What Is Contracture

Morrey`s system (Table 14.2) divides elbow contracture into three categories: extrinsic, intrinsic, and mixed. Simply put, extrinsic contractures develop secondarily into an extra-articular source. This can include any tissue from the skin to the joint capsule. Intermediate muscles, such as brachialis or triceps, may be involved. Extrinsic contracture secondary to ulnar neuropathy is also described. Conversely, intrinsic contractures occur secondary to intra-articular pathology. Intrinsic contracture occurs secondarily to intra-articular pathology, such as fracture union, arthritis or intra-articular adhesions. Mixed contractures contain extrinsic and intrinsic contracture characteristics. Muscle contracture makes muscles tense and difficult to move and stretch.

The causes of muscle contracture are not always preventable, but a wide range of treatment options are available to relax tense muscles and maintain or restore the range of motion of your muscles. Treatment may include physical therapy, medications, and braces. Surgery may be helpful for certain types of contractures. Tendon extension operations for equine deformities should be carefully considered. In patients with early signs of distal contractures and weakness, lengthening of the Achilles tendon can lead to excessive stretching and exacerbate weakness, which may accelerate wheelchair dependence (Jeu, 2002). Main et al. (2007) found that serial irrigation of the tendo-Achilles tendon is an effective alternative to tendon extension surgery in patients with DMD and moderate tendoral tendor tendillary contractures without significant tightness of the iliotibial ligament. Although they found that serial watering may not be as effective as surgery, it could be considered in patients with contraindications to surgery. Symptoms of contractures include incredibly stiff and tense muscles that resist stretching, resulting in pain, decreased range of motion, and impaired joint mobility.

Moderate to severe cases include the use of toe extensions (for distal contracture of the limbs) and splints with bandages. Baagãçe 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 damage. 2019; 33(11):1460-1466. Regular exercise can help maintain proper joint mobility and range of motion to reduce joint stiffening and muscle tightening. Exercise also improves blood circulation and activates muscles, which helps prevent the formation of contractures. Contractures are defined as the absence of a full passive range of motion (ROM) of a joint resulting from structural changes in non-bone tissues such as muscles, tendons, ligaments, joint capsules, and/or skin. Contractures occur when normal elastic connective tissue is replaced by inelastic fibrous tissue. There are many causes of contractures, including chronic inflammation (rheumatoid arthritis), deformity (osteoarthritis, scoliosis), immobility (after fractures or surgery), injuries (burns, stroke), disease (Parkinson`s disease), or a combination of these factors. The flexibility of the joints is conversely associated with aging.

In general, there is a systemic decrease in the active and passive movement of all joints with age, with the decline becoming more pronounced during the ninth decade. However, not all older people experience a decrease in joint flexibility with age. Significant increases in ROM can be achieved with movement, activity and good stretching programs (Hoffman et al 2005). Contracture occurs when the normally stretchy (elastic) fabric is replaced by a non-stretchy (inelastic) fiber-like fabric. This fabric makes it difficult to stretch the area and prevents normal movements. In babies and children, the typical areas affected by muscle contracture are the elbows, wrists, fingers, knees and ankles. Throat contracture, called torticollis, is often seen in babies and can get worse if the baby is constantly breastfed or bottle-fed on the same side of the body. Contractures. PM&R Knowledge Now website of the American Academy of Physical Medicine and Rehabilitation. Available at: now.aapmr.org/contractures. Accessed October 7, 2020.

Muscle contractures also form due to a decrease in satellite cells….