Spasticity: Conservative Treatment Options 

I watch this video every time I get frustrated with my post-stroke recovery and it empowers me to keep going with rehab.

Thank you so much. It helps me understand more of what my 32 year old son was suffering with. He passed 20 months ago today. Heartbreaking.

I'm in Australia and I have upper arm therapy once week. I have a combination of things that I do to recover my arm and hand such as mirror box, estim, and botox injections every 6 months. In the 3 years since my stroke my spasticity has improved so much. Hard work and commitment pays off.

"There is no challenge you can't overcome with the right attitude." This thought is a gift, thanks!

Thanks for another excellent info video. Looking forward to the next video in the series .Great job

I've just recently found your channel and and am so thankful because it feels liberating to get educated on my condition and be able to help myself at hm in addition of my therapy to improve the results of my recovery I suffered a freak stroke in May at 20, the doctors can't even find a cause, I don't have cholesterol or high BP so they've just said maybe I was too stressed

Excellent explanations. Thank you so much Dr Tara

Thank you very much for all the positive knowledge of yours! God Bless.🙏🙌

I was losing faith in my husband's stretching and brace program. It seemed so passive. My husband wants to walk more, not sit in splints. He's frustrated. So thanks for getting me back on track. I will trust his doctor and his physical therapist. Patience and faith.

I’ve been waiting to have this “aha” moment. Thanks for the enlightenment. Such a good way to explain. 👍🏼👍🏼 more please!

You deserve 10k subscribers. Great advice and thank you so very much

Excellent explanations - thank you so much!

Thank you so much; this information is very helpful

Thank u so much i learned alot from ur videos. Im also a stroke survivor. I hadstroke last Aug. 30 and imdoing well in my recovery with the help of my pt and ur videos

Thank you , Dr. Tara, for the spasticity tutorial video!...As an MS patient, stretching is a MUST!

Such wonderful videos and easy to understand explanations!! :) I’m a newer OT

Dr. Tara excellent video on spasticity

Thank you for creating this!

I have had a PT use dry needling on my effected leg and it has helped with pain and spasticity.

You are right Dr. I am using a foot drop splint for foot drop (over 6 months now) due to Spasticity and it has not helped me overcome it. Stretches are still in progress, very slow progress but signs are positive. Would be waiting for next video to to know more about bracing. Unfortunately I do not have any acupressure expert for neurological cases. Thanks again for your amazing videos.

Thanks for sharing... yes... I do exercise in evening.. our office at SCHINDLER UNIVERSITY.. After head injury, it was a accident resulting paralysis.... falling on my head... now I recovered very well..

Thank you so much for explaining. For a while I thought I had MSA, but I recently saw a movement disorder specialist like yourself and told me what I had was spastic. After hearing you explaining it further I can see it now more clearly. Yes my body retracts a bit when I try to stretch, cold affects me as well, slurred speech... anyways, thank you so much for making this video. I will continue watching and taking further advise from my doctors and listening to you as well.

Thank you I have spasticity from multiple sclerosis. A lot of your videos have helped me.

Another great informative thanx Dr!

Tara, thank you for your comments about spasticity. I experienced a stroke in June 2019, and while being in physical therapy no one discussed spasticity, only that my left arm and leg demonstrated a lot of tone. In December, in therapy my left arm extended, affecting my shoulder and neck and head that i could not control. Really scary! This has occured 4 more times since then. I am afraid of it, and am listening to your presentations to understand what I can do to prevent it. I try to keep my hand touching something, engaged to not act suddenly. Also your instruction videos on learning to use arm and leg have helped med understand therapy much better. Thank you, sincerely Mike

Can't wait for your education on acupuncture video. Thanks Doc.

Thank you for explaining it to me. I have a spastic leg. I have MS and have never had a stroke.

This is sooooo interesting. Thank you

Really appreciate your efforts ❤️

Very helpful for me.. Thank you so much... ❤️🙏❤️

Youve mentioned things that my rehab team has never tol me. I discovered and directed much of my own treatment plan.

This is great info. Thank you! I have shared your link to all my fellow ms ‘ers. Spasticity is a huge problem for us and it seems spastic and weak hip flexors along with foot drop warrants the most attention. Can u please show stretches for those areas and placement for estim would be greatly appreciated! Wish I lived in a Orlando!

Thank you for this explanation of spasticity. I’m an MSer. I have spasticity on my left side. I do use a Bioness to help me walk. I’m a nurse working full time. Thank you for this content.

I liked that video...keep up the good work!

great explanation. liked the seatbelt. thank you.

i have watched this video so many times and every time I watch it the more appreciative I am for it. What an excellent description of a condition that's been giving me so many headaches. I have severe spasticity on my left side, especially in cold weather (upper and lower) and i'm really struggling with it, but I do lots of stretching and find that it helps me tremendously. THANK YOU DR TARA YOU ARE GODSENT!

