Ligamentous Laxity and Hypermobility of the Knee.
What is ligamentous laxity or hypermobility of the knee?
Ligamentous laxity of the knee refers to increased looseness in the ligaments that support and stabilise the knee joint. People often describe their knees as feeling "too flexible," prone to giving way, or just never quite right despite no obvious injury. It is sometimes called knee hypermobility, and while the terms are often used interchangeably, ligamentous laxity specifically refers to the looseness of the ligaments themselves, while hypermobility describes the resulting excess range of motion in the joint.
This is not a rare condition — it is more common in women, in people with connective tissue disorders such as Ehlers-Danlos Syndrome or joint hypermobility syndrome, and in dancers, gymnasts and other flexibility-based athletes. It can also develop after significant knee injuries where the ligaments have been stretched or partially torn.
What causes it?
The most common causes are genetics and connective tissue differences — some people simply have naturally looser ligaments across multiple joints, not just the knee. Conditions like Ehlers-Danlos Syndrome and Marfan Syndrome are often associated with systemic hypermobility that includes the knee. Hormonal changes, particularly during pregnancy, can also temporarily increase joint laxity. Previous knee injuries, including ligament sprains and tears, can leave residual laxity even after the tissues have healed.
Symptoms
The most common complaints are chronic knee pain, a sense of instability or "giving way," swelling after activity, and difficulty with activities that require sustained stability — such as standing for long periods, walking on uneven ground, going down stairs, or participating in sport. Some people find that their knee hyperextends (bends backward beyond straight) which can be painful and contributes to poor mechanics further up the chain.
It is worth noting that not everyone with knee hypermobility experiences symptoms. The problems tend to arise when the surrounding muscles are not strong or coordinated enough to compensate for the loose ligaments, which is exactly where physiotherapy comes in.
How is it diagnosed?
Diagnosis is primarily clinical — a physiotherapist will assess your range of motion, joint stability and movement patterns, looking at how the knee behaves under load compared to normal. Assessment often includes the Beighton Score, a standardised nine-point scale widely used to measure generalised joint hypermobility, which helps determine whether hypermobility at the knee is part of a broader pattern across multiple joints. Imaging such as X-ray or MRI may be used to rule out structural damage like meniscal tears or ACL injuries that can present with similar symptoms.
How can physiotherapy help?
This is a condition where physiotherapy can make a genuine and lasting difference. Because the ligaments themselves cannot be tightened without surgery, the goal is to build the muscular support system around the knee to the point where the joint behaves stably despite the laxity. With the right program, most people with knee hypermobility are able to return to full activity including sport.
Treatment at Articulate typically includes targeted strengthening of the quadriceps, hamstrings, glutes and calf muscles, as well as balance and proprioception training to improve the knee's ability to self-correct under load. We also work on movement patterns — things like how you land from a jump, how you squat, or how your foot and hip position affects the forces going through your knee — because people with hypermobile knees are often using compensatory strategies that worsen their symptoms over time.
Where appropriate, taping or bracing can provide short-term support while the muscles are building strength. For people with a systemic connective tissue condition, we take a more comprehensive approach that considers the whole body rather than treating the knee in isolation. The Ehlers-Danlos Society is an excellent resource for patients wanting to understand more about hypermobility-related conditions, and Hypermobility Connect Australia provides local peer support and information for Australians navigating these diagnoses.
Our physiotherapists Yulia Khasyanova, Emma Cameron and Mauricio Bara both have specific experience with hypermobility and associated conditions. Yulia holds multiple certifications through the Ehlers-Danlos Society and has a particular interest in the complex presentations that often accompany systemic hypermobility. Both are members of the Australian Physiotherapy Association, Australia's peak body for the profession.
To book an appointment or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
If you or a loved one has questions about Ligamentous Laxity or Hypermobility of the Knee and how our physiotherapists might be able to help please call us on 07 3706 3407 or email [email protected]. We would love to work with you!
Ligamentous laxity of the knee refers to increased looseness in the ligaments that support and stabilise the knee joint. People often describe their knees as feeling "too flexible," prone to giving way, or just never quite right despite no obvious injury. It is sometimes called knee hypermobility, and while the terms are often used interchangeably, ligamentous laxity specifically refers to the looseness of the ligaments themselves, while hypermobility describes the resulting excess range of motion in the joint.
This is not a rare condition — it is more common in women, in people with connective tissue disorders such as Ehlers-Danlos Syndrome or joint hypermobility syndrome, and in dancers, gymnasts and other flexibility-based athletes. It can also develop after significant knee injuries where the ligaments have been stretched or partially torn.
What causes it?
The most common causes are genetics and connective tissue differences — some people simply have naturally looser ligaments across multiple joints, not just the knee. Conditions like Ehlers-Danlos Syndrome and Marfan Syndrome are often associated with systemic hypermobility that includes the knee. Hormonal changes, particularly during pregnancy, can also temporarily increase joint laxity. Previous knee injuries, including ligament sprains and tears, can leave residual laxity even after the tissues have healed.
Symptoms
The most common complaints are chronic knee pain, a sense of instability or "giving way," swelling after activity, and difficulty with activities that require sustained stability — such as standing for long periods, walking on uneven ground, going down stairs, or participating in sport. Some people find that their knee hyperextends (bends backward beyond straight) which can be painful and contributes to poor mechanics further up the chain.
It is worth noting that not everyone with knee hypermobility experiences symptoms. The problems tend to arise when the surrounding muscles are not strong or coordinated enough to compensate for the loose ligaments, which is exactly where physiotherapy comes in.
How is it diagnosed?
Diagnosis is primarily clinical — a physiotherapist will assess your range of motion, joint stability and movement patterns, looking at how the knee behaves under load compared to normal. Assessment often includes the Beighton Score, a standardised nine-point scale widely used to measure generalised joint hypermobility, which helps determine whether hypermobility at the knee is part of a broader pattern across multiple joints. Imaging such as X-ray or MRI may be used to rule out structural damage like meniscal tears or ACL injuries that can present with similar symptoms.
How can physiotherapy help?
This is a condition where physiotherapy can make a genuine and lasting difference. Because the ligaments themselves cannot be tightened without surgery, the goal is to build the muscular support system around the knee to the point where the joint behaves stably despite the laxity. With the right program, most people with knee hypermobility are able to return to full activity including sport.
Treatment at Articulate typically includes targeted strengthening of the quadriceps, hamstrings, glutes and calf muscles, as well as balance and proprioception training to improve the knee's ability to self-correct under load. We also work on movement patterns — things like how you land from a jump, how you squat, or how your foot and hip position affects the forces going through your knee — because people with hypermobile knees are often using compensatory strategies that worsen their symptoms over time.
Where appropriate, taping or bracing can provide short-term support while the muscles are building strength. For people with a systemic connective tissue condition, we take a more comprehensive approach that considers the whole body rather than treating the knee in isolation. The Ehlers-Danlos Society is an excellent resource for patients wanting to understand more about hypermobility-related conditions, and Hypermobility Connect Australia provides local peer support and information for Australians navigating these diagnoses.
Our physiotherapists Yulia Khasyanova, Emma Cameron and Mauricio Bara both have specific experience with hypermobility and associated conditions. Yulia holds multiple certifications through the Ehlers-Danlos Society and has a particular interest in the complex presentations that often accompany systemic hypermobility. Both are members of the Australian Physiotherapy Association, Australia's peak body for the profession.
To book an appointment or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
If you or a loved one has questions about Ligamentous Laxity or Hypermobility of the Knee and how our physiotherapists might be able to help please call us on 07 3706 3407 or email [email protected]. We would love to work with you!
