Once again, welcome back to the ThreeSpires Physiotherapy blog. In the last couple of blogs we have been examining how joint contractures can affect patients and what they are. In this blog post I thought we should look at how they can be prevented and how physiotherapy can help with preventing and treating them.

So, firstly the main point to note is that joint contractures are usually preventable and that the best way to treat joint contractures is to prevent them happening in the first place. I know that this sounds like common sense (and it is!) but it is a key point to note as once a patient has a full-blown contracture it is very difficult to treat without extremely aggressive and usually painful interventions. A good, daily routine of stretching and taking each joint through a full range of motion makes sure that any patient who is in bed has the chance to take all their joints e.g. the elbow through a good range. It also gives carers and any staff a chance to see if any joint is stiffening up and then decide on a plan of action. Generally, this stretching routine does not need to be onerous and can be done very quickly. By having a regular routine in place like this it means that staff are aware of anyone who is beginning to tighten up and can begin doing more with this patient to prevent things worsening and them having a full-blown joint contracture.

Personally, as a physiotherapist, I think that care homes, hospitals and medical professionals  should treat joint contractures in the same terms that we treat pressure sores e.g. they are fully preventable, very disabling, hinder rehab and once you have one it is very difficult to treat. Therefore, the best way is to have a good daily routine of assessment and stretching of all limbs each day. Often unfortunately this approach does not happen and for the lack of a few minutes of moving a patient’s elbow and wrist through a full range they then lose that movement forever.

Sometimes a short period of stretching of a particular joint each day may not be enough and in these cases it is important that they are seen and assessed by a physiotherapist to determine the next step. For example if someone has a large amount of tone in that limb following a stroke, they may need a brace to keep the joint from being bent all day. Or possibly they may simply need a bit more manual stretching each day than the staff can currently provide.

I hope that you have enjoyed reading this blog, if you have any concerns about anyone who has become immobile recently and whom you suspect is at risk of a joint contracture please get in touch. Our physiotherapists have a large amount of experience of working in care and nursing homes and assessing and treating patients with contractures.

For anyone reading: we are a home visit physiotherapy service, based in Lichfield but serving anywhere within a 20 minute drive including areas such as Sutton Coldfield, Tamworth, Cannock, Burton and Rugeley. We offer a wide range of services including paediatric physiotherapy, post-operative rehabilitation, neurological physiotherapy and neck and back pain relief. If you need further information or would like to book an appointment we can be contacted on 0788 428 1623 or via enquiries@threespiresphysiotherapy.co.uk