synchronization index score.
In conclusion, the results suggest that individuals who are determined to be severely hypermobile have decreased postural stability in the extended head position and in the rotated head position when compared to non-hypermobile individuals.
This increased instability may lead to an increased risk of musculoskeletal injuries, especially in sports that require head extension and rotational movements.
Joint laxity
The presence of joint laxity can be determined by the following
1. Finger hyperextension test
In the forearm retroversion position, the examiner extends the subject's five fingers until pain is felt.
A score is added for any range of motion greater than 90°.
2.Elbow hyperextension test
The amount of elbow extension is measured with a goniometer, and a score is added for hyperextension exceeding 10°.
3.Sump opposition test
Bend the wrist and extend it so that the fingers touch the forearm.
If the fingers attach to the forearm flexor surface, a score will be added.
4.Knee hyperextension test
In a standing position, bend forward with both knees extended.
The amount of knee extension is measured using a goniometer.
If the knee is hyperextended by more than 10 degrees, a score will be added.
5. Forward Bend Test
Bend forward and touch the floor with both knees extended.
If your palms and hands touch the floor, your score will be added.
The score results in 0~9, with 0~2 being no joint laxity, 3~4 being moderate, and 5~9 being obvious joint laxity.
This is the Beighton-Horan Joint Mobility Index, which is a simple test using only a goniometer.
It cannot be self-diagnosed, so if you want to know, you have to go to a specialist.
Why do we have imbalances? Consider
The results of the study showed that rotating the head to the right and in a retroflexed position caused a loss of standing balance, but the same thing may be seen when the eyes are open and the head is retroflexed.
This suggests that the stress on the vestibular region and the muscles of the neck may cause imbalance. This may be the case.
It should be noted that some cases of orthostatic hypotension with vestibular neck disorder may not originate from vestibular and neck muscles, as it may also be related to orthostatic hypotension of autonomic dysfunction origin.
Back to the topic at hand, the neck has a high density of muscle spindles and cervical afferents are involved in tonic cervical reflexes to maintain postural stability.
It is also known that weak intrinsic receptive signals derived from knee receptors impair balance.This suggests that imbalance is not a surprising problem for people with joint laxity, when intrinsic receptor problems are also taken into account.
Given that people with joint laxity who do not fall into these categories can also have problems with postural control, health care professionals working with athletes should also be aware that being aware of this can be helpful in injury prevention.
In the case of vestibular disorders, it may be necessary to consult a specialist, but even in cases of muscular origin, those involved need to take measures to help these people.
Although the study did not provide specific methods, one recommendation was to provide a program to activate the muscle groups derived from standing balance. This is a good idea.
Aydın E, Metin Tellioğlu A, Kurt Ömürlü İ, Polat G, Turan Y. Postural balance control in women with generalized joint laxity. Turk J Phys Med Rehabil. 2017; 63(3):259-265. published 2017 Jan 2. doi:10.5606/tftrd.2017.160
Conclusion
The results of this study suggest that people with joint laxity, for whatever reason, have difficulty with postural control and lose balance when in certain positions.
Based on the conditions that are likely to be present, athletes who play aesthetic sports or ball games should consider the possibility that there is a cause for this when they have poor balance.
I have a score of 5 or higher on the test mentioned above, so I am not good at standing balance, but I was convinced by the research.
I would like to start taking some measures.
