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Contractures After Stroke: How to Prevent and Reverse Them

stroke patient with hand contractures

Contractures after stroke are characterized by stiff, tight muscles and joints. It often occurs in the upper extremities and can lead to clenched hands after stroke. However, the condition is not limited to the hands.

Contractures can develop in any joint in the body that is affected by spasticity, like the elbow, ankle, or knee. Ultimately, this condition can affect your ability to take care of yourself (like holding a toothbrush and dressing yourself).

To help prevent and reverse contractures after stroke, it helps to understand why spasticity occurs along with the best rehabilitation methods for treatment.

This article will walk you through all of it. Let’s get started.

Causes of Contractures After Stroke

Contractures are characterized by extreme stiffness in the muscles, joints, or connective tissue that limits your range of motion.

Contractures are a form of spasticity, a condition where muscles become stiff and tight after stroke. When spasticity is left unmanaged, contractures can develop.

For example, if you had spasticity in your hand after stroke, and things continued to worsen, your hand might curl and clench into a tight fist, resulting in a hand contracture.

Spasticity is best understood as a miscommunication problem between the brain and the muscles. When a stroke has damaged the brain’s motor neurons that communicate with your affected muscles, the muscles “clench up” in response.

Rehabilitation for contractures involves restoring the connection between the brain and the muscles. You’ll learn how next.

Rehabilitation and Treatment for Contractures After Stroke

Contractures develop when spasticity has been left unmanaged. If you suffer from contractures after stroke, there is hope for recovery.

You can reverse contractures after stroke by participating in daily, consistent rehabilitation using the following methods:

1. Stretching

To help reduce contractures after stroke, start by gently stretching the affected muscles. If you have hand contractures after stroke, it can help to use a split to prop your hand open. When splints aren’t feasible, you can try using a basketball or other object to stretch your hand on.

2. Range of Motion Exercises

Next you’ll want to move your affected muscles through gentle range of motion exercises. This will help get blood flowing and encourage the muscles to loosen up. However, increased blood flow isn’t the only goal…

Want 25 pages of stroke recovery exercises in PDF form? Click here to download our free Stroke Rehab Exercise ebook now (link opens a pop up for uninterrupted reading)

3. Massed Practice

To reverse contractures after stroke, the goal of rehabilitation is to rewire the brain through neuroplasticity. Here’s how it works:

When you practice physical therapy stroke exercises, specific neurons in the brain fire. The more these neurons fire together, the stronger their connection becomes. It’s like the popular neuroscience saying: “neurons that fire together wire together.”

The more you practice PT stroke exercises (i.e. massed practice) the more your brain will regain the ability to correctly send motor signals to your affected muscles. As this communication is restored, mobility will improve, and the contractures will slowly be reversed.

4. Passive Exercise

physiotherapist stretching a stroke patient with contractures

If you have contractures after stroke, you might not be able to practice PT exercises on your own. Does this mean you’re out of luck? Not at all!

Patients with severe spasticity and contractures after a stroke can still participate in passive exercise where the muscles are assisted through the movement. You can do this yourself by using your non-affected side or enlist the help of a therapist or caregiver.

Although you aren’t “doing it yourself,” passive exercise still helps activate neuroplasticity. It will take time to see results, but if you put in consistent work, your contractures will loosen up and mobility can improve.

5. Electric Stimulation

Electric stimulation is a rehabilitation method used to treat spasticity and mobility issues after stroke. It involves applying electric currents to the affected muscles through the skin. Patients will see the best results by combining electrical stimulation with rehabilitation exercise, especially after a stroke.

6. Botox

To boost your contracture recovery efforts, you can try spasticity-reducing treatments like Botox. This drug is a nerve-blocker that temporarily relieves spasticity and contractures.

Although the treatment is temporary and requires repeat treatments, you can use the relief as a “window of opportunity” to get rehab exercises done. That treats the root problem, so when the Botox wears off, some of your improvements will remain.

7. Rehab Technology

When patients pursue stroke rehabilitation at home, it can be difficult to stay motivated to exercise daily. Since consistency is key for results, rehab devices can help.

Home therapy tools like Flint Rehab’s FitMi help patients with severe spasticity regain mobility by motivating high repetition of rehab exercises. Even patients with clenched hands have reported remarkable improvement after using FitMi for just a couple months.

8. Orthoses

Orthoses include splints and props that are custom-fitted to support and gently stretch open the affected muscles and joints. They might be recommended by your therapist and will be adjusted to best suit your needs.

9. Surgery

Sometimes contractures are painful and affect your quality of life. If the above treatments don’t help, your physician may recommend surgery as a last resort.

How to Prevent Contractures in Stroke Patients

The rehabilitation methods mentioned above help reduce contractures in stroke patients. But how can you prevent them in the first place?

The same methods used to reverse contracture can be used to prevent them. Gently stretching the affected muscles and taking them through their range of motion can help prevent contractures from forming.

Most of all, massed practice of rehabilitation exercise can help manage spasticity, reduce contractures, and improve mobility.

We hope this article has inspired you to start moving to prevent and manage contractures after stroke. Good luck!

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My husband is getting better and better!

“My name is Monica Davis but the person who is using the FitMi is my husband, Jerry. I first came across FitMi on Facebook. I pondered it for nearly a year. In that time, he had PT, OT and Speech therapy, as well as vision therapy.

I got a little more serious about ordering the FitMi when that all ended 7 months after his stroke. I wish I hadn’t waited to order it. He enjoys it and it is quite a workout!

He loves it when he levels up and gets WOO HOOs! It is a wonderful product! His stroke has affected his left side. Quick medical attention, therapy and FitMi have helped him tremendously!”

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What are these “WOO HOOs” about?

FitMi is like your own personal therapist encouraging you to accomplish the high repetition of exercise needed to improve.

When you beat your high score or unlock a new exercise, FitMi provides a little “woo hoo!” as auditory feedback. It’s oddly satisfying and helps motivate you to keep up the great work.

In Jerry’s photo below, you can see him with the FitMi pucks below his feet for one of the leg exercises:

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Many therapists recommend using FitMi at home between outpatient therapy visits and they are amazed by how much faster patients improve when using it.

It’s no surprise why over 14,000 OTs voted for FitMi as “Best of Show” at the annual AOTA conference; and why the #1 rehabilitation hospital in America, Shirley Ryan Ability Lab, uses FitMi with their patients.

This award-winning home therapy device is the perfect way to continue recovery from home. Read more stories and reviews by clicking the button below: