Spasticity is a common challenge for those recovering from neurological conditions like stroke, cerebral palsy, and multiple sclerosis. It can cause muscle stiffness, tightness, and spasms, making everyday activities like dressing, eating, and writing difficult. Fortunately, targeted exercises can help loosen tight muscles, improve mobility, and restore functional movement.
The following exercises are meant to provide a guide for individuals experiencing spasticity in the hands, wrists or elbows. We hope that with regular practice of these exercises you will see improved mobility, reduced stiffness-related discomfort, and greater independence.
Getting Started: Essential Exercise Tips
Before jumping into the exercises, keep these key guidelines in mind:
- Move slowly and with control to prevent triggering spasms.
- Focus on deep, steady breathing to help your muscles relax.
- Stretch before strengthening to enhance flexibility and reduce stiffness.
- Perform each exercise 5-10 times, increasing gradually as tolerated.
- If you feel pain or excessive discomfort, stop and consult a healthcare professional.
Best Hand Exercises for Spasticity
Hand spasticity can make it hard to open the fingers or grasp objects effectively. Oftentimes, this can directly impact daily activities such as holding a glass or grasping a pen. The following exercises are meant to encourage greater flexibility as well as fine motor control in the affected hand.
1. Passive Finger Stretches
This stretch is ideal for individuals who experience severe finger stiffness, making it difficult to open their hands. It helps lengthen tight muscles and improve hand flexibility, which is crucial for performing daily tasks such as grasping objects or typing.
How to perform:
- Use your unaffected hand to gently extend and spread each finger apart. If it is hard to spread the fingers apart, start by intertwining your fingers, using the fingers of the unaffected hand to help separate those on your affected hand.
- Hold the stretch for 15-30 seconds.
- Avoid forcing any movement and apply gentle pressure.
- Repeat as needed to improve flexibility.
Provided you do not feel any discomfort, you can continue to practice this exercise as much as you feel comfortable.
2. Finger Extension with Resistance
This next exercise is a little more advanced but also beneficial for those who struggle to open their fingers due to persistent tightness. Finger extensions help to strengthen the finger extensors which can help counteract the tendency for the hand to remain clenched, improving overall dexterity.
How to perform:
- Wrap a rubber band around your fingers.
- Slowly spread your fingers apart, working against the resistance.
- Hold the position for a few seconds before releasing.
- Repeat several times to build strength and control.
3. Hand Opening Against a Surface
For individuals with difficulty fully opening their hand, this exercise encourages gradual relaxation and extension. It can help in tasks like holding utensils or turning doorknobs more effectively.
How to perform:
- Place your affected hand flat on a table. You can use the unaffected hand or a caregiver to make sure it is flat.
- Gently press down to extend your fingers and palm.
- Hold for 10-20 seconds, ensuring a gradual and controlled motion.
- Repeat as necessary to enhance mobility.
4. Thumb Opposition Exercise
For individuals who struggle with gripping or pinching objects due to thumb tightness, this exercise may be beneficial. It can improve thumb mobility and fine motor skills necessary for tasks such as buttoning shirts and holding small objects. One thing to note is that it does require some control so it may be a little bit difficult for some.
How to perform:
- Touch your thumb to each fingertip one by one, forming an “O” shape.
- Hold each position for a few seconds before moving to the next fingertip.
- Repeat for multiple cycles to improve coordination.
This is a common exercise for many individuals in rehab following a stroke and is used throughout the MusicGlove rehab game to improve mobility in an engaging way.
5. Finger Tapping
If fine motor coordination is a challenge, this exercise helps improve control and finger independence, aiding in writing and other precision tasks.
How to perform:
- Place your hand on a table with fingers extended.
- Tap each fingertip to the surface, moving from the index finger to the pinky and back.
- Repeat for 10-15 cycles.
This exercise will require some existing motor control to be effective but overall is a great way to improve the fine motor skills and control in your fingers.
6. Finger and Palm Stretch
This last exercise for hand spasticity is another stretch to help individuals experiencing both overall hand stiffness and difficulty in grasping objects. It enhances flexibility and reduces tightness in the fingers and palm.
