Definition

A contracture is a condition where the body's tissues become stiff. These tissues, which should be flexible, typically include muscles, tendons, ligaments, and skin. Contractures occur when these tissues, especially muscles or joints, become shortened, limiting movement and flexibility. This happens when the soft tissue beneath the skin loses its ability to stretch.

Muscle contractures cause the muscle to shrink and shorten, while contractures in the ligaments or tendons around joints make the joints stiff and immobile. Skin contractures typically result from scarring, causing the skin to become shortened and rigid.

This condition often causes pain and restricts movement in the affected body part, prompting patients to seek treatment, including physical therapy.

Causes

The most common cause of contracture is a lack of movement in the affected area, such as in patients with joint disorders, severe arthritis, or osteoarthritis. Contractures happen when a muscle or joint is kept tense for too long, resulting in shortening and dysfunction. Common causes include:

• Brain and nerve disorders

Conditions affecting the brain and nervous system, such as cerebral palsy, polio, stroke, nerve damage, and Parkinson’s disease.

• Genetic conditions

Conditions characterized by muscle weakening and tissue loss, such as Duchenne muscular dystrophy (DMD).

• Lack of movement. Prolonged immobility of a body part.
• Traumatic injury
• Burns

If you want to know more about Duchenne muscular dystrophy, you can read it here: Duchenne Muscle Distrophy - Definition, Cause, Symptoms And Treatment

Risk Factor

Several factors increase the risk of developing contractures, including:

• Age
• Most common in individuals over 50.
• Gender
• Men are at higher risk than women, with faster progression of symptoms.
• Hereditary factors
• People of Northern European descent have a higher risk.
• Family history
• Contractures can run in families.
• Occupation
• Some research suggests a correlation between contractures and jobs involving vibrating tools.
• Diabetes
• Alcohol and tobacco use

Symptoms

The main symptoms of contracture are pain and decreased ability to move a particular body part. As contractures worsen, movement becomes restricted, and the tissues become less flexible. You may have difficulty performing simple movements, such as extending your limbs or straightening your fingers.

Diagnosis

A doctor will conduct a physical examination and ask about family history, medical conditions, and the duration of the stiffness. The affected area will be moved to assess the range of motion. Additional tests, such as X-rays or MRIs, may be ordered to determine whether the contracture is caused by issues in the muscles, tendons, or ligaments.

If nerve damage is suspected, further tests such as a brain CT scan or electromyography may be needed. Contractures are often diagnosed through X-rays.

Management

Treatment for contractures varies depending on the severity, location, and underlying medical conditions. The doctor will also consider any impairments in the patient's range of motion. Once a diagnosis is made, the patient will consult with a doctor regarding appropriate treatment. The earlier a contracture is treated, the more likely the patient is to regain normal movement. The reverse is also true.

Some treatments for contractures typically involve a combination of:

• Medications
• Pain relievers and anti-inflammatories can help reduce pain and inflammation.
• Physical therapy
• The goals of physical therapy are to increase range of motion, strengthen muscles, and stop contractures from getting worse. Physical therapy works best, though, when it is regular and combined with exercises the patient does at home. People who are at a high risk of contractures, such as those with cerebral palsy or those who are in the hospital for an extended period of time, can also benefit from physical therapy as a preventative measure.
• Occupational therapy
• Helps patients regain independence in daily activities and is often done alongside physical therapy.
• Assistive devices (splints or casts)
• Used to reposition bones, muscles, and tendons to improve movement.
• Electrical stimulation or heat therapy
• Newer, non-traditional techniques that may delay or avoid surgery.
• Surgery
• The only way to fully remove or correct contractures is by stretching tight muscles through surgical procedures.

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Complications

Delaying or ignoring treatment can make it harder to restore normal range of motion.

Stiff muscles, joints, and skin can interfere with daily activities at home and work.

For those with conditions like cerebral palsy, muscular dystrophy, or multiple sclerosis, ongoing medical care is essential to maximize treatment outcomes.

If you’ve been in the hospital for a long time or have experienced an injury, it’s important to inform healthcare providers about any stiffness or loss of movement you are experiencing.

Prevention

Contractures are easier to prevent than to treat. Regular exercise can help prevent joint and muscle stiffness. Leading an active lifestyle can reduce the risk of contractures.

Patients who require long-term care in hospitals should continue moving their joints regularly, either actively or passively. Physical and occupational therapy can also prevent stiffness in high-risk areas.

When to See a Doctor?

If you experience a burn or injury, contact medical professionals immediately. If you suddenly have difficulty moving an injured body part or have a condition like rheumatoid arthritis that could lead to contractures, see a doctor. If needed, consult with an orthopedic specialist to discuss your condition and the appropriate treatment plan.

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