joint contracture
/ kon-TRAK-cher /
Leave a door unopened for long enough and the hinges seize; force them and they barely budge. Joints behave similarly. When a joint is held in one position and not moved through its full range, the soft tissues around it gradually shorten and tighten until the joint can no longer straighten or bend fully. That fixed loss of motion is a joint contracture.
A contracture is a lasting restriction in a joint's range of motion caused by shortening and stiffening of muscles, tendons, ligaments, the joint capsule, or skin. It develops when a joint sits in a shortened position without regular movement — a knee left bent in bed, an elbow held flexed by tight muscles after a stroke, a hand curled by spasticity, or skin tightened by a burn scar. Once established, a contracture is not just stiffness that loosens with a stretch; the tissue itself has remodelled, and reversing it is slow, sometimes impossible without surgery.
In rehabilitation, contractures are among the most preventable yet most disabling complications of immobility and abnormal tone. A fixed bent knee can make standing or walking impossible; a clawed hand can defeat dressing and hygiene; a contracted hip can make even sitting in a wheelchair difficult. Because prevention is far easier than cure, much daily rehabilitation effort goes into regular range-of-motion movement, good positioning, splinting, and managing spasticity — the whole point being to keep tissues at their full length before they ever have a chance to shorten.
A patient who spent months in bed with his knees always slightly bent can no longer straighten them fully; when staff try to stand him, the stiff knees buckle. Daily range-of-motion exercises from the start would likely have prevented it.
A joint left bent for weeks may set in that position — easy to prevent, hard to undo.
A contracture is a different problem from spasticity, though spasticity can cause one: spasticity is an active, velocity-dependent muscle resistance that medication may ease, whereas an established contracture is a passive, structural shortening that no drug will release.