How to perform:
- Hold your affected hand with your other hand.
- Gently pull back the fingers and palm.
- Hold for 15-30 seconds, then relax.
- Repeat as needed to improve flexibility.
You can also have a caregiver assist you with this stretch if you are unable to hold the affected hand. For a greater stretch, try straightening the elbow with the arm stretched out in front of you, then gently use your unaffected hand to extend the fingers, palm and wrist back toward you.
Of note, individuals with severe hand spasticity may benefit from using a splint, especially at night. If the hand is clenched and very challenging to open, it may be beneficial to roll a clean washcloth into the palm to gently stretch the fingers and prevent moisture buildup. Talk with your occupational therapist for more personalized recommendations.
For more hand exercises and stretches, check out our YouTube series on Best Hand Exercises for Stroke Patients!
Best Wrist Exercises for Spasticity
Wrist stiffness can limit movement and make everyday tasks like pouring a drink or using a computer mouse extremely difficult. The goal of this next group of exercises is to focus on improving flexibility and control for individuals experiencing wrist spasticity.
1. Passive Wrist Stretches
This first exercise for wrist spasticity is meant to help those experiencing limited wrist mobility. The goal is to try and restore a more functional range of motion or one that doesn’t limit regular everyday activities of living.
How to perform:
- Use your opposite hand to gently bend the affected wrist forward and backward.
- Hold each position for 15-30 seconds.
- Repeat daily to improve flexibility.
Remember to not push too hard either way and always stop if you feel pain or unnecessary discomfort. For a challenge, try completing this exercise with your arm stretched out in front of you with your elbow extended.
2. Wrist Flexion and Extension
If weakness and stiffness make it hard to move the wrist freely, this exercise can help restore strength and fluidity. This exercise will require some control and can help with both stretching and strengthening.
How to perform:
- Rest your forearm on a table with your hand hanging off the edge.
- Slowly bend your wrist upward (extension) and then downward (flexion).
- Perform 10 repetitions in each direction.
3. Wrist Figure 8s
This last exercise is meant to improve rotational flexibility and functional movement and should be appropriate for most individuals.
How to perform:
- Keep your elbow bent at 90 degrees.
- Slowly rotate your wrist outward and inward, as if making a figure 8 with your hand.
- Repeat 10 times each way.
Remember to move slowly and stop if you feel any pain or discomfort.
Elbow Exercises for Spasticity
Tightness in the elbow can make it challenging to bend or extend the arm fully. This next group of exercises focused on improving range of motion and reducing stiffness or spasticity in the elbow.
1. Passive Elbow Extension Stretch
This first stretch encourages gradual extension for those with difficulty straightening the elbow. It is appropriate for most individuals, however remember to go slow and stop if you feel any pain or discomfort.
How to perform:
- Use your opposite hand to support your affected arm out in front of you.
- Slowly straighten your elbow as much as possible, allowing gravity to gradually straighten it.
- Hold for 15-30 seconds before relaxing.
2. Assisted Elbow Bends
Alternatively, if the first stretch is too difficult on your own, a caregiver or therapist can help with an assisted elbow bend, described below.
How to perform:
- Hold your forearm with your opposite hand (or with the help of a caregiver).
- Gently bend and straighten the elbow, keeping the upper arm still.
- Repeat 10 times, ensuring smooth, slow movements.
This gentle movement promotes controlled flexibility and allows you to get the most out of the stretch in the safest way.
Final Thoughts
By incorporating these spasticity exercises into your daily routine, you can improve flexibility, reduce stiffness, and enhance mobility. Stretching, strengthening, and functional movement work together to create a comprehensive approach to managing spasticity. While those with severe spasticity may benefit from using a splint to provide a gradual stretch to the joints, these ideally would only be used temporarily.
You can consider other treatment options for spasticity here as well.
Patience and consistency are key to seeing progress. Keep practicing, and over time, you’ll notice improved control and comfort in your movements.
We hope these exercises are helpful!
