How to Get Past Plateaus after Stroke

How to Get Past Plateaus after Stroke

By Dr. Daniel K. Zondervan

If you or a loved one has had a stroke, you know that the road to recovery is not a straight line. Often times there is rapid recovery during the first three months, but then progress slows down. This eventually leads to a dreaded “plateau” in recovery after about six months. Today we are going to dissect that plateau, and then give you some practical tips on how to get past it.

Is the Plateau a Real Thing?

Before we go any further, let’s get the hard truth out of the way. Plateaus during stroke rehabilitation are real and well-documented. Basically what this means is that there will come a time when things get difficult. For a long time, doctors and scientists believed that this was the end of the road. The good news is that now we know that they were wrong.

Why Do Plateau’s Occur?

In order to know how to break out of plateaus, it helps to understand what causes them to begin with. Immediately after a stroke, the brain goes into a “heightened state of plasticity”. This gets complicated, but you can think of it as a defense mechanism for the brain. When the brain is damaged by a stroke, it reacts by temporarily making it easier for itself to reorganize. This reorganization is responsible for a lot of the spontaneous recovery that happens in those first three months after stroke. Unfortunately, the brain eventually reverts back to a less pliable, but still plastic state. This can feel like a flat line at first, but additional recovery is still possible.

Another reason plateaus occur is the basic fact that any time we try to learn something, whether we have had a stroke or not, we experience what are called “diminishing returns”. I’ll give you an example. Say you want to learn to draw, so you sign up for a drawing class. If it is your first class, you are going to leave knowing ten times more about drawing than you did before you started. Now fast-forward a year. The difference in your drawing ability between your 100th class and your 101st class is going to be much smaller. But again, that doesn’t mean you’re not improving. The same goes for recovery after stroke. Which brings us to the best part.

How to Get Past Plateaus (Yes It Is Possible!)

The number one most important thing you can do when things get tough is this: don’t give up. You may feel like you have stalled out, or that any further recovery is out of your reach. That is just not true. Study after study has shown that if you continue to work hard, you will get better. Just be patient. If you need some help, we have some great tips for keeping up your motivation.

Another great tip is to try something new. Think back to our drawing example. It probably makes sense to you that if you switched into a more advanced class after a year, you would start learning a lot more again. In terms of stroke rehabilitation, you can change up your regimen, try a new type of therapy, or pick a new skill you want to learn (like playing piano) and practice that. Simple changes like this can give you a boost, since they add the variety the brain craves during learning. Plus mixing it up makes it easier to maintain your motivation, because you don’t feel like you are stuck doing the same things day after day.

So remember, don’t give up hope. Even when the road is dark, there is always a light up ahead. You just have to know where to look.

About the Author

Dr. Daniel K. Zondervan received his Ph.D. from UC Irvine, where he performed research on novel methods for optimizing stroke recovery. He has over six years of experience in the field of rehabilitation science and has published several peer-reviewed journal articles on the topic. He now writes for Flint in hopes of using that knowledge to impact a broader audience.