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How to Tone it Down After a Stroke
By David Dansereau
Spasticity is tight, stiff muscles that make movement,
especially of the arms or legs, difficult or uncontrollable. Exercise can be an
important part of the health care regimen to tone down spasticity. Before we
explore this, however, you should first understand how your brain controlled
your muscles before your stroke and what might be happening on the inside now
that your brain was injured.
Before your Stroke
Your brain communicated to your muscles through your spinal
cord and told your muscles when to tighten and relax to help control movement.
The muscles in your limbs had finely tuned sets of stretch
receptors to tell the brain how much tension they are under. This helped the
brain move the body safely to avoid injury.
After your Stroke
If your stroke damaged the part of your brain that
controlled movement of muscles, your brain might not be hearing those important
signals from the affected muscles. The body goes into a “safe mode” to keep the
When the damaged brain is no longer able to understand the
usual signals from the muscle, the spinal cord might send its own impulses to
the muscles in those limbs to remain contracted, or tight, so the muscles don’t
get overstretched and torn.
Negative Effects of Spasticity
- Stiffness in the arms, fingers or legs.
- Painful muscle spasms.
- A series of involuntary rhythmic contractions and
relaxations in a muscle or group of muscles that lead to uncontrollable movement
or jerking, called clonus
- Increased muscle “tone.”
- Abnormal posture.
- Hyperexcitable reflexes
Reset Spasticity and get out of ‘Safe Mode’
When your computer senses it might be in danger of losing
vital data, it reacts by going into safe mode. Yes, you can ignore this signal
from your computer and continue to work (at lower performance) in safe mode or
you can reset/reboot your computer and free up memory to improve performance.
Just like on your computer, the safe mode in your body
(spasticity) causes an eventual loss in movement control through
uncontrollable muscle tightness. To reset your muscle connection and tone down
spasticity, you’ll need to give your brain a boost to free up more memory for
recovery. One of your best recovery tools to help your brain regain control is
Rewiring the injured area in the brain through exercise
takes repeated, consistent practice and is hard work. But it is that hard work
that makes the brain change and improve (neuroplasticity) for voluntary
movement to return. As the brain retakes responsibility for muscle control,
spasticity can lessen or stop, restoring the usefulness of the limb and
Here are exercise-based options for toning down spasticity:
- Robotics to provide physical assistance.
- Virtual reality, exercise games and mental practice such as “Wii-habilitation,”
using a Nintendo game console to make exercises fun and interesting.
- Bilateral training: repetitive, simultaneous movement.
- Constraint-induced therapy: forcing the use of the affected
side by restraining the unaffected side.
- Functional electrical stimulation (e-stim) with biofeedback:
A treatment that stimulates nerves by sending an electrical current through the
skin while monitoring the muscle activity.
In addition to traditional medical treatment, speak with
your health care provider to determine what exercise or health programs might
be most beneficial to you and your unique needs. Be sure to keep up with the
program to tone down spasticity.
David Dansereau, MSPT, is a physical therapist and private practitioner in Providence,
R.I. He also is a stroke survivor. Learn more about Dansereau by going to www.my-physical-therapy-coach.com.
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