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Clenched Hand After Stroke: Causes, Treatment, and Rehabilitation Techniques

man with relaxed hands after rehabilitation for clenched hand after stroke

A clenched hand after stroke occurs when spasticity in the hand begins to worsen into a contracture. This can lead to curled fingers, tight joints, and a clenched fist.

To help you relieve spasticity and contractures in the hand after stroke, this article will discuss everything you need to know. Let’s get to it.

Cause of Clenched Hands After Stroke

Spasticity is the main culprit of a clenched hand after stroke.

When stroke damages the part of the brain that controls motor function, your brain may have difficulty sending signals to control your hand, including signals that tell the hand when to relax.

Without proper signals from the brain, the hand may become clenched as the body tries to protect the muscles from tearing.

Furthermore, stroke patients that rely on their non-affected side to complete daily tasks – and neglect rehabilitation for their affected hand – increase the risk of getting a clenched hand after stroke.

Because when spasticity is left unmanaged, it can worsen into contractures. When contractures occur in the hand, it leads to stiff joints, curled fingers, and a tightly clenched fist.

Treatment for Clenched Hands After Stroke

Movement is critical during stroke recovery, so it shouldn’t come as a surprise that stroke rehab exercise is one of the top treatments for a clenched hand after stroke. However, it’s not the only option.

Here are the methods commonly used to treat a clenched hand after stroke:

1. Hand Therapy Exercises

Hand therapy exercises can be used to practice therapeutic movements with the affected hand. The goal is to perform high repetition of the exercises to spark neuroplasticity: the mechanism the brain uses to form new neural pathways.

Daily practice of hand therapy exercises for stroke patients can help rewire the brain and slowly reduce the spasticity in the hand. In time, the clenched hand will slowly relax and open up.

Sometimes the spasticity gets worse before it gets better, so don’t be discouraged. As long as you’re not pushing yourself to the point of pain, keep exercising your hand.

See all hand therapy exercises »

2. Passive Exercise

You might wonder how you can practice hand therapy exercises with a clenched hand. Ideally, you can use your non-affected hand to open your affected hand to complete the exercises passively. This simply means that your affected hand exerts no effort. Instead, your “good” side does all the work.

Although you aren’t exerting effort with the affected hand, passive exercise helps activate neuroplasticity. It takes time to see results, but passive exercise can slowly help improve mobility.

See all range of motion exercises »

3. Botox

Even with passive exercise, some patients may have severe spasticity where they cannot get their clenched hand open. When spasticity is severe, talk to your therapist about getting Botox injections.

Botox is a nerve-block that temporarily relieves spasticity after stroke. Some therapists recommend getting Botox injections to loosen up the hand, which creates a window of opportunity to participate in hand therapy exercises.

If you do your hand therapy exercises daily, then it will address the root problem.

Learn more about Botox for stroke patients »

4. Hand Splints

Some occupational therapists recommend using a splint to stretch open the hand. Talk to your therapist to see what they recommend. If you’re strapped for cash, you can try using a basketball or soccer ball to stretch your hand on.

See therapeutic gloves for stroke patients »

5. Passive Stretching

Splints allow you to passively stretch your hand – but you don’t need a splint to stretch. Whenever you can, try to gently stretch your clenched hand. For example, you can stretch your hand over your leg while you’re sitting down watching a movie. Keeping the hand stretched and stimulated will help reduce the spasticity.

6. Combination Therapy

Many patients with clenched hands after stroke can benefit from a joint approach. In the early stages, it can be useful to use Botox and hand splints to get the hand to open. Then, once you experience some relief, you can try hand therapy exercises and passive stretching.

The more proactive you are with your hand therapy, the more results you will see. Movement is key to recovery!

Relaxing Clenched Hands After Stroke

Overall, clenched hands occur when spasticity in the hand begins to worsen. This happens most often after a massive stroke or if the affected hand is neglected for too long.

The best rehabilitation technique includes hand therapy exercises. Many patients benefit from using a joint approach by adding Botox or hand splints to their regimen.

Talk to your physical or occupational therapist to see what’s best for you.

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See how Susan is recovering from post-stroke paralysis

“I had a stroke five years ago causing paralysis on my left side which remains today.

I recently began using FitMi.

At first it was difficult for me to be successful with a few of the exercises but the more I use it, the better my scores become.

I have recently had some movement in my left arm that I did not have before.

I don’t know if I can directly relate this to the use of the FitMi but I am not having occupational therapy so I conclude that it must be benefiting me.

The therapy modality motivates me to use it daily and challenges me to compete against my earlier scores.

I heartily recommend it!-Susan, stroke survivor

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