Muscles And Messages: Stroke's Impact Explained

A stroke occurs when the blood supply to the brain is interrupted, either due to a blocked or burst artery. This interruption causes brain cells to become damaged and can lead to cell death if the brain is deprived of oxygen for too long. The effects of a stroke vary depending on the severity and location of the stroke, but one common question from survivors is, Why do my muscles and messages get broken?

Messages travel between the brain and the muscles, controlling how our muscles feel and move. If the part of the brain that sends and receives these messages is injured by a stroke, it can result in muscle spasticity, where the muscles feel stiff and tight and may resist movement. This is caused by a disruption in the complex process of neural messaging between the brain and the muscles. The brain controls both involuntary and voluntary muscle activity, and when this process is interrupted, it can lead to muscle weakness, paralysis, and changes in muscle tone and coordination.

Rehabilitation and physical therapy are crucial for improving muscle function after a stroke. Dedicated rehabilitation can help individuals recover movement and improve muscle activation and strength. Passive range-of-motion exercises, where a therapist or caregiver moves the affected limbs, can also help activate neuroplasticity and improve muscle function. Active exercises, such as repetitive active exercises, are also important for strengthening neural pathways and improving muscle function.

Paralysis and muscle weakness occur when messages can't travel properly from the brain to the muscles

Paralysis and muscle weakness can occur when messages can't travel properly from the brain to the muscles. This happens because a stroke disrupts the complex process by which the brain controls muscle movement.

The brain controls both involuntary and voluntary muscle activity by sending neural messages to the muscles. These messages are transmitted from the motor cortex, located in the brain's frontal lobe, to the spinal cord, and from there to the motor neurons. When these neurons fire, the impulse travels to the specific muscle, instructing it to contract or relax.

However, when a stroke occurs, this process is disrupted. A stroke takes place when the blood supply to the brain is interrupted, either due to a blocked or burst artery. The resulting tissue damage in the brain leads to changes in how the brain and muscles communicate. Depending on the severity and location of the stroke, this can result in paralysis or muscle weakness on one side of the body.

Paralysis, or hemiplegia, occurs when the neural signals from the brain to the muscles are completely severed. On the other hand, muscle weakness, or hemiparesis, happens when the connection is damaged but not lost entirely, allowing some neural signals to still pass to the muscles.

In addition to paralysis and muscle weakness, a stroke can also cause muscle spasticity, which can make muscles feel stiff and tight, and they may resist movement. Spasticity can affect a person's ability to walk, their balance, and increase the risk of falling. It can also impact activities such as opening the hand or reaching for something.

To manage these issues, treatment options such as physiotherapy, occupational therapy, and medication may be recommended. It is also important for individuals recovering from a stroke to stay as active as possible and continue doing their exercises, as reduced movement can worsen muscle spasticity.

A stroke can cause muscle stiffness, known as spasticity, or hypertonia

Spasticity can affect the leg and arm muscles, making it difficult to walk, affecting balance, and causing fatigue. It can also impact the ability to open the hand or reach for something. Physiotherapists and occupational therapists can provide treatment for spasticity, and in severe cases, doctors may prescribe medication. It is important to stay active and continue exercising to manage spasticity.

Hypertonia refers to increased muscle tone and tension. This happens when a stroke damages the part of the brain that sends inhibitory signals to the muscles, instructing them to relax. As a result, the muscles continuously fire, leading to increased muscle stiffness and tension. Hypertonia commonly affects the limbs, particularly the arm and hand, making them stiff and difficult to move.

If left untreated, hypertonia can lead to contractures, which are shortening and stiffening of muscle, tendon, ligament, or skin fibres. This results in a decreased range of motion and restricted function in the affected joints, commonly including the hips, knees, ankles, elbows, wrists, and shoulders. Spasticity is a type of hypertonia that often appears after a stroke, causing involuntary muscle contractions and spasms that are worsened by movement.

To summarise, a stroke can cause muscle stiffness, known as spasticity or hypertonia, due to disruptions in the communication between the brain and muscles. This can lead to tightness, resistance to movement, and fatigue. Treatment options include physical therapy, occupational therapy, and medication in severe cases. Staying active and exercising are crucial for managing spasticity.

