Spasticity in Stroke is caused by damage to nerve pathways within the brain that control muscle movement.
Symptoms of spasticity can include increased muscle tightness (hypertonicity), clonus (muscle jerks/a series of rapid muscle twitches), and limited range of movement of your joints (contractures). The severity of spasticity can range from a mild tight feeling in your arm or leg, to severe tightness, restricted movement and pain.
See below for tips and tricks to help manage your spasticity.
Managing your tone (Spasticity)
Increased tone, also known as spasticity, is a potential symptom of strokes where there is an abnormal increase in stiffness of muscle, which if left untreated can cause issues with pain, movement and can limit day to day function.
What causes Spasticity?
Passive movement
Gentle passive range of movement, using your unaffected arm to assist, can help to relax tightness, relieve pain and increase range of the movement. The movements should be gentle, performed slowly, and should not move into the painful positions, as this can make the muscle react, and the tightness worse. Each time you revisit the movements, look to see if you can get a little bit further into the movement before the pain hits.
Please watch this video for a follow along passive range of movement video for moderate to severe muscle weakness and spasticity.
Please watch this video for a follow along passive range of movement video for moderate to severe muscle weakness and spasticity.
Posture and support
Providing effective support for high tone limbs can help to reduce tightness and relax tight joints. When managing tone in the arm especially, allowing a moderate to severely impaired arm to hang unsupported causes increased strain in the weakened structures supporting your shoulder joint, this can cause pain/discomfort, can actually worsen that tight sensation, and in severe cases, can partially dislocate the humerus from the shoulder joint (subluxation).
To help manage this, support should be used whenever you are sitting or lying down. This aims to support the weight of the impaired arm, reducing strain on the shoulder and allowing those tightened muscles to relax slightly, reducing the impact of spasticity.
To support your arm, use a pillow, or cushion to provide support. Follow this link to see the optimal sitting and lying positions for someone affected by a stroke, created by the Chest, Heart and Stoke Scotland charity.
To help manage this, support should be used whenever you are sitting or lying down. This aims to support the weight of the impaired arm, reducing strain on the shoulder and allowing those tightened muscles to relax slightly, reducing the impact of spasticity.
To support your arm, use a pillow, or cushion to provide support. Follow this link to see the optimal sitting and lying positions for someone affected by a stroke, created by the Chest, Heart and Stoke Scotland charity.
In sitting
When sitting, whether it is in your chair, sofa or a wheelchair, ensure adequate support for the arm. Placing a pillow under the elbow, extending down past the fingers will both support the weakened shoulder, and allow the rest of the arm to relax. Aim to have the wrist straight and fingers fully extended as long as it is comfortable to do so.
In lying
Positioning will depend on the way you lie in bed:
On your back
Aim to have 1-2 pillows under your lower arm, supporting the elbow while allowing the fingers to stretch out by your side. Try to ensure your feet are in a neutral position, and if the bed type allows, a pillow placed between the bottom of your feet and the base of the bed can prevent your foot from dropping down. Also ensure your neck and shoulders have adequate support.
On your unaffected side
The affected leg on top should have 1-2 pillows underneath it to provide support. The arm can be extended out in front with further pillows providing support right down the arm.
On your affected side
Ensure your affected shoulder is in a comfortable position and not trapped under your body. The affected leg can be straight, with the unaffected leg bent up with a pillow underneath for support.
On your back
Aim to have 1-2 pillows under your lower arm, supporting the elbow while allowing the fingers to stretch out by your side. Try to ensure your feet are in a neutral position, and if the bed type allows, a pillow placed between the bottom of your feet and the base of the bed can prevent your foot from dropping down. Also ensure your neck and shoulders have adequate support.
On your unaffected side
The affected leg on top should have 1-2 pillows underneath it to provide support. The arm can be extended out in front with further pillows providing support right down the arm.
On your affected side
Ensure your affected shoulder is in a comfortable position and not trapped under your body. The affected leg can be straight, with the unaffected leg bent up with a pillow underneath for support.
Other things to consider
There are a range of other factors that can influence spasticity and potentially make it worse, these are commonly referred to as triggers for your spasticity. These triggers can include issues such as pain, infection, constipation, stress, temperature (especially cold) and many more. If any of these issues are a problem, and you feel your spasticity is worsening, then managing them can help to improve your symptoms.
Please speak to your GP if you feel any of these issues may be a factor in your spasticity.
Please speak to your GP if you feel any of these issues may be a factor in your spasticity.