Contractures

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KEY POINTS

• A contracture is when your skin, muscles, tendons, or ligaments tighten or shorten. It can limit your ability to move normally.
• Contractures can be treated with special exercises, and splints or braces to stretch the muscles. Sometimes surgery is needed.
• Contractures may be prevented by changing positions often and moving injured arms or legs.

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What is a contracture?

A contracture is a tightening or shortening of skin, muscles, tendons, or ligaments. Tendons are strong bands of tissue that attach muscle to bone. Ligaments are strong bands of tissue that connect one bone to another to form the joints. Contractures can happen around any joint, and limit your ability to move.

What is the cause?

Contractures may be caused by problems that affect the nervous system, muscles, or joints, such as:

• Burns
• A stroke
• Multiple sclerosis
• Cerebral palsy
• Injuries, such as a head injury with coma
• Having to stay in bed for several months after an illness, serious injury, or surgery
• Long-term swelling and irritation of tissue around joints

What are the symptoms?

Symptoms may include:

• Trouble moving your joint
• Muscle pain and stiffness
• Muscle weakness

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have X-rays or other tests.

How is it treated?

Contractures are usually treated with gentle exercise. Exercises designed by a physical therapist can help you move your joints with little or no pain. You may need several months of physical therapy for your symptoms to improve. Caregivers can help with exercises if you are not able to exercise on your own.

If you are not able to move your body due to an illness or injury, your caregiver will need to move your body often, such as turning you side to side every few hours and bending or stretching your arms and legs every few hours. Bending and straightening your joints will help keep them mobile. Massaging your arms and legs will help blood flow. Massage can also help relieve pain and prevent stiffness. A physical therapist can show caregivers how to do the massage. These treatments also helps prevent pressure ulcers (bedsores).

You may need to use splints or braces to help stretch your muscles and joints.

If other treatments do not work, you may need surgery to relieve stiffness or pain. If you have severe nerve damage, or have not been able to move the joint at all, surgery may not improve your ability to move the joint.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Do the exercises recommended by your physical therapist.

Ask your provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent muscle contracture?

If you have an illness, injury, or surgery and you have to stay in bed for a long time to recover:

• Change positions often.
• Move your muscles as often as possible, especially by bending of your joints.
• Ask your provider about having physical therapy.
• Ask your provider about using a continuous passive motion (CPM) machine, which moves your arms and legs to help you stay flexible.