Movement Retraining while dealing with Spasticity

Should someone focus on “neuroplasticity” or spasticity if you have damage to the brain? The answer is not so easy but It is SUPER important. In this video, I will discuss my rationale to this somewhat complicated question.
Learn the stages of motor recovery and how to select the best exercises for you.
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[@michellemaikoetter6289]

I am seven years out today from a right side ischemic stroke at age 35. I have left side hemiparesis and foot spasticity. Physical therapy has gotten me to the point where I am graduating with my bachelor's in nursing in December. I still have lots of work to do but I use your videos to adjust my PT home exercises, they've helped a lot, thank you!

[@larryvinal4124]

I have just found your channel. I am a stroke survivor since Dec.2, 2006. Love your information.

[@ronpadlo7301]

Larry, we are sort of in the same place? I had a hemografic stroke 12/31/2007 but I am alive and this wonderful young ladybug brings to many renewed strength,hope, and vigor thank you for everything God and for dr. Tara Tobias!

[@ericsalinas1839]

This channel is gold

[@rehabhqofficial]

I appreciate that :)

[@iamnumberfour383]

Yes i agree 100 percent bro

[@christiannaguit7618]

platinum maybe

[@poojahm120]

The above channel is too good. Very much needed. You are awesome mam . Blessed with humility caring patience.

[@varunnevatia2943]

I follow your videos desperately for recovery from my spasm in foot . I am sometimes fed up with spasticity but get motivated after watching your videos. Thanks ma'am.

[@user-qh9si4zt1e]

ello, thank you very much. According to my understanding, the entire injured body is one unit. There is no separation. My method is circular movements thousands of times until the tension of the head, neck, arms, legs, back is released, all circular movements thousands of times.

[@scysa]

This is the best set of videos i’ve found on spasticity

[@allanrichardpacis7175]

Thank you Dr. Tara for sharing this info. Aside from physical therapy and rehab, a stroke survivor must be well-informed in order to set what to expect from recovering. Your videos are so helpful especially to a stroke survivor like me.

[@jes587690]

You put out great videos that is going to help me regain my ability much as possible. Thank you for your help!

[@rehabhqofficial]

I am rooting for you 100%!!

[@PathfinderARA]

I don't know if you're producing newer videoes or not, but I have to tell you how much I have enjoyed listening to your presentations on spasticity. I have cerebral palsy, so I deal with various levels of spasticity. Sure, I have always had doctors and therapists, who were interested in helping me with it, but until recently I didn't bother educating myself on it and why we need to be treating it. My point is we can't only recommend treatments without properly educating people. Once somebody understands, whatever goes further. I have a new neurologist, and he suggested doing Botox on various muscles. He is like you, he's very good at explaining and making somebody comfortable.

[@BIG1TOWER]

I have improved so much, I just hope the spastic in my hand relax a bit more. After my stroke I hand very little movement in my left arm and hand, that was 11 months ago now I have full movement but I’m dealing with tone. I watch all of your videos you have helped me so much.

[@vikramgour9343]

Ca I get your email to you I have also same Problems

[@haidernaeem3147]

Hi Can you please email me on [e-mail] That after how many months you regained your hand movement

[@vikramgour9343]

My email [e-mail] I send you mail check and reply

[@legendary8838]

I’m still waiting for movement in my left hand

[@anthonydavis4829]

The stress of quarantine and covid 19 will put your skills in greater demand. I pray instructors are as good as you. Great video.

[@prossiification]

I love your videos. You inspire me so much to persist with my rehab. Thanks!

[@Bethh3890]

I can't thank you enough for putting these videos out for us. They are extremely helpful for us dealing with spasticity. You are appreciated!❤️

[@Nina_2288]

🧡🦋🧡 Dear Dr. Tara, thank you very much for this video again! Super explanations that bring symptoms and treatments into relation. Neuroplasticity is real and spastics can be eliminated!! I benefited so much from your exercises and gained so much back and drastically reduced spastics. Lots of greetings! 🌺🌸🌺 Nina

[@rehabhqofficial]

Nina, I am so glad to read this. As much as I would like to take any credit for your success....YOU are the reason for your success. Hard work, determination, and a positive attitude is 90% of recovery. Keep it up!!!! Oh, and keep the emojis coming. They truly make my day 🤗 Regard, Chico 🐶 and Tara 🙃......

[@rodneydangerfield7153]

Thank you, Dr. Tara, for your very informative video!

[@albertbennett224]

Awsome video im just starting back covid hit my family hard between grieving and the stress of every day life i now will attempt to regain my home therapy routine

[@elodieleaf]

You are so helpful 🌟🌟🌟🌟❤️your video's are also great for sharing with friends/family. Thankyou🙏🏼🌺

[@jirapolottpobukadee1139]

I love your program.

[@rehabhqofficial]

Thank you. I hope it helps :)

[@virtuosoproductions4589]

In my experience, clonus and neuroplasticity were more connected. Whenever my brain learned something new, that night my clonus was at the highest intensity because spinal cord(dumb brain) didn't want to hand over control of that muscle back to the brain. Movement dependent spasticity was always present and still haven't gone away from certain muscles after six years even though I work out 5 out of 7 seven days. Still working on it. Godd video non the less.

[@saultopaul3981]

Great info. Thank you for helping with your knowledge and experience.

[@rehabhqofficial]

Thank you for watching! I hope it helps

[@miltonmayes3860]

This is so very informative!❤🙏

[@farhadfatah81]

Thanks dr tara

[@janjenkinson1829]

Hi Tara, I bought the buckle resistance band from Amazon that you shared a link. Anyway it was VERY DIFFICULT to unbuckle it was impossible to do with one hand. Had to return. This might be a one off. Love you

[@pedrorossi9443]

I love your videos. Thank you so much god bless you.

[@poojahm120]

Excellent channel , mam you are tooo good . I wonder how you understand our problems. Post the videos regarding the same . Thank you so much mam ( God sent angel) ❤❤

[@FullTimePatient37]

Dr Tara you are amazing 😍 What do you suggest for progressive general dystonia ( with Dysphagia and severe dysphonia). Thank you ❤

[@LIZVICIANA]

Thank you!!!!!!! So much

[@patricktrudeau9589]

Thank you so much for recommending this fellow on Instagram. He is very inspiring and I started fallowing him right away! So so good 😊

[@slokanath4943]

can you please provide his name/ Instagram ID?

[@ccd1449]

Thank you so much

[@rehabhqofficial]

Thank you for watching!!! I hope it helps

[@alefeb1]

Could you cover pronation and supination exercises for the wrist/arm?

[@faisalsaeed1784]

Alright doctor I have been following your videos on spasticity but my spastic foot is causing lot of problems for me . after the surgery my muscles gets stiffen up for walking for a while. with exercise the stiffness decreases to some degree but after a while it gets stiffens back. how do we stop this from happening again and again is it going to take years to train our brain new movements?

[@norbertolara4943]

God bless yuor program,im Iglesia Ni Cristo from Philipine.ty.doc.

[@aseelalhusseini1793]

Thank you for your great channel! Where can I get the fingers and wrist splint you used on the patient to open her hand?

[@pauline627]

Hello doc Tibia. My left hand is very cold,hence it caused my fingers curl inward and my arms flexing up. What can do to help

[@jheneal052210]

doc, ventosa cupping is it possible for my stroke rehab?

[@becauseofwhoyouare6716]

HAPPY NEW YEAR! # Ataxia. Dr. Tara in addition to SCA-3, I am dealing with neuropathy (& sciatica from pinched nerve in lower spine). I am in pain especially on standing and walking.Can pinched nerve be unpinched?

[@katevanloon916]

my friends baby is startng CIMT for crebral palsy.she'll be 7 months. i am so relieved and hopeful for her when i see that this een works for adults

[@maarannatarajan1258]

Good day Madame, Your speech is making me to self believe. In Jan 2022, by an accident, left skull removed and after 3 months same skull fitted. Now I almost recovered, my right foot was not acting. Just guide me what exercises to do. Thanks

[@bryanb0016]

Thanks!

[@rehabhqofficial]

Thank you so much! 🙏

[@mcbreartyfull]

Great stuff

[@rehabhqofficial]

Thanks for watching!

[@majdaboudargham2554]

my dad had a stroke in the left cerebellum it has been 9 and half months and still hi is unable to walk normally.he raises his left hand while stepping on his left leg. is there any hope that he will improve ? if yes what do you recommend?

