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Multiple Sclerosis and Muscle Spasticity

Updated: Apr 27

Multiple sclerosis, or MS, is a neurological condition that affects the nerves in the brain and spinal cord. 'Sclerosis' means scarring or hardening of tiny patches of tissue. 'Multiple' meaning this happens at more than one place in the brain and/or spinal cord. The damage to nerves seems to be due to the immune system mistakenly attacking the nerve coating which is made of a fatty protein called myelin.


This results in a wide range of symptoms, which effect people in different ways. Including,

·         muscle stiffness and spasms, known as spasticity

·         problems with balance and co-ordination

·         difficulty walking

·         numbness or tingling in different parts of the body

·         vision problems, such as blurred vision

·         problems with thinking, learning and planning

·         fatigue


Spasticity or muscle spasms is a common issue with Multiple Sclerosis and other neurological conditions. Most people with MS will experience spasticity at some point and it is the main cause of disability.


It causes extreme muscle tightness on one side of a joint and can cause weakness, poor balance and even issues with bladder & bowel function.

 

Spasticity develops when there is an issue with a neural pathway that controls a particular movement pattern. Issues with Dorsiflexion of the foot (foot drop) is a common symptom, and this presents as a weakness of the dorsiflexor muscle (that lift the foot), the hamstring which is the knee flexor; and the hip flexors which lift the leg from the hip. The spasticity or tightness develops in the opposing muscles – the quads at the front of the thigh and in the calf.


The muscle can become so tight that it can't function normally and will generally get progressively weaker as spasticity progresses.

 

There are different types of spasms:

  • Tonic, where the muscle is always tight and contracted even in resting

  • Clonic, where the muscles jerks violently when moving quickly

  • Flexor, common following stroke, is where a joint is permanently flexed/ bent. Eg. the forearm constantly bent in towards the chest

  • Extensor, common in MS, is where the joint becomes excessively straight. Eg. legs or back going into a spasm where they straighten excessively and can’t be easily released. This can happen more in the mornings on waking.

 

When working with MS clients it’s important to understand how spasticity works in order to release tightness in the correct muscles, build strength in the opposing weak muscles or provide alternative movement patterns to compensate for disabilities caused by spasticity. It is also important to understand which exercises may initiate a muscle spasm in your class and how to moderate this.

 

Muscular Sclerosis can cause extreme muscle tightness known as spasticity

If you have been diagnosed with Multiple Sclerosis or other neurological conditions and would like to improve your muscle strength and flexibility, to reduce pain levels, facilitate normal movement patterns, improve balance and posture, in order to maintain independence and confidence, get in touch to discuss how I can help you.


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