Thanks so much…MS causes spasticity so I learn something every time I hear about strategies. ☺️

I was told that spasticity comes because inhibitors do not work. Your explanation is much more complex and makes real sense. Thank you so much for your super videos, you are such a big help on my road to recovery, Dr. Tara 💛🙏🤗

Thank you.

You speak very practical and educative. Had take dosage of botox to reduce spasticity. Recommended by my physician. Thank for uploading meaningful videos.

thank you so much

Your advice was so excellent, I constatly flap at my knees while walkib, your advice will be kindky appreciated

Thank you!

I loved this video thanks a million helped a lot

You are the best. 🙌

when i stand in the shower without myAFO it is shaking time first have to reposition my leg to relax my exercize for my tremors i do the threshold stretch feels so relaxed afterwards but since i left hospital i do exercizes loe them👍👍wait for more vids

I need this help. Thank you

Good good good Acupuncture has worked very well for me. She includes e-stim at strategic points.

Excellent RU-vid video on spasticity from a Board Certified Neurologic Clinical Specialist (NCS) Physical Therapist, Dr. Tara Tobias

Don't forget Massage Therapy! I am a Licensed Massage Therapist and have a client who had an accident in his early 20'd and left side is Hemiplegic; his left arm has Spasticity starting at Scalenes and down complete left arm. We use moist heat first to the area, then stretch by straightening that arm as high as comfortable and each time he goes a bit further. We do Massage Therapy to the complete back area- he sits at a Tabletop Unit in a wheelchair; claims it breaks Spasticity and often into the 3rd arm overhead/flexion stretch is when the Clonus kicks in. I use a massage tool that gives consistent percussion around the entire Scapula, Teres and Seratus, Latissimus muscles as well. He does well with that tool. Right now I am doing a 30 minute session twice a week at his home. Thank you more than words for sharing the information in this video- I am so grateful to learn about Neuro actions and reactions. God bless you and your family.

Thank you for this very informative video. I had a stroke at 36. Spasticity has been a complete nightmare. These tips are helpful. Appreciate you sharing your knowledge with us.

Thanks

it has been 5 years since stroke while in the hospital had alot pt lower exstematies, asked pt on arm and hand and was told that since arm/ were smaller muscles that they didn't come back as quickly I have since asked pt but they seem to be more concerned with leg I do have spascity and suppinated foot I find my afo very painful, finally went podiatrist who ordered me a custom insole which helped for a while maybe I need a new one

Stretching is for sure, do it until you get a little bit of pain not too much But you got to keep doing it 👍🏽

Thankyou very much so much informative🌹

Do you great videos can you speak more about ataxia all these exercises and things to talk about go for Add tax year as well please let us know at the beginning of videos thanks

This is the first time I am reading so much related information. I just wish Drs here knew more about this because I am getting so misunderstood

THANK YOU for posting this video. Re increase over time: I have what PTs have severe spasticity in my leg and hip flexors. At the 9 yrs mark of my recovery I developed EXTREME pain in my lower hamstring behind my knee when moving from flexion to extension. Sit to stand was BRUTAL (and my pain threshold is pretty high). After multiple evals over 2 yrs, the final diagnosis was shortening of the hamstring muscle. Increasing Baclofin to 60 mg per day and Taking some BOTOX from my calf and injecting it to my hamstring brought pain down to 50% which is totally manageable. I wish the FDA would allow more than 600 units total for tbe whole body. Doc would add more (just a bit) to ham. This validates the conclusion that took 2 years to arrive at. See below for my journey to reaching this diagnosis and fix

Are you still going to do a video on acupuncture? If you are can you please go in depth on the use of e stim for upper extremity recovery in the acupuncture video?

Hello! Thank you very much for your Videos here on RU-vid. I'm a physiotherapiest from Germany and did my exam last year. Now i'm working mostly with neurological patients. Often i'm still overtaxed by the complexity of diseases and symptoms. Especially spasticity. Can you recommed a book about spasticity treatment? We learned nearly nothing about it and i want to do good and effective therapies. But sometimes i just dont know better. Maybe you can help me out :) Greetings from Germany!

Dr Tara, I was searching on youTube for an explanation to the spasticity that I started experiencing after I had a stroke in January of this year when I saw your video explanation about spasticity and I immediately subscribed the video and gave it a thumbs up in the end. I stretch my quads some days of the week. Could you please delve deeper into type of exercises that is good for spasticity of the things ? I usually would lay on my stomach and pull my legs as far as I can towards my head high enough to feel the stretch on my my thighs. about 5 minutes

Wish you would share differences between spasticity in stroke vs MS

Doc, can you please do a video on e stim?

Meu inglês é pobre, mas entendi e está a me fazer muito bem. obrigado.

I go every 3 months for Botox at the Hospital. It is a process. This got worse after my heart attack July 1, 2019. Hereditary. I had emergency surgery with no heart damage. Easy as pie. The Spasticity is work. I was always a fit athlete. Cycle for 50 years now. Now I can't cycle due to sore quads. I stretch and exercise daily. Use to be a competitive swimmer and semi-pro skateboarder. I gotta keep working at this daily. 154 pounds with proper BMI. Eat healthy too. Looking into Nerve Ablation. MRI of lower back in a few months to see of I am a candidate.

