Contracture Deformity

A contracture deformity is the result of stiffness or constriction in the connective tissues of your body. This can occur in your muscles, tendons, ligaments, and skin. You can also experience a contracture deformity in your joint capsules. This is the dense fibrous connective tissue that stabilizes the joint — and adjoining bones — at the deepest, most internal level.

Contracture deformity restricts normal movement. It develops when your usually pliable connective tissues become less flexible. This means that your range of motion will be limited. You may have difficulty:

• moving your hands
• stretching your legs
• straightening your fingers
• extending another part of your body

Contractures can occur in different parts of your body, such as:

• Muscles: A muscle contracture involves the shortening and tightening of the muscles.
• Joints: If there is contracture in the joint capsule where two or more bones connect, you will experience limited range of motion in that area of your body.
• Skin: Skin may contract where it has been scarred a burn or from past surgery. This will limit your ability to move that part of your body.

Symptoms of contracture deformity

The main symptom of contracture deformity is reduced ability to move an area of your body. You might also have pain, depending on the location and cause of the problem.

Common causes of contracture deformity

The most common causes of contracture are inactivity and scarring from an injury or burn. People who have other conditions that keep them from moving around are at high risk for contracture deformity. That’s because the muscles and joints they aren’t moving through their normal range of motion are prime candidates for tightening.

For example, joint contractures are common in patients discharged from intensive care units or after long hospital stays. Other causes include diseases that are inherited or that develop in early childhood, such as:

• Muscular dystrophy: People with this disease often experience muscle tightness because significantly weak muscles impair their ability to move.
• Cerebral palsy: This disease causes muscle tightness and limits movement.
• Central nervous system diseases: These includes polio, multiple sclerosis (MS), or Parkinson’s disease.
• Inflammatory diseases: Having rheumatoid arthritis (RA) puts you more at risk for contracture deformity.

When to seek help

If you get burned or injured, seek immediate medical assistance. Call your doctor if your ability to move the affected part of your body is suddenly limited.

Seek treatment for chronic diseases and underlying conditions such as rheumatoid arthritis. Treatment can help decrease or prevent symptoms.

Assessing and treating symptoms

Medical exam

Your doctor will give you a physical exam and ask about your medical history. Be prepared to explain your symptoms. Your doctor will probably ask you about:

• the specific location of your problem
• the intensity of your symptoms
• how much movement you still have
• how long your movement of that area has been restricted

Your doctor may order X-rays or other tests to diagnose your condition.

Physical therapy

Physical therapy is one of the most common treatments for contractures. It helps to increase your range of motion and strengthen your muscles. Physical therapy sessions require regular attendance for best results. Your physical therapist can show you exercises to do at home. They can also provide hands-on therapy to improve your mobility.

Devices

You may need to wear a cast or a splint to help stretch the tissues near the problem area. A continuous passive motion (CPM) machine may be used to keep moving the affected part of your body.

Medication

Your doctor may prescribe medication to reduce inflammation and pain. In cerebral palsy patients, botulinium toxin (Botox) is sometimes injected into muscles to reduce tension and minimize spasms.

Surgery

Surgery may be needed to lengthen muscles or repair ligaments, tendons, or bones damaged in an accident. For example, your surgeon may repair a ligament in your knee, with the hope that you’ll regain full range of motion in the long term.

Consequences of delaying treatment

Delaying or forgoing treatment may make it difficult or impossible for you to regain your range of motion. Stiff muscles, joints, and skin can interfere with performing everyday tasks at home and work.

People with diseases such as cerebral palsy, muscular dystrophy, and multiple sclerosis should be under continual medical care for the best outcomes.

If you have stayed long-term in the hospital or have been injured, it’s especially important to tell your doctor about any stiffness or loss of movement you have.

Preventing contracture deformity

Regular exercise and an active lifestyle can help prevent muscle and joint stiffness. Ask your doctor or physical therapist about the best exercise program for you. When playing sports or lifting heavy objects, use caution to prevent injuries.

If you are injured, see your doctor right away. Follow your doctor’s treatment recommendations to help prevent contracture. Physical therapy and devices that passively move your joints can also help prevent problem areas from stiffening.