Hypermobility Syndrome, AKA Joint Hypermobility Syndrome (JHS), Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT), Hypermobility Spectrum Disorders (HSD)

October 31, 2015

Study: Ligaments: A source of musculoskeletal disorders

Ligaments: A source of musculoskeletal disorders

Solomonow, Moshe. "Ligaments: a source of musculoskeletal disorders."Journal of bodywork and movement therapies 13.2 (2009): 136-154.


This is an extremely informative review article by Moshe Solomonow, University of Colorado, on the mechanical and neurological properties of ligaments and how these properties relate to trauma induced disorders. I found the article useful to understand the various terminologies that are frequently used with ligamental pathophysiology. It was also interesting to read why I feel better after a night's sleep when I do, and why not when I don't. It also helped explain why frequent rest periods (which would be the equivalent of "regular rests" for healthy individuals) are important for the health of ligaments when they are not healthy in my condition. The benefit from exercises at the anatonical/structural level is also explained. The article does not mention hypermobility but explains both physiology and pathologies of ligaments in the context of collagen.

Some relevant excerpts: 

"Over all, moderate repetitive stimulation of ligaments coupled with appropriate rest and recovery allows the tissue to hypertrophy, increase its strength and protect joint stability in persons exposed to more demanding physical activity." 
"Similarly, static or repetitive loading of a ligament, within its physiological limits, when extended over a period of time result in creep which is an expression of cumulative microdamage within the collagen fibers structure of the tissue. The accumulated micro-damage triggers inflammatory responses as well." 
"Due to the mechanical properties of viscoelastic tissue, two classes of disorders originate from ligaments; mechanical and neuromusculoskeletal. Mechanical deficits such as joint laxity, instability, osteoarthritis, sprain, rupture, etc., are the direct result of creep, tension–relaxation, hysteresis and time/frequency dependence of the length–tension of ligaments. The same mechanical factors are also manifested with complex sensory–motor disorders (or syndromes) associated with changes in proprioception and kinesthetic perception, reflex activation of muscles, joint stability and overall performance."