Definition
Contractures are a tightening of muscles, tendons, ligaments, or skin. It makes it hard or impossible to move nearby joints.
Contracture Deformity of the Hand |
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Causes
Causes may be:
- Deformity
- Time spent without moving
- Injury
- Long-term swelling
Problems that affect nerves and muscles almost always lead to contractures. Examples are:
Spasticity is a change in muscle tone. It is caused by injuries to the brain or spine, such as stroke. It can also lead to contracture.
Risk Factors
Things that may raise the risk of this problem are:
- Rheumatoid arthritis
- Tenosynovitis—swelling of the tissue that covers a tendon
- Polio and other diseases of nerves and muscles
- Trauma
- Burns
- Scarring
- Being inactive for a long time
Diagnosis
You will be asked about your symptoms and past health. Your joints will be examined for range of motion.
Images may be taken of the body. This can be done with x-rays.
Treatment
The goal of treatment is to ease pain and increase function. Choices are:
- Physical therapy to increase strength and mobility
- Occupational therapy to learn how to do daily tasks
- Ultrasound therapy to ease pain and promote healing
- Massage therapy casts or splints to keep the joint in position
Some people may need surgery when other methods do not help. Surgery can release tight tendons, ligaments, and joints.
Prevention
Movement and physical therapy may prevent this problem after an injury or surgery. It may also be prevented by managing health problems, such as rheumatoid arthritis.
RESOURCES
American Academy of Physical Medicine and Rehabilitation http://www.aapmr.org
National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov
CANADIAN RESOURCES
Canadian Centre for Occupational Health and Safety http://www.ccohs.ca
Health Canada https://www.canada.ca
References
Baagøe SK, Kofoed-Hansen M, et al. Development of muscle contractures and spasticity during subacute rehabilitation after severe acquired brain injury: a prospective cohort study. Brain Injury. 2019; 33(11):1460-1466.
Contractures. PM&R Knowledge Now—American Academy of Physical Medicine and Rehabilitation website. Available at: https://now.aapmr.org/contractures. Accessed October 7, 2020.
Giugale JM, Fowler JR. Trigger Finger: Adult and Pediatric Treatment Strategies. Orthop Clin North Am. 2015 Oct;46(4):561-569.
Kiefer M, Bonarrigo K, et al. Progression of Ankle Plantarflexion Contractures and Functional Decline in Duchenne Muscular Dystrophy: Implications for Physical Therapy Management, Ped Phys Ther. 2019; 31(1):61-66.
Trigger finger (stenosing tenosynovitis) in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/trigger-finger-stenosing-tenosynovitis-in-adults. Accessed October 7, 2020.
Revision Information
- Reviewer: EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS
- Review Date: 09/2020
- Update Date: 05/12/2021