[@gidelilah8027]

I should point out that I am new to this channel and so if this question has already been asked, I do apologise - do you have any advice for reversing severe muscle atrophy and weakness please? Thanks very much.

[@eswarikamireddy260]

This is really what I wanted to hear in a longer time. I never thought with my severe stiffness in legs, couldn't make them normal. But I have a question. You said rewiring with brain but when spinal cord is the blocking part, can we still try this rewiring?

[@sarahcurlee5580]

Just found this page. It's great! do you have any videos on dystonia and popping tendons?

[@rehabhqofficial]

Thanks for watching! I do not have any videos specific for dystonia.

[@siewchinwong6451]

May i know how one can overcome the spasticity of the knuckles ? My father had stroke 1 year ago and now he still could not close his fingers as the knuckles joint are too stiff. Any advice will be appreciated.

[@Stephanie-PDX]

Because of my brother and sister in law, my mom's rehab stopped maybe 2 months after her stroke because at that point there wasn't any noted improvement. I fought for it to continue because after her stroke I fully educated myself on everything stroke related, especially neuroplasticity, but they weren't interested. It was a severe ischemic. It will be 3 years on Thanksgiving that I found her on her kitchen floor. She is still paralyzed on right side, her paralyzed leg/foot points down and veers outward. No improvement so she's confined to a wheelchair. She also has a severe case of Aphasia to the point it's really impossible to have a conversation and short term memory is pretty bad. I guess my question is, after this much time of essentially doing nothing, can anything be done to help at this point? I have read about bio markers that can show the potential for a person's recovery. I know in the beginning is the most important time for rehab for recovery, unfortunately my power for her to continue was removed. I know this is long and probably not the right place to be asking, I just came across you tonight. You are so fantastic and getting close to the anniversary of her stroke, and the fact I haven't been able to even see her because of the pandemic, just makes me really sad and in the back of my mind, I feel like even after a long while without any therapy, there still might be a small chance to improve her quality of life. I would take even a 5% increase at this point. Thank you for your time. You are truly a gift to those who are able to benefit from your knowledge and instruction.

[@jeanniehowell685]

I had a brain stem stroke about 2.5 years ago she must want to get better and like me try try and try again I'm going keep trying I'm still paranoid and not walking yet but exercising and trying it's a slow process patience patience don't give up

[@siewchinwong6451]

Nutrition is important too for brain recovery. Coconut oil may help with memory.

[@stevefrye1042]

tara- it has been 12 years since stroke s ton ofspastic pain my pain doctor wants me go the way of ofSCS therphy what do you think about chances of this working for me?

[@semiromer9436]

Where can i get the hand splint you where using

[@lakenroth2174]

Hello I have Cerebral Palsy and Essential head tremor my head will shake back and forth sometimes but I take Gabapentin for that when I go to the Neurologist the nurse practitioner will check my knees and my left knee will kick out when she tabs on it Why is that?

[@jennawilliams5594]

Would love to know where a therapist/clinic can get a brace w/adjustable hinges like the one you're using on the patient at minute 9:45! (Neuro-based OT here, working in a small clinic without relevant mentorship. Thank you SO much for your videos!)

[@minicutegamer9244]

My right hand can move and have nospasticity.. My finger ca do fulfist but can not do otherwise to openthefist ..cannot command myfinger to open please advise

[@lynnecameron6645]

Thank you. I'm still working at it!

[@rehabhqofficial]

Hi Lynne!! I am glad to see you in the comments!! Keep at it. In case no one has told you this today, you are doing an amazing job. 😊 Without knowing you personally, the fact that you continue to watch and learn tells me all I need to know. :)

[@lynnecameron6645]

@@rehabhqofficial Thank you. 😊

[@contactcpl5729]

dear doctor, how to practice open the hand ?

[@MsCmeehan]

I have MS and spasticity resulting from exacerbation where entire left side paralyzed 15 years ago. Now I trip and don’t have foot drop. They’re thinking it’s spasticity of knee and hip. But I don’t feel any thing different. When I see my reflection in glass I can see I’m not holding my left foot normally. Is the ran air splint for hip and knee? Thanks!

[@romellcaisido9878]

My pt told me im will not move again my arms im a 4 mons post stroke it is true?

[@aaronoyster9627]

Dr. T, Thanks for the video. I'm considering getting an air splint. What was the brand name of that one you recommended?

