📌 Personal Note:

This article is based on my personal experience and research.  It’s not medical advice.  Want to add your story? Email me — contact info is at the bottom.

Understanding Spasticity After Traumatic Brain Injury (TBI)

Spasticity doesn’t only happen after strokes or spinal cord injuries — it’s also a major challenge for survivors of traumatic brain injury (TBI). According to WakeHealth.edu, over 1 million Americans live with upper limb spasticity, and it’s often seen in stroke, spinal cord injury, multiple sclerosis (MS), cerebral palsy, and TBI.

For TBI warriors, spasticity can affect the hands, shoulders, wrists, and feet, especially the Achilles tendons. It can be painful, restrict movement, and interfere with daily life. Fortunately, there are many tools available — including medication, stretching, bracing, and surgery — that may help relieve or manage symptoms.

What Is Spasticity?

Spasticity is a condition where certain muscles continuously contract, leading to stiffness, pain, or involuntary movements. It occurs when there’s damage to the brain or spinal cord, especially in the areas that control voluntary movement.

If untreated, spasticity can lead to serious complications like:

• Contractures (muscles freezing in place)

• Overactive reflexes

• Chronic constipation

• Urinary tract infections

• Pressure sores

Symptoms That Often Accompany Spasticity

• Muscle weakness

• Tightness or stiffness in certain areas

• Clonus (muscle bouncing when stretched)

• Decreased coordination or movement control

Studies show that up to 38% of stroke survivors and a significant number of TBI survivors experience spasticity at some point during recovery.

Medication for Spasticity

Most treatments begin with muscle relaxers to relieve tightness and reduce spasms. Common medications include:

• Baclofen – Acts on the central nervous system

• Tizanidine – Targets nerve impulses

• Dantrolene – Reduces muscle tension

• Botox (Botulinum toxin) – Injected directly into affected muscles

🧠 Note: Oral meds affect the entire body, so even unaffected muscles may feel weak.  Botox injections allow for more targeted relief, especially helpful when only certain areas are affected.

However, like most medications, they aren’t a cure — they work best when combined with stretching, therapy, or orthotic devices.

Bracing & Orthotics

Braces and splints are often used to maintain muscle length, reduce contractures, or support proper joint alignment.

• 

  Serial Casting: Gradual repositioning using a series of casts

• Static Splints: Hold limbs in place but may not reduce spasms

• Dynamic Splints (like SaeboStretch): Allow for involuntary movement like sneezing or yawning

• Anti-Spasticity Orthoses: Custom-designed to relieve joint pressure and gently stretch muscles

• Functional Orthoses: Add support and reduce strain to help with walking or hand use

Stretching After TBI

Stretching is one of the most effective tools for managing spasticity. Especially after TBI, passive stretching (done with help from a caregiver or therapist) can keep muscles lengthened and reduce tightness.

• Passive Range of Motion (PROM) exercises help prevent contractures

• Regular stretching routines can improve mobility

• These are often done alongside medication or Botox

When Surgery Is Needed

When spasticity becomes severe or leads to deformities, orthopedic surgery might be recommended. These procedures may:

• Lengthen tendons that are too tight

• Nerve crush and or nerve block 

• Release muscle tension or stiffness

• Help improve posture, mobility, and quality of life

This is usually a last resort after other treatments have been tried.

A Global Issue

Spasticity affects more than 12 million people worldwide, including:

• 80% of people living with MS

• A large portion of stroke and TBI survivors

• Children and adults with cerebral palsy

Personal Reflection

As a TBI survivor, I’ve experienced the ups and downs of managing spasticity. In the video below, I talk with a licensed massage therapist while he works on me.  We dive into real techniques and recovery conversations.

🎥 Watch my experience and interview here.

Let’s Build This Together 💪

If you’ve lived with spasticity and want to share your story, your voice matters.  My goal is to create a resource-rich community for survivors, caregivers, and students.

📩 Want to contribute?
Email me — my contact info is at the bottom of this page.

Nolan@CoachNolan.com