It is important to start doing therapeutic exercises as soon as your doctor clears you to after a stroke. Many people may experience shoulder weakness which can lead to shoulder pain. 

How can I increase my shoulder strength and decrease pain after a stroke?


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Having a stroke often results in one-sided weakness. This weakness will usually
affect the upper extremity as well as the lower extremity. It is important to
start doing therapeutic exercises as soon as your doctor clears you to after a
stroke. Right after a stroke, many people may experience shoulder weakness which
can lead to shoulder pain. In order to regain strength and mobility in the
shoulder, you must retrain your brain through a process called neuroplasticity
[https://home.neofect.com/blog/why-neuroplasticity-matters-to-post-stroke-rehabilitation]
. Neuroplasticity is the brain’s ability to create new connections and neuro
pathways by performing repetitive movements.

Common shoulder conditions one may exhibit after a stroke are:

Shoulder Subluxation: A shoulder subluxation is when one partially dislocates
the shoulder and the head of the arm bone comes partially out of the socket.
This can be caused by weakness or spasticity. Another common physical condition
after a stroke is a paralyzed arm.. A paralyzed arm often hangs to the side of
the body, and without the proper support from the shoulder muscles, gravity
stretches the tissues around the shoulder complex causing a shoulder
subluxation. Therefore, it is important to provide proper support for the
affected arm at all times.

Treatment ideas: Perform repetitive and gentle motions in order to retrain the
brain through the process of neuroplasticity. The stronger the neural pathways
are the more relaxed your shoulder will be! In order to address the pain, one
can use a sling or kinesio taping, however, one should not use a sling all the
time! Electrical stimulation is another common treatment idea. Electrical
stimulation
[https://www.strokeassociation.org/en/about-stroke/effects-of-stroke/physical-effects-of-stroke/physical-impact/functional-electrical-stimulation] 
can help increase blood flow, decrease pain, decrease inflation, and increase
function.

Frozen Shoulder: Frozen shoulder is characterized by stiffness and/or pain in
your shoulder. This is caused by non-use of the shoulder for an extended period,
and symptoms usually begin gradually, worsening over time.

Treatment ideas: In order to treat frozen shoulder, it is important to do
gentle, therapeutic exercises and keep that shoulder moving. Many doctors will
recommend taking an over-the-counter anti-inflamortary medication to decrease
inflammation and pain allowing for increased range of motion. Electrical
stimulation can also help with frozen shoulder by increasing circulation and
decreasing pain.



Tone/Spasticity in Shoulder: Spasticity in the shoulder is caused by involuntary
muscle contractions. When these muscle contractions are more mild, it can cause
muscle tightness. If it is more severe, however, it can cause uncontrollable
spasms. Tightness and spasms in the muscles caused by a stroke can result in a
great amount of shoulder pain.

Treatment ideas: When addressing tone and spasticity, you will need to perform
repetitive shoulder exercises in order to retrain the brain through the process
of neuroplasticity. Retraining the brain will help you have more control over
your movements as well as help relax the muscles. Many doctors will prescribe
medications such as Botox or Baclofen to help decrease the tone and spasticity.
Medications should be used in conjunction with therapeutic exercises for optimal
results.

Central Post Stroke Pain: Sometimes after having a stroke, people can suffer
from Central Post Stroke Pain which is when your brain misinterprets stimulation
as pain. This is caused by a neurological condition.

Treatment ideas: Unfortunately, Central Post Stroke Pain is very hard to treat.
Talk to your doctor about different pain meds that may help address this issue.

One way to help address shoulder pain and shoulder weakness is by using the 
Neofect Smart Board [https://www.neofect.com/en/product/pt-shoulder-arm/] to
retrain the brain by doing repetitive therapeutic exercises based on the theory
of neuroplasticity. The Neofect Smart Board unweights the user’s affected arm
and focuses on repetitive functional movements in order to increase overall
range of motion, coordination, and timing through reach retraining activities in
a virtual reality world.



The Smart Board provides therapeutic gaming activities that simulate aspects of
daily living as well as some fun, innovative games that mimic movement patterns
that are common in everyday life. Technology does not only make therapy more
motivating and fun, it also allows for our clients to accurately track their
progress. The Smart Board allows for a high intensity and a high repetition
program in a short amount of time. A recent study performed at Stanford Medical
Center found that for best results it is important to utilize the Smart Board
for at least 30 minutes a day, five times per week. Consistency is key!

To find out more information regarding the Smart Board please call us at
888-623-8947 or email us at contactus@neofect.com.