Contracture Prevention After Spinal Cord Injury

What is a contracture?

A contracture is a shortening of muscles, tendons, or ligaments after a spinal cord injury (SCI). Contractures limit movement of a joint, such as your wrist, elbow, shoulder, or ankle. Contractures can start to develop as soon as 1 week after your SCI.

What causes a contracture?

The nerves that control your muscles may have stopped working after your injury. This makes it hard to move your muscles. The nerves to one muscle may be stronger than to another muscle. This imbalance can make a muscle on one side of a joint stronger, causing it to bend inward. It may be hard to move or straighten your muscle. Spasticity can also cause a contracture. Spasticity is when your limb moves on its own.

How is a contracture treated?

  • Functional electrical stimulation (FES) is used to stimulate a muscle with electricity to make it move. Ask if FES is right for you.

  • Serial casting is used to help your joints extend. A cast is applied over a joint that is starting to contract. The cast will be applied, removed, and reapplied every 3 to 5 days, over a period of several weeks. Each time the cast is reapplied, your joint will be extended further. The goal is for the joint to be extended over time until it returns to the correct length.

How can I help prevent a contracture?

  • You may need a splint or other device to hold your limb in the correct position.

  • Healthcare providers will teach you how to position your body to help prevent a contracture. They will also show you ways to help control spasticity.

  • Range of motion (ROM) exercises help keep your joints flexible to prevent a contracture. You may need to have someone help you do the exercises. Ask which ROM exercises are best and how often you should do them.

Contact your healthcare provider if:

  • You have a joint that is beginning to contract.

  • You have trouble doing your ROM exercises.

  • You have problems with spasticity.

  • You have redness, a blister, or an open sore.

  • You have pain, swelling, or burning in your limb.

  • Your fingers or toes are unusually numb or pale.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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