There are many causes of ligamentous laxity, namely post-trauma, genetic causes, or overuse injuries. Typically, those who have ligamentous laxity present with tight and painful muscles that overlie the lax joint. Some are able to strengthen their muscles enough to stabilize the loose joint, however there is a sub-section of the population where their degree of ligamentous laxity coupled with their level of activity causes persistent symptoms. Usually, if you place external stability with either taping or bracing you may find a degree of improvement, and this may have predictive value of benefiting from ultrasound-guided prolotherapy to a lax ligament.
As the diagnosis of ligamentous laxity is clinical, it cannot be properly assessed with diagnostic imaging (x-ray or MRI), we rely on the presence of a history of trauma, congenital ligamentous laxity, or overuse injuries, coupled with positive physical exam finding of positive provocation testing. Typically, a health care provider with their manual therapy designation would be able to perform this type of testing. Once referred for ultrasound-guided prolotherapy, we would re-examine the area of concern to confirm the diagnosis and narrow down the lax ligamentous structures.