[@rehabhqofficial]

Thanks for watching Aaron! Links are in the description.

[@nolaigmckaigney7135]

handsplint recommendations please

[@RichardPhillips-ve4ru]

Can you address the walking issue of not being able to move my foot left and right..I can rotate right but not left

[@PintoClare]

Do you have a comment on electrical stimulation (NMES) and is it beneficial?

[@jes587690]

How do you lift your leg, with a lot of spasticity, into the car? I use to think this was weakness due to MS but I've learned that spasticity is a major obsticle in the bodys ability of movment. I've started work on streaching my affected leg but need to find a way to get my foot into the car in the meantime.

[@Sarah-wt2zk]

What kind of exercises is good for the right leg that can't even move at all ? It is due from a subdural hematoma that has more blood on the right side? Can't even wiggle the toes

[@myrnasedayon3785]

is ems recommended during this spaciticy

[@tylermiller9634]

Hi there, Firstly can i say thank you for your videos, a real eye opener. My question, do you recommend massage in the affected spasticity area (leg/foot)? Would this be helpful or hinder? Thanks again from the UK

[@rehabhqofficial]

Thanks for watching! There is no evidence to suggest massage will "cure" spasticity. However, massage is great to decrease pain and help the body to relax which can help decrease the severity of spasticity. I hope that helps!

[@tylermiller9634]

@@rehabhqofficial Thank you, yes that does help. Keep up the great work 👍

[@ryanblackalternativeartist]

So I am walking again and I've been trying to improve my gait but I still can't just walk normal and I don't understand why cause my affected side is strong enough

[@fepunsalan2117]

Doc im a hemorragic stroke survivor..im recovering now..i can walk w cane..but i afraid someday iexperience nuero spasticity..doc what exercises i ferform that i can recover fast?

[@tbonegddss]

Thank you so much for your videos. I have MS, and both of my legs get very spastic when I stand. I am still working on finding the correct Botox dose, and only receive shots in my quads and calves. Any ideas for full legs spasticity? Thanks!💜

[@rehabhqofficial]

Thanks for watching Sara and for sharing your story!! I have a playlist titled spasticity with a variety of leg exercises. Generally speaking, if something is title "knee lock out" and/or "stiff leg" it is referring to quad and calf spasticity. I hope that helps!

[@paintthecitypink]

I have such bad spascity after my tbi my foot is completely on it’s side and I can’t move my hand and arm yet

[@bronwenh1861]

I have Hereditary Spastic Paraplegia. I have a horrible time walking downhill. Is there anything training wise to do?

[@Spectre2434]

Will this help with spastic paraplegia?

[@HUMAN28284]

Is any problem with standing if patient has any movement

[@leannpruce8914]

What is the brand of that wrist/hand splint ?

[@relaxwithnature6532]

Could you suggest a good hand splint to keep the hand open please?? I tell you stroke recovery will drive you crazy if you’re not strong. I have days where my spasticity is at a minimum and them you wake up one day and the spasticity is 100 time worse. This severely affected my motivation. Thanks for the video, I hope you’re doing fine in the pandemic.

[@rehabhqofficial]

Hi Tamara, happy to see you in the comments again. :) I am sure you are not alone in your frustration. There is currently not a hand splint that I think works well for spasticity. Stay tuned. I should have one that is going to "check all the boxes" available for purchase by the end of the year. It will be in the $200 price range which is comparable (in price) to the saebo :)

[@lorylou2281]

I had no idea what I was dealing with. I do now know that trying to muscle through things doesn't always work. After watching quite a few of your videos, saying to myself, I've seen that, I've felt that, I thought I dealt with that. My question is, if you have had a brain injury and didn't know it, could the brain on its own, continue to affect more and more of the body?

[@kishorsawant7033]

Good afternoon madam I i suffered stroke 21 months back.still I m not able to swallow food properly.toungue is become over sensitive .please help me .Thank you

[@cheriallan8706]

Thank you so much for this amazing resource! It is really supplementing my in-person therapy, and I love the explanations. Can you recommend a brace or exercises for the radial deviation of my wrist? And I'd love help with finger/hand/wrist exercises too!

[@kavindathiranagama3221]

How can we train the patient in bed to do the hand and leg movements?patient can only do the eye opening at now.muscle tightening as well there at arms so please let me know how eliminate these things at bed and how train body movements when patient in the bed.

