Muscle contractures , also known as contracture deformity, occur when the soft tissue under the skin loses its elasticity and cannot stretch. In other words, it is a permanent shortening and hardening of muscle fibers that reduces flexibility and makes movement difficult. It can also affect tendons and ligaments , and occur anywhere in the body. It occurs when a muscle loses elasticity. If a muscle cannot move and stretch, nearby joints also lose mobility and become painful.
The most common trigger is prolonged muscle spasticity in the affected area, usually as a result of an underlying condition such as cerebral palsy. They often result in restricted or limited movement of the affected body part, as well as pain. When trying to stretch the contracted muscle, the person will feel it become very stiff, which will increase the muscle pain .
Main causes of contractures
Muscle contractures are caused by permanent shortening of muscle fibers and changes in normal muscle structure.
Sarcomeres are the fundamental units of muscles that cause muscle fibers to contract. With muscle contractures, sarcomeres become too long when muscle fibers contract. This increase in sarcomere length prevents the muscle from contracting normally, resulting in muscle weakness.
Muscle fibers are encased in an extracellular matrix, a mesh-like network composed of collagen and other proteins that help transmit force and provide muscle contraction. With muscle contractures, the amount of collagen within the extracellular matrix increases, causing a tightening of the fibers that restricts movement.
Muscle contractures also form from a decrease in satellite cells, which are specialized stem cells that can rebuild muscles and are necessary for muscle regeneration and repair. Without an adequate amount of this type of cell, others, such as fibroblasts, increase significantly within the muscle tissue, causing muscle fibers to become stiff and fibrotic.
These changes in sarcomeres, collagen within the extracellular matrix, and satellite cells are the result of conditions in which neurological input to the muscles from the brain and spinal cord is reduced. This is due to lack of use, injury, or neurological and neuromuscular conditions, such as:
- Underlying brain and nerve conditions : Muscle and joint contractures can be due to several underlying conditions or disorders that affect the brain and nervous system, such as cerebral palsy, polio, rheumatoid arthritis, stroke, and nerve damage.
- Genetic condition : They sometimes also occur as an inherited disease, as in the case of muscular dystrophy, a condition characterized by weak muscles and tissue loss.
- Prolonged lack of mobility in the affected limb .
- Traumatic injury
- Burns
Types of contractures
As a general rule, contractures are not classified in themselves, but they can be named according to the way in which they originate.
Post-traumatic or defensive contractures
These are those that arise due to an impact, such as a car accident, since they arise as a defensive response to protect the sensitive structures of the body.
Postural contractures
These are slow and progressive injuries due to bad posture. At first they do not cause much pain, but if they continue the problem can become worse. It is very common to have neck contractures due to maintaining a bad posture.
Contractures due to hypotonia
This type of contracture usually occurs when playing sports because it occurs when the muscle is weak and we apply more force than it can withstand.
Within the type of contractures, we can also classify them by the area of the pain.
Neck contracture
These are the most common muscle contractures because they accumulate a lot of tension due to poor daily posture and, when it comes to exercising, they are a forgotten area.
Back contracture
As in the previous case, it is also a muscle contracture. It is usually caused by making great efforts without the correct posture and, of course, by not having a correct body posture.
Lumbar contracture
Lumbar contractures are located in the lower back and are caused by various reasons, such as having made a great physical effort or having a sedentary lifestyle.
Shoulder contracture
It is a type of contracture that is quite annoying because the pain is persistent. It may also be accompanied by a slight inflammation of the area.
It is common for it to be caused by stress or lifting heavy weights.
How to prevent contractures
Unfortunately, some muscle contractures cannot be prevented no matter how much we maintain a correct posture or do a good warm-up and stretching after each training session, but there are things that are advisable to do to avoid them as much as possible.
Stretching and warm-up exercises
As we mentioned before, preparing the body before a sports session is important so that the muscle is ready to work. Likewise, stretching also helps to avoid contractures, but you should not push the muscle to its limits.
Do daily exercise
Having a daily exercise routine also helps prevent those unwanted contractures because it helps keep the body and muscles in shape. However, if you have never practiced any sport, you should start little by little.
Correct posture
Having a correct posture is not only for aesthetic reasons, but it also helps to avoid contractures, especially if you have to sit for a long time or constantly lift weights.
Apply heat
When you feel that a muscle is sore, a good way to relax it is by applying heat to the area to reduce the pain.
How to eliminate contractures
If even with the above recommendations it has been impossible to avoid muscle contracture, these are some of the most commonly used treatments to cure them.
Physical therapy
Physiotherapists are great allies when it comes to treating a contracture and reducing its severity. They perform stretching and mobility exercises to relax muscle tension.
At this point, relaxing massages also help to eliminate those contractures that are causing great pain. Professionals often use relaxing oils to obtain better results.
Orthopedic devices or splints
Braces or splints are custom made to fit different parts of the body and are used when the contracture is significant. Their function is to provide prolonged, low-intensity stretching over a long period of time to increase the length of the muscle. Once an increase in muscle length has been achieved, another brace or splint may need to be made to fit properly.
Surgery
Surgery is the last resort when it comes to removing a contracture, but it is very necessary in severe cases where muscle contractures limit the range of motion for daily life activities. Tight muscles can be surgically cut and tendons can be lengthened to allow greater mobility.
Muscle contractures cause muscles to become tight and difficult to move and stretch. It is not always preventable, but there are now a wide range of remedies and treatments available to help relax muscles and preserve or restore range of motion.