Spasticity occurs when the muscles involuntarily contract or become stiff. It is most often caused by a neurological disorder and can significantly affect a person’s mobility and ability to perform day-to-day activities. A physical therapist will develop a detailed treatment program aimed at reducing muscle tension and improving strength and mobility in the affected areas, to help the person function as independently as possible.
Physical therapists may also use methods such as moist heat, electrical stimulation, low-level laser therapy, and cryotherapy to help reduce pain and muscle tension. Casting or orthotics may also be used to improve specific joint mobility or prevent further loss of motion. Physical therapy treatment plans are specifically designed for the individual and their goals.
Physical therapy will probably not get rid of spasticity, but it will likely help reduce it.
Spasticity is unlikely to totally subside as it is caused by damage to the brain and spinal cord. The goal of physical therapy treatment is to reduce spasticity as much as possible to prevent joint contractures and help the person live more independently.
The sooner someone begins physical therapy for their spasticity, the better.
Physical therapy is regularly conducted in the hospital immediately after a person has experienced a stroke, traumatic brain injury, spinal cord injury, or other neurological impairment, which may all lead to spasticity.
As soon as someone with spasticity is given the OK by their doctor, they can begin physical therapy.
This depends entirely on the person’s symptoms and goals. Typically, a physical therapist will take you through a series of stretches aimed at improving muscle length and joint mobility. They may also use modalities to reduce muscle tension and alleviate the pain that you are experiencing.
Working to strengthen the antagonist muscle group — muscles that perform the opposite movement of the muscle that is spastic — may also be used to further improve joint mobility and function. Most importantly, they would work on improving the affected area’s ability to perform functional tasks like walking, standing from sitting, getting out of bed, and more.
The short answer is: It isn’t. Physical therapists will examine each person individually and design a treatment plan specific to their needs. Most treatment plans will include prescribed exercise, hands-on treatment, education, and possibly modalities to reduce pain. This is true for people seeking physical therapy with or without spasticity.
Ideally, you would go to a physical therapist who has experience treating patients with neurological impairments. There are also physical therapists who are board certified clinical specialists in neurologic physical therapy.
These specialized therapists have extensive training in neurological physical therapy and have passed a rigorous test administered by the American Physical Therapy Association (APTA). The APTA has a database to help you find a specialist in neurologic physical therapy in your area.
Individuals with spasticity caused by a neurological impairment are typically under the direct care of a neurologist. A neurologist may prescribe medications such as muscle relaxants, benzodiazepines, or anticonvulsants to reduce muscle tension and spasticity.
Occupational therapy may also be necessary if the person is having difficulty performing daily activities. Occupational therapists help people regain independence by improving hand-eye coordination, improving fine motor skills, and helping them learn or relearn how to perform everyday tasks.
A person should stop doing physical therapy if the treatment is worsening their symptoms or causing severe pain. When beginning physical therapy, it is typical to experience some pain and discomfort. You shouldn’t give up on physical therapy after one or even a few visits because of this.
However, if you aren’t making progress after a few weeks, and you are having significantly increased pain or declining in function, stop physical therapy and consult your physician.
If performed correctly, physical therapy shouldn’t make spasticity worse. However, if the therapy is too aggressive, the spasticity may worsen.
Spasticity is velocity-dependent, meaning it will increase with quick or rapid movements. If a person is stretched or moved too quickly or forcefully, the spasticity is only going to increase. This is why it’s important to see a physical therapist with experience treating patients with neurological conditions.
Dr. Gregory Minnis is a physical therapist with an interest in orthopedic manual therapy. His work experience includes orthopedic physical therapy, sports medicine, neurological rehab, advanced assessment and treatment of running injuries, and advanced treatment of the pelvic complex, spine, and extremities.