SPG 4 Denovo

Until genetic therapy is available the focus of therapy should be to minimize the effects of the spasticity that occurs as the individual ages.

Why “Length and Strength” Are Important If You Have Spasticity

If you or someone you know has spasticity, you may have heard a doctor or therapist talk about the importance of “length and strength.” These two words might sound simple, but they are key to helping people with spasticity move better, feel better, and live more comfortably.

In this article, we’ll explain what spasticity is, what “length and strength” mean in this context, and why they matter so much for everyday life.

What Is Spasticity?

Spasticity is a condition that makes certain muscles too tight or stiff. It usually happens when someone has damage to the brain or spinal cord. This can occur after events like a stroke, brain injury, cerebral palsy, multiple sclerosis, or spinal cord injury.

In a person without spasticity, muscles tighten and relax as needed to help the body move smoothly. But in someone with spasticity, some muscles stay tight all the time or suddenly tighten without warning. This makes movement harder, less smooth, and sometimes painful.

Spasticity can affect walking, sitting, using your hands, and doing many everyday tasks. It can also lead to long-term problems like joint damage, pain, and difficulty taking care of yourself.

That’s where “length and strength” come in.

What Do “Length” and “Strength” Mean?

In this context:

• Length means keeping muscles stretched to a healthy length. It’s about flexibility and range of motion—how far you can move your arms, legs, or other parts of your body.
• Strength means keeping muscles strong, especially the muscles that work opposite to the tight (spastic) ones.

Let’s look at each of these in more detail and why they are important.

Why Muscle Length Is Important in Spasticity

When muscles are tight all the time, they don’t stretch like they should. If this continues for a long time, the muscles can shorten and lose their flexibility. This can cause contractures—a permanent tightening of the muscle, making it hard or impossible to move the joint.

Here’s why keeping muscle length is so important:

1. Prevents Contractures

If you don’t stretch spastic muscles regularly, they can shrink and lock your joints in one position. For example, a tight calf muscle might keep your foot pointed down, making it hard to walk. Daily stretching helps keep muscles at a healthy length and joints moving freely.

2. Improves Movement

Short, tight muscles make it harder to move. If your hamstring muscles (on the back of your thigh) are too tight, you might not be able to straighten your knee fully. This can affect how you stand or walk. Stretching helps your muscles work better together, making movement easier.

3. Reduces Pain

Tight muscles can pull on joints and nerves, causing discomfort or pain. Stretching those muscles gently can help relieve pressure and make your body feel more relaxed.

4. Helps with Hygiene and Care

If muscles become too tight, it can be hard to clean or dress certain body parts. For example, a tight arm may stay bent, making it hard to wash or put on clothes. Keeping muscles long and flexible makes it easier to care for yourself or for caregivers to help you.

Why Muscle Strength Is Important in Spasticity

Many people think that spasticity only causes tight muscles, but that’s only part of the picture. While some muscles are too tight, other muscles become weak from not being used enough. These weaker muscles often work opposite the spastic ones.

Building strength in these weaker muscles is just as important as stretching the tight ones.

1. Creates Balance in the Body

Muscles work in pairs. If one muscle is tight and strong (because of spasticity) and the other is weak, the body becomes unbalanced. For example, if your biceps (which bend your elbow) are spastic, and your triceps (which straighten your elbow) are weak, your arm may stay stuck in a bent position. Strengthening the triceps helps pull the arm back into a straighter, more useful position.

2. Improves Control and Function

Strengthening muscles helps you control your movements better. Even if spasticity causes unwanted movement, strong muscles around the joint can help stabilize and support that joint. This means you’ll have more control and feel safer when standing, walking, or using your hands.

3. Prevents Injury

Weak muscles can’t protect your joints well. If your legs or core muscles are too weak, you may be more likely to fall or hurt yourself. Strength training can make you safer and more stable during daily activities.

4. Supports Use of Equipment

If you use braces, walkers, or wheelchairs, strong muscles can help you use them better. For example, if you wear an ankle brace, strong thigh and hip muscles will help you walk more effectively with the brace.

Putting Length and Strength Together

Stretching (for length) and strengthening (for strength) should go hand in hand. If you only stretch tight muscles but don’t strengthen the weak ones, your body may still be out of balance. And if you only do strength training without stretching, your muscles may become even tighter.

A good therapy program will focus on both:

• Stretching the spastic muscles (like calves, hamstrings, or biceps)
• Strengthening the opposing or weak muscles (like shin muscles, quadriceps, or triceps)
• Doing functional movements like standing, walking, reaching, or grabbing
• Using tools like braces, casts, or therapy bands to help the process

This combined approach can improve posture, movement, and independence.

Final Thoughts

Living with spasticity can be challenging, but working on muscle length and strength can make a big difference. Stretching helps prevent tightness, pain, and joint problems, while strengthening builds balance, safety, and control.

Everyone with spasticity is different, so it’s important to work with a doctor, physical therapist, or occupational therapist to create a plan that works for your needs. With regular stretching, strength training, and support, many people with spasticity can move better, feel better, and live more independently.