Spasticity is actually a motor disorder common in individuals with neurological or neuromuscular disorders such as strokes, cerebral palsy, multiple sclerosis, traumatic brain injury, or spinal cord injury.
Spasticity is velocity-dependent abnormal muscle tightness. This means that the muscle will involuntarily contract when you move or when someone moves your limb for you, quickly. This is because spasticity results from hyperexcitability of the stretch reflex.
But, why? In a healthy brain, the brain sends signals along nerve paths to control muscles. After a stroke, there can be breakdown and imbalance in how the brain communicates with your muscles. This can lead to over-excited neurons and nerve pathways, which then deliver the wrong message to your muscles causing them to involuntarily contract.
When a muscle involuntary contracts it makes it difficult to move the joint. When a muscle is unable to fully contract and relax it results in the tightening of surrounding tendons, muscles, and soft tissue.
Examples of how spasticity may present:
- A clenched fist
- Tensed fingers
- A bent arm held against the chest
- Tightness in the knees
- Involuntary crossing of the legs
- A foot that’s bent at an angle
- Foot drop
- Curled toes
Muscle spasticity can cause:
- Stiffness
- Contractures (fixed tightening of muscles, tendons, and soft tissues)
- Muscle spasms
- Overactive reflexes
- Clonus (uncontrollable rhythmic jerking)
- Changes in posture
- Difficulty in walking
- Pain
- Reduced function
- Lower levels of independence
Now the big question, what can I do about spasticity?
One of the best ways to manage spasticity is...EXERCISE!
There are four exercises that you can do yourself or with the help of family/friends that can be effective:
- Stretching
The goal of stretching is to maintain and/or increase joint mobility. When you hold a stretched position for an extended period of time it aids in the elongation of soft tissues. Sometimes this level of stretch is also achieved with positioning, splints, or serial casts. Remember to never stretch to the point of pain. A little discomfort is okay, but it should not be too painful.
- Range of Motion
Range of motion exercises whether passive or active is a great way to send signals to the motor cortex of the brain, increase muscle flexibility, reduce stiffness, and prevent painful contractures. You can perform passive exercises on your own or with the assistance of another person. If you don't have active movement yet, no worries, passive range of motion exercises are a great starting point. Also, because spasticity is velocity dependent you must be mindful to perform all exercises slowly!
- Exercises of the opposite muscle
You want to be careful not to over-exercise the already tight muscle. For example, if your bicep muscle is tight you don't want to keep doing exercises that bend your elbow. Instead you want to make sure you exercise the opposite muscle. In this case example, it would be the tricep muscle. Therefore, you would want to focus on exercises where you extend or straighten your elbow. It's important to know that muscles can only pull – they cannot push. Therefore many of your muscles work in what we call antagonistic pairs. This means that when one muscle contracts the other one must lengthen and relax. If our bicep muscle is tight it is the contracted muscle. In order to get the bicep muscle to relax, we must get the tricep muscle to contract instead.
- Weightbearing
Weightbearing is a great way to lengthen and stretch spastic muscles. If your arm is spastic, it may be a good idea to do some preliminary stretching first to see if you can straighten out your arm. Once your arm is straight you can weight-bear on a firm surface such as your bed (depending on the type of mattress, the countertop, or a table. If you arm is unable to straighten you can try weightbearing through your elbow first. If your leg is spastic, standing (if you are safe and able to do so) is one of the best to bear weight through your lower body.
