Definition
Contractures refer to the permanent tightening of tissues. This includes muscles, tendons, ligaments, or skin. It makes it hard or impossible to move the nearby joints.
Causes
Contractures may be caused by:
- Deformity
- Immobility
- Injury
- Chronic inflammation
Certain disorders that affect nerves and muscles almost always lead to contractures. For example:
Spasticity is a change in muscle tone. It is caused by injuries to the brain or spine, such as stroke. It can often lead to contracture.
Risk Factors
Factors that may increase your risk of contractures include:
- Rheumatoid arthritis
- Tenosynovitis —inflammation of a tendon and its sheath
- Polio and other diseases of nerves and muscles
- Trauma
- Burns
- Scarring
- Prolonged inactivity
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 your bodily structures. This can be done with x-rays .
Treatment
Treatment includes:
Therapy
- Physical therapy can helps to increase mobility, joint elasticity, and muscle strength.
- Occupational therapy can help bring back movement to do daily tasks.
The main goal is to maintain or improve range of motion. Treatmen may include:
- Ultrasound—for large joint contractures
- Therapeutic massage
Casts or Splints
Casts or splints can keep the joint in a better position. They may help to stretch soft tissues. They are often used for contractures cause by nerve injury or immobility. Casts need to be changed on a regular basis.
Surgery
Surgery may be needed to release tight tendons, ligaments, and joints. This may be used if other treatments have not worked well.
Prevention
Prevention of contractures depends on the cause. After acute injuries or orthopedic surgery, contractures may be prevented by:
- Early movement
- Physical therapy
- Continuous passive motion (CPM) machines—keep joints in motion
Aggressive care of issues like rheumatoid arthritis may also delay or prevent contractures.
Revision Information
- Reviewer: Warren A. Bodine, DO, CAQSM
- Review Date: 05/2018 -
- Update Date: 12/31/2018 -