Monday, July 9, 2012

Fighting Spasticity

In my last post Definitions for Recovery, I talked about breaking spasms and fighting spasticity – the muscle tightness that keeps me from walking and using my hand normally. These are the treatments that have made a significant difference:

Electrical Stimulation: Electrodes placed strategically on my skin emit an "alternating" electrical current mimicking my body's own electrical conductivity and stimulating my weak muscles. This has helped improve my own nerve conduction and muscle responsiveness. 3x/week.

Strength Training: Strength-building exercises are key to fighting both spasms and spasticity. Muscles go into spasm as a protective measure against further injury. For example, the spasm on the inside of my calf and foot defends against my weak ankle rolling out. By building strength in my ankle over time, I can break the spasm cycle. Already, muscle I've built in my upper back has significantly reduced spasms in my chest, improving range of motion in my shoulder. 3x/week.

Pressure Point Massage: Look for a massage therapist like mine who has extensive training in sports injury rehabilitation (mine used to travel with the L.A. Lakers), as well as knowledge of kinesiology and neurology. My masseuse works through all three layers of muscle, sometimes applying pressure so deep, her hands shake. 1x/week.

Botox: (Post 1-26-12)

Baclofen: I take a low daily dose (20 mg) of this muscle relaxant – helpful especially in the beginning when exercise increased the stiffness in my muscles. I hope to soon reduce my dosage and ultimately discontinue it.

Home Program: I continue to be active; to wear my nighttime foot and hand braces; and to stretch and exercise my hand 5-6 times/week.

Next post: how you know you're on the right track – what it feels like when spasms start to break down.

Tuesday, July 3, 2012

Definitions for Recovery

In the hospital I acquired a stroke survivor's vocabulary. My left arm was "flaccid" – hanging loose and limp. Then "tone" set in. Normal muscle tone is a state of balanced tension – not too loose and not too tight. My muscles have too much tone: they are no longer "elastic," they are "spastic": characterized by tightness and lack of coordination.

Many of the medical personnel who have treated me use "spasticity" as a blanket term to describe the muscle tightness commonly felt by stroke survivors. However, the two therapists who work with me most frequently attribute some of my symptoms to "spasm." I am not only spastic, I am “spasmodic.”

What is the difference?

Spastic (spasticity) describes a neurological condition that causes the muscles to over-contract when in use, thus creating a sensation of tightness; spasticity is velocity-induced tightness.

Spasmodic (spasm) refers to a physical condition in which muscles contract because the nerves are irritated. Spasm can be in effect even when the muscles are at rest.

Why is this important?

Spasm can be corrected permanently. By breaking spasm, muscles can achieve a greater range of motion. This, in turn, allows greater options for strengthening the muscle. Muscle weakness is a common factor in both spasm and spasticity. Strengthening muscle counteracts both conditions. 

I’ve been told spasticity will be with me the rest of my life; but I’ve also been told that strengthening muscles and repetitive use to form new neural pathways can reduce its impact to the point where it won’t bother me much of the time. This is what I’m working toward.

Next post: How the A-Team and I are breaking spasms and fighting spasticity.