Contractures

(Contracture Deformity)

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:

Symptoms

Contracture causes:

  • Loss of motion in a joint
  • Pain

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

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.
Last reviewed September 2020 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS
Last Updated: 5/12/2021

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