Saturday, May 18, 2013

Spasticity and Multiple Sclerosis: Not Just A Knot in the Muscles

By Lisa Emrich, Health Guide Friday, June 03, 2011

The topic of spasticity has been on my mind since I’ve been experiencing it more lately.  Four years ago, I did not understand what was spasticity and what was not.  I complained of really tight muscles to my neurologist who suggested that I exercise more.  His advice was logical but it didn’t directly solve my problem.

For many months I lived with this excess tightness which no amount of stretching seemed to resolve.  Yoga was nice, as was swimming, but I never seemed to achieve that blissful level of release in my muscles which I so desired.

It wasn’t until a year later (or so) that the tightness and stiffness in my legs got to the point where I just had to complain about it in an appointment.  During this appointment, I was consulting with the nurse practitioner who prescribed a trial of Baclofen.  I started at a low dose as she suggested and gradually increased it every few days ever so much. 

Within about a week, I began to feel a difference.  Thank goodness!! 

The message from my brain and through my spinal cord had been misinforming my leg muscles to pull against themselves.  Or rather the spasticity was the result of an imbalance between hyperactive muscle stretch reflexes and muscle contractions. The prescription medication served to disrupt this incorrect message and to break the cycle of stretching and pulling which tied up the muscles in knots.

Keep in mind that my experience with spasticity is just that…..my personal experience.  Many MS patients have spasticity which is much more dramatic and disabling than I have had.  My spasticity primarily effects my calves and hamstrings.  However, it is actually more common in MS patients to have spasticity in the thighs (front of the leg) and dorsiflex muscles (on the shins).

With the tightness and resistance to stretching showing up on the back of my legs, it becomes important to try to strengthen the muscles on the front of my legs in addition to gently stretching the calves and hamstrings.  My physical therapist recommends a few simple stretches.

One stretch involves sitting in a chair and placing your foot on another chair (or sitting along side the edge of your bed with one leg hanging off and your torso facing the head/foot board).  If you cannot reach your foot in the straightened leg, use a towel or yoga strap to wrap around your foot.  Keep your knee straight (or as straight as you can get it) and pull on your flexed foot.  Hold the stretch for a full minute and repeat with the other leg.  Repeat this cycle at least three times.

Currently, the knot in my outer calf muscle is causing me some minor grief.  To isolate that particular muscle, I repeat the above stretch but pull my foot to point toward the opposite leg (a bit pidgeon-toed).  Sometimes I will even use my other hand to massage the tight muscles and to rub on the “sore spots” for additional relief.

By Lisa Emrich, Health Guide— Last Modified: 09/06/12, First Published: 06/03/11