Dysphagia, or swallowing problems, can cause issues with eating and drinking

Dysphagia occurs when there is an issue with the complex process of swallowing, which involves many muscles and nerves working together to move food or drink from the mouth to the stomach. When this process is disrupted, swallowing may feel uncomfortable or slow, and coughing or choking can occur when trying to swallow water, food, or even saliva.

There are three types of dysphagia: oral, oropharyngeal, and esophageal. Oral dysphagia occurs when there is an issue in the mouth, where the jaw, teeth, and tongue work together to tear food into smaller pieces. Oropharyngeal dysphagia happens when there is a problem in the throat, making it difficult to transfer food from the mouth to the throat. Esophageal dysphagia is when the problem is in the esophagus, the tube that connects the mouth to the stomach, which squeezes food or liquid down in a wave-like motion.

Treatment for dysphagia may include medications, changes to eating habits, and sometimes procedures. Speech-language pathologists can assess the patient's ability to swallow and provide treatment. Treatment may involve swallowing therapy, changes to diet, such as softer foods, and the use of special utensils. In some cases, feeding tubes or surgery to widen the oesophagus may be necessary.

It is important to seek medical help for dysphagia as untreated, it can lead to serious health issues such as aspiration pneumonia, which is a common complication after a stroke.

Foot drop, a common type of weakness or paralysis, makes it difficult to lift the front part of the foot

Foot drop is a common walking challenge caused by a stroke. People with foot drop cannot lift the front part of the foot due to weakness or paralysis of the muscle that normally lifts it. This results in the foot dragging or scuffing along the ground while walking, and can cause poor positioning and unsteadiness of the ankle and knee while standing.

Foot drop is caused by damage to the brain's ability to send and receive messages to the muscles. This damage can be caused by a blocked or burst artery, resulting in reduced blood supply to the brain. The brain controls both involuntary and voluntary muscle activity by sending neural messages to the muscles. When a stroke occurs, this complex process can be disrupted, resulting in muscle weakness or paralysis.

The muscle that lifts the foot is called the tibialis anterior. The tibialis anterior can be stimulated to contract and lift the foot through functional electrical stimulation (FES). FES sends small pulses of electrical stimulation to the nerve that controls the muscles lifting the foot. This can improve walking speed and balance, and reduce fatigue and the risk of falling.

Other treatments for foot drop include gait training with assistive devices, braces and orthotics, and surgery (although this is rare).

A stroke can cause shoulder pain, usually on the side of the body affected by the stroke

A stroke occurs when the blood supply to the brain is interrupted, either due to a blocked or burst artery. This interruption can cause tissue damage in the brain, which often leads to changes in how the brain and muscles communicate. This disruption can result in muscle spasticity, where the muscles feel stiff and tight and may resist movement. The effects of a stroke on the muscular system can vary, but survivors often experience muscle function impairment, tone issues, and coordination problems.

One common issue that can arise after a stroke is shoulder pain, which can be caused by various factors. Shoulder pain after a stroke is often associated with conditions such as hemiparesis (one-sided weakness) or hemiplegia (one-sided paralysis). Improper positioning of the shoulder, neglect, learned nonuse, and spasticity can all contribute to shoulder pain. Additionally, secondary complications like diabetes, limited arm function, post-stroke pain, and neuropathy can increase the risk of shoulder pain.

Frozen shoulder, or adhesive capsulitis, is another possible cause of shoulder pain after a stroke. It is characterized by stiffness, pain, and limited range of motion in the shoulder joint. This condition typically develops gradually and can last for several months or even years. Frozen shoulder can be particularly common in individuals who have experienced a stroke, especially if the arm has been immobilized or partially dislocated.

The management of shoulder pain after a stroke involves addressing the underlying causes and promoting adaptive brain rewiring. Rehabilitation methods such as range-of-motion exercises, electrical stimulation, and mental practice can help improve mobility and relieve pain over time. Additionally, pain management techniques such as therapeutic taping, shoulder braces, positioning techniques, massage therapy, acupuncture, medications, and injections may be used to alleviate shoulder pain during the rehabilitation process.

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