Spasticity is caused by miscommunication from your brain, not your muscles. Normally your muscles are in constant communication with your brain about how much tension they’re feeling, and the brain has to constantly monitor this tension to prevent tearing. So your brain continuously sends out messages telling your muscles when to contract and relax. When a stroke damages part of the brain responsible for muscle control, this communication is thrown off. The damaged part of your brain no longer receives the messages that your muscles are trying to send, and as a result, your brain no longer tells them when to contract or relax. So, your muscles keep themselves in a constant state of contraction in order to protect themselves. This is how spasticity is created.
Which begs the question: how can you fix it? Why Botox Is Only a Temporary Spasticity Treatment?
One way to reduce spasticity after stroke is by using “nerve block” drugs like Botox. Botox blocks the release of chemicals that signal your muscles to tighten, which makes your muscles relax. We have heard many stroke survivors rave about the muscle-relaxing benefits of Botox. However, without getting your brain on board, Botox merely addresses the symptom of spasticity, not the real problem. This means that once the Botox wears away, the problem will come back.
So how can you make spasticity after stroke go away for good?
This is where neuroplasticity and therapeutic exercise comes into play.
Why Exercise Is the Best Spasticity Treatment
The key to reversing spasticity permanently is by rewiring the brain through neuroplasticity. Neuroplasticity helps dedicate more brain cells to controlling your affected limbs. In order for this rewiring to occur, you have to repeat effective rehab exercises over and over and over. The more you practice, spasticity exercises, the more your spasticity will subside. It’s like paving new pathways in the brain. The more you reinforce those new pathways, the more your brain-muscle communication improves, and your spasticity goes away as a result!
Types of Exercise to Treat Spasticity after Stroke
Some spasticity is minor (muscle tension) while other spasticity is severe (paralysis).Different levels of spasticity require different types of exercise. Here are 3 ways to treat spasticity with exercise (then we’ll share 4 more steps for post-stroke paralysis:
1. Range of Motion Exercise - When you first start to treat spasticity, it’s likely that your muscles will be very stiff. To help loosen them up, start with range of motion exercises like this wrist stretch from: Be sure to emphasize high repetition so that you canactivate neuroplasticity and start to loosen up the spasticity.
2. Active Stroke Spasticity Exercises - If you have some movement in your spastic muscles, the active rehabilitation exercise will be your ticket to success. A great stroke spasticity exercise for legs is knee extensions. Again, the more reps you do, the more your brain will rewire itself and reduce your spasticity. You’ll recover from stroke quickly this way because it’s the only way to retrain your brain to relax your spastic muscles – permanently.
3. Combining Exercise with Electrical Stimulation - Another great way to boost your results from your stroke exercises is by combining it with electrical stimulation. Research shows that combining electrical stimulation with stroke rehab exercise leads to better results.
How to Treat Spasticity in Paralyzed Muscles
Sometimes muscles become so stiff with spasticity that they become paralyzed. The following methods can help reduce spasticity in paralyzed muscles:
4. Passive Exercise - When you can’t move your muscles after stroke, you can begin the neuroplastic rewiring process through passive exercise. This simply means assisting your affected muscles through each movement – either with the help of a caregiver or by using your non-affected side. Although you aren’t “doing it yourself,” passive movement still helps activate neuroplasticity. As you begin to regain movement, you can graduate to active exercises.
5. Botox and Medication - While Botox only provides temporary results, it’s very useful for individuals who suffer from severe spasticity. Botox can actually be used to create a window of opportunity to do your rehab exercise — otherwise severe spasticity will prevent you from doing therapeutic exercises.
Remember: you need to get your brain on board in order for your results to stick. Botox alone won’t create lasting results, but repetitive rehab exercise will. Aside from Botox, other medications used to treat spasticity are Diazepam (Valium), Baclofen (Lioresal),Dantrolene (Dantrium), Tizanidine (Zanaflex), Clonidine (Catapres). Talk to your doctor to see if medication is a good option for you.