[@willemh3319]

about the leg sometimes it does no matter how hard you try it and then the ground is VERY close 😱

[@MaticN91]

I have a stiff leg while walking. Have MS (multiple sclerosis) since 2007. While walking it sounds like when a diver comes from the sea and stamps down with his flippers. Any advice on that??? thank you in advance :D

[@deannafulwood1155]

You have helped me alot!! I have left side weakness with spasticity . One thing I have noticed, when I do exercises on my left foot/ankle I tend to get increased tingling to my left hand/arm. I noticed that if I pull my fingers on my left side, my foot relaxes. Is there a correlation in the peripheral nervous system?

[@rehabhqofficial]

Thanks for watching! Generally speaking, in many cases, with my patients I have noticed that when the arm relaxes there is an effect on the leg as well. :)

[@HalfWarrior]

Hi Deanna; same as you, my left side is paralyzed.I don’t have the same correlation to my hand and foot,but oddly for me, my left arm and leg flex upwards simultaneously when I yawn!

[@jeffmills4103]

I have the same yawn experience. Weird.

[@HalfWarrior]

@@jeffmills4103 Hi Jeff;yes, it's bizarre, but somehow I have always known my left arm and leg have a connection;but I still can't control specific movements;or isolate them on the left.

[@reyalamo5157]

Hi. Im hemoragic head stroke. My motor moving but my senses damage. Im very dstructed specially when weather rainy or cold feel so much pain. And my emotion i cnt control. What ppssble im going 2do. Pls help. Thnks.

[@rehabhqofficial]

Thank you for watching and for sharing your story!! These are all very common problems that can occur with hemorrhagic stroke. Hang in there!

[@KuldeepSharma-sj3oz]

I had brain surgery done in 2017 July ..but till now I m not getting dorsiflexion in foot ..I am getting frustrated .. doing exercises daily both active and passive.pls help

[@nitinyadav6562]

Thanks for sharing.... Actually I got head injury...

[@bryanb0016]

This is such an awesome video Dr. TOBIAS! atleast for me, it gives me a better understanding of what my therapists are doing to me and for me

[@kianobedoza922]

how do you deal with parakinesia brachialis oscitan..i had a mild stroke last end of july..will this go away eventually on its own..thanks

[@aminujamiu758]

Please contact your Physiotherapist

[@mcad-12]

I had brain surgery 4 months ago because they removed the tumors. After the surgery I cannot move my right arm and fingers. After 4 months I can now moved my arm up and down. My wrist has a little movement and my fingers keep curling but it can feel hot and cold and also pain. What should I do? And when i feel pain at my shoulder my arms is involuntarily going down.

[@rehabhqofficial]

Thanks for watching and for sharing your story! It sounds like you are making excellent progress! I strongly recommend working with a therapist in person. The shoulder "going down" can mean a variety of things and it would be best to work with a therapist in person to help you figure out the exact cause. Changes in skin temp and pain many times go "hand in hand". Here is a video that might help for your pain questions: kzbin.info/www/bejne/nJOwZ3Zqbr51hqs

[@carmellajames7898]

OR ON HERE

[@sheilasylvain6669]

Question, can you rewire if It's been more than three years with the spasticity. I have a SCI.

[@joynickerson5102]

Great question. I have HSP

[@rehabhqofficial]

As I say in the video, humans never stop rewiring.

[@virtuosoproductions4589]

All your life even if you are a healthy person.

[@raineldagibbs1963]

I had a relapse of Transverse Myelitis last April, my affected leg (right leg) is acting up again and would not cooperate with me in many ways...lol. Do I need to see an ordinary Physiotherapist or do I have to go to a Neuro Physiotherapist?

[@rehabhqofficial]

Thanks for watching and for the excellent question! I think I neuro therapist will understand TM better. Also many neuro OP centers in my area do not double book which would also be beneficial

[@raineldagibbs1963]

Thank you so much for your reply and your help. Sadly, I am from Ontario, Canada and neuro physio are hard to find in my area.

[@atenglangit1]

How to fix trendelenburg gait???