Accupunture works for me

Unfortunately I can not wear my afo anymore because of leg swelling and on open sore at the very top of my afo caused by the afo! Am not sure why the leg is swollen but I will need to see my doctor,he is only a general practitioner and there is not an orthotist in my area!

Hey doc, have you ever heard of an e stim unit called ARPwave PRS they claim . It also creates new neuro patterns to re-train the brain-to-body communication! That would be a perfect e stim unit for upper extremity recovery after a stroke?

When straighten your affected arm at the elbow how would I know if its my bicep or elbow flexor has spascity? I definitely know I have resistance while trying to straighten out my affected arm at the elbow!

Thanks dr Tara

Okay you said that load sounds and bright lights and pain what about strong smells because my family all smoke and I have told them that it effects me but they think that it's in my head

Can you please better explain,what you have seen clinically that neuromuscular e stim has done for upper extremity? How do you use e stim to be beneficial for upper extremity recovery?

Also where is video for lower body stretches? Thanks

what can help my knees to bend? they go spastic while I am walking and then I fall because it doesn't bend. What muscle does that; what AFO's should can I try? Will a brace AFO help me bend my knee?

Stretching in the flexor synergy will increase the tendancy of the reflex arc to flex more... So is stretching and bracing are good...??

Good iñformation

videos are very informative but explain if botox can help bend knee with hyper tone. Thank you.

could you recommend exercise for inversion plantar flexion from stroke ?

What are the best treatment options for patients in the flaccid stage?

i heart dr tobias

I've been suffering 😫 for two years with uncontrollable muscle spasms on right leg! I've been to several doctors nothing helps! I have rls too. I was diagnosed with scartica.

can youbeat high tone by repetative movement of bicep for example

How do you correct the reflex arc in the arm? Thru the muscles or the brain?

Please how do you get paraplegia lower limbs due to stroke to move especially weight shifting to allow movement...have a patient who can move the left leg but is unable to move the right entirely it only assume knee partial knee flexion and ankle heel off

Hello Dr. Tobias, been dealing with spasticity in my right calf since January 2020, and it looks like its gotten to my right hand starting around March of 2022. I've done MRI's on my brain, neck, and spine. EMG. CT Scan. Lumbar Puncture. The doctors tell me that everything looks mostly normal, nothing too notable where they can say "AHA! THATS WHATS CAUSING IT!" I've learned that this is mainly caused by brain damage or stroke, and according to the MRI's, I dont have any brain damage. I haven't had a stroke. My doctors are still having me run tests to figure out what it is. We tried botox in early August, but had to start with a low dosage because too much will numb the muscle, and unfortunately looks like it was too low. Hoping next Friday when we go up on the dosage, it works. But there is just mystery left and right. What do you think? Looks like botox is my best shot right now, but I want to give acupuncture a try for a while. Did it once this week, hoping to do it a few more weeks and see some effects. Also want to try Electrical Stimulation. I'm only 31, so dealing with this is tearing me apart because I can't really work out. I also got clonus in my right foot that gets active if you touch my right heel a certain way.

Did you post the part two video?

Hello. Is there any way you could talk about an unrecognized stroke? And how that would affect someone after 5 months of being untreated?

What are the surgical procedures for bad spasticity 10+ years

Hey, I had spinal cord injury 7months before and I need to know if massaging my legs with warm oils will increase spasticity please help.

But how do you use it if you cannot move it? Go to constraint on, in my case the right arm so I have to use the affected arm I have recovered some movement in my affected leg by try try and try again guess I need to do that with my arm ( have some spasticity but not severe in the arm do have internal rotation I do try stretching (using strong arm)

What is exercise for curly foot fingers,kindly give demonstation

Unfortunately,I do not wear my afo now because of my leg swelling and open sore on my leg at the very top of the afo

Hey doc is this the same as tone in the leg. How is it fixed or strengthen?

Hi doc.is it possible for me to recover after being stroke a couple of months ago and then left part of my body was paralyzed but It can feel the way I touch it.

Good

I observed lately that I'm experiencing sudden involuntary movements or jerking of my affected leg and arm especially when I am lying down on my back. Is this a good dogn or not? Thank you Dr. Tara..

Please what is the best way to communicate with you, I have an issue like this that I really need help with and I have seen multiple physio’s and doctors and they usually don’t know what I’m going on about when I try and explain my struggle or push me out the door with strengthening excercises that never seem to help

How do we know if the physical therapist is adept at these techniques and not winging it

I have spasticity on legs because of spinal injury. Baclofen helps with my speech but it makes more stiff on my legs and clonus a lot. If I stop it my legs are less stiff but my speech become very worst. What’s your suggestion? My fingers also affected. I am an IT engineer and I need to type a lot and it should be faster.

Can E-Stim work for Hereditary Spastic Paraplegia? I have a client with this condition on the lower body.