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Fall 2011

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Focus on Regaining Flexibility

Stretch and Strengthen to Ease Muscle Spasticity

By Christopher Tolisano

Flexibility is a vital component of human movement. It is even more important for patients undergoing stroke recovery and rehabilitation. Stroke survivors often find that certain parts of their body are now tighter due to muscle spasticity.

What is flexibility? It is the amount of movement at a joint in the body. The muscles and tendons that surround a joint directly affect its movement. If these muscles uncontrollably contract (spasticity), then the joints they surround can become tight.

The elbow is a common area of concern for stroke survivors, and an example of how spasticity and the resulting lack of flexibility can cause dysfunction. Your elbow joint should be able to fully extend to a straight line and fully bend so that your hand touches your shoulder. After a stroke, the elbow stays bent more than straightened because of the spasticity in the muscles that bend it. The stroke has damaged parts of the brain which control the bending and extending of muscles, and therefore joints.

To improve this condition, a proper recovery plan should emphasize lengthening these muscles that stay tight and spastic. The longer they stay tight, the harder it will be to increase movement at the affected joints.

Every muscle group has another muscle group that works in the opposite direction. Using the elbow joint as an example, the triceps muscle extends the elbow, and the biceps muscle flexes the elbow. Contract the biceps and the elbow bends and triceps lengthen. Straighten the elbow and the triceps contract and biceps lengthen. If one of these muscles stays contracted or tight for a long period of time, the opposite muscle group lengthens and weakens. When a muscle is stretched out for too long, weakening occurs. Flexibility of opposing muscle groups should be addressed as well, but not nearly as much as the tighter muscle group.

The effects of this imbalance can drastically increase recovery time of the elbow joint’s functionality. Therefore, we must not only stretch the tight or spastic muscles, but also strengthen the muscles that have stayed lengthened and relaxed.

Posture is another major factor in decreased flexibility. Standing up as tall as possible and as often as possible will move your body back into better posture. Standing tall is a stretch for muscles that are tight from sitting. The more you stretch these muscles, the easier walking and balancing will become.

Daily stretches are also good for the brain. The brain needs to be taught flexibility as much as muscles do. Like learning a new language, the brain needs constant reminders and practice for the flexibility program to become successful and long lasting. Learning recommended at-home stretching exercises is the key to a successful and speedy recovery.

Christopher Tolisano is a Licensed Athletic Trainer who specializes in musculoskeletal injury and stroke rehabilitation. With Dr. Lori Bartels, Tolisano’s intensive-stroke rehabilitation program in St. Petersburg, Fla., blends components of Western sports medicine and traditional Eastern yoga practices. For more information, visit bestdaytoday.com.

Tips for a Successful Recovery Plan

Make sure that your daily flexibility program addresses your entire body.
Include stretches that are designed especially for you.
Talk to a professional about developing an individual program.
Consider your lifestyle, old injuries and limitations due to stroke as part of your program design.
In cases of severe loss of use, a specialist should be on hand to assist with your stretching.

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