What is a Contracture?

A contracture is a structural change in muscle tissue which results in permanent contraction and an inability to move the muscle. Once a contracture occurs, it cannot be reversed, and someone's range of motion will be limited as a result. Contractures are associated with a number of medical issues, ranging from severe burns to genetic conditions. There are a number of steps which can be taken to reduce the risk of developing contractures and to address them in the early stages before a muscle becomes essentially frozen.

One reason for a contracture is a condition known as hypertonic stress. Muscles in a state of hypertonic stress are sent constant signals to tighten and contract. Over time, the muscle tissue starts to change, and it enters a state of permanent contraction. Spastic cerebral palsy is a condition commonly associated with hypertonic stress and other conditions linked with spasticity can also lead to contractures.

Another cause of a contracture is a scar. Burn victims in particular are at risk of developing contractures because their burns thicken and make it difficult to move the underlying muscles, causing contractures. Likewise, people who have undergone multiple open surgeries can sometimes develop contractures at the surgical sites. Prolonged immobility can have a similar impact on the muscle tissue. In a condition known as capsular contracture, the body reacts to a foreign object in the body such as an implant by tightening muscles around the implant, which can displace the implant or make it difficult for the patient to move.

Signs that a contracture may be beginning to occur can include stiffness in a muscle, pain with normal range of motion, and difficulty moving a muscle. Treatment includes gentle stretching exercises to encourage the muscle to elongate and relax. These exercises must be repeated regularly, even if they are painful. Massage can also sometimes help, especially when it is administered by a skilled physical therapist. Surgery may be used in some cases if other treatments are ineffective.

If a patient is at risk for contractures, his or her doctor will discuss the risks, recommend exercises, and monitor the patient for early signs of muscle stiffness. Patients sometimes have difficulty adhering to treatment regimens, and it's important to remind patients that the consequence of failing to do stretching exercises can be a permanent loss of motion in the involved limb or area of the body. While stretches may be time consuming and not very enjoyable, the alternative is more unpleasant.