[@barbaradascalos7070]

check videos here on hip drop

[@salimrosa1965]

👍👍

[@sabima456]

Hi mam. My daughter 2 and half-year-old having spasticity on legs and she is not walking even she can't stand on her won..... Cud u please help me with ur great suggestions

[@sabima456]

And also she is having sessors gait while sleeping and standing

[@muratatlantis8472]

İmmediate effects for hemiplegics, single leg stance withknee flexion an extension, Dear Tara can you explain thia visually

[@rehabhqofficial]

HI Morat! Thanks for the question! I am having trouble understanding what you would like me to explain. Can you maybe explain this in another way? I am happy to make a video to deepen your understanding :)

[@muratatlantis8472]

İ have seen that paper via pubmed

[@rehabhqofficial]

@@muratatlantis8472 ok, i think I found the article. I will review it and hopefully get back to you or make a video :)

[@muratatlantis8472]

İ tried something, but stance is extremely hard for me,hard to keep balanced,you had published ve similar videos before, i remember, thax forr all but that article ve points importance for hemiplegicslike me.

[@fredkotthaus1518]

Can one ever get to the place where spasticity is a non issue. through these videos and your help, I have reduced the amount and intensity of spasticity in my leg, knee and ankle. How it does still kick in every once in a while.

[@rehabhqofficial]

Thanks again for your excellent questions Fred! Generally speaking, there is no "cure" for spasticity. However, again, in general, spasticity is lack of input from the brain. My conclusion is that the best way to "manage" spasticity is to keep working at the "neuroplasticity". I hope that helps!!

[@fredkotthaus1518]

@@rehabhqofficial yes ma'am it has helped me a lot, Thank you for your response

[@virtuosoproductions4589]

I spoke to one of the leading researchers on stroke recovery in the world. According to him you have to allocate large part of your brain to the spastic muscle I.e. lymp. Means keep moving it. I had the same question.

[@fredkotthaus1518]

@@virtuosoproductions4589 thanks for the response. I plan to do just keep moving bud.

[@virtuosoproductions4589]

@@fredkotthaus1518 no problem, we all, help one another.to do the same, I do lungs walk, zigzag, obstacle and backward sideways lunge walk pronate feet walk. This is all in addition to normal walk outside which has different surfaces like concrete, asphalt, grass; with up and down grade. Next, I'm gonna take up little dancing. Btw, the different type of walk i do that in my basement hallway which is about 30 feet long. This is just for lower extremities. I'm quite stable on my feet now. Most important thing is not to sit at one place. I keep moving even if it is for 5 feet. Like dr T. Said spasticity is movement based. Body is protecting itself from future traumas. Our spinal cord has taken over the control because brain went off-line for those muscles. Finally, I dont take any medication bow. I was on muscle relaxants briefly. My stroke was massive caused by a surgery around carotid artery. TC

[@mattmortenson9677]

What I did to get better in the last year was I got really f****** pissed about the situation. I swore a lot and through s*** and then I realized that nobody was going to be able to help me except for Jesus Christ! So then I started praying to God in the name of Jesus Christ and all the information I needed was put right in front of me. Amen

[@hopeh6176]

Hi Doctor. My husband affected arm has almost no movement. Yet he feels pain.If my hands are cold and touch hes affected arm he feels it .yet he can't move he's arm.

[@rehabhqofficial]

Thanks for watching and for sharing! This is a very common problem. I am working on a video that will address this. Stay tuned!

[@hopeh6176]

@@rehabhqofficial Thank you Doctor. Take care look forward to seeing this. Blessings 🌿

[@larryechols9293]

Will neuroplasticity solve spasticity ?

[@howardjones638]

The pain. In hip and foot is really bad

[@powgan1556]

It's hard to get ades in a nursing home to get people up that have PTSD and it's battle for the ades to get them up (not every day) so these people decline from laying in the bed. The drugs that are supposed to help with PTSD make the chronic constapation worse. It's a vicious cycle 😭😰 most people just give up. Is there anything that can help? I'm a Christian I believe in prayer but it is such a battle it's very discouraging. When to them the answer is more pills, pills then after they give more pills they still don't get them up 😒🤯. UGH!

[@maudiewilson7901]

I get spastic when I sit for 30 minutes or more

[@davidlinick8296]

Have you considered doing evaluations and making recommendations via Zoom ? (Not suggesting that this would be without financial compensation)

[@ronpadlo7301]

I know I would be interested in zoom therapy, thank you for bring up that comment!