Monday, August 01, 2011

contractures Multiple Sclerosis

Muscles, tendons, and ligaments operate joints; and well - dysfunction begats dysfunction often painful and even more mobility restrictive.

Why do joint contractures happen? Limited use, spasticity, muscle imbalance, and more - hey it’s Multiple Sclerosis - muscles act weird.

Ignoring contractures may be a result of not understanding and/or denial of MS progression, lack of access to resources, impairments and/or like Patti a dislike of physical therapy. … Not addressing contractures early can only lead to pain, more draconian therapy or surgery.
“Contractures represent a common but preventable source of excess disability among nursing home residents.” Contractures in Nursing Home Residents 
Undoubtedly treating contractures is more challenging in the pre-care facility era. Patti’s therapy program has evolved to a simple daily prescribed routine of wearing her “Neuroflex Technology” a couple hours each day. 

She’s even managed with her signature wild and crazy socks to make it a fashion statement. Though as pictured, Patti an obsessive ‘fidgetor’ has fidgeted the velcro all wonky – all the more benefit to regular monitoring by staff.

While MS progression has left Patti non-ambulatory, her ability through treatment to extend her legs makes all the difference in the world when I transfer her with a one person transfer technique from wheelchair to bed 4-5 nights per week, or as a prerequisite for outings.  

Yet no matter how much something is viewed positively from the outside looking in - it is wise to always remember you are not the one sitting in the wheelchair or wearing the brace.
“Loss of ambulation can be a symbolically powerful moment in the progress of disability from MS … Individuals may re-experience these emotions with each prescription of an assistive device …” Primer on Multiple Sclerosis by Barbara Grier
As a caregiver / carer, family or friends - you must continue your MS education; stay involved and supportive of treatments. In a sense you are the incentives for effort.

related entries:

Caregivingly Yours, Patrick Leer 
web site:  


  1. I learned about contractures the hard way! I brought my weird finger up to MANY drs. all whom dismissed it--NO OT/PT--now it is too late, thought I guess I do my own. Even "MS Experts" couldn't make me a simple brace for my pinkie. My other fingers are now involved and as time goes on...makes me sooo mad that I KNOW I could have helped them earlier! The knee---geez. I am lucky, I know.

  2. I just found your blog as I wrestle with "carer" or "caregiver" or...I think I'll follow you as I consider what to do on my end. I'm caring for my mother who contracted MS in 1969. Now, she is 71 and 100% dependent. We are handling this challenge on a huge scale. What I've read here is encouraging.

  3. I had a massive MS contracture of my left hand and the Dr's said it would be eventually be stuck that way... I started going to a Structural Integrator, which is a person who does a specific manual therapy and my hand opened after less than 10 minutes worth of painless work and has been fully functional ever since. Im a 30 yr old massage therapist who still worked everyday and can't afford insurance. This was the biggest ray of hope for me.


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