Contractures are a medical condition where a joint is held in a fixed position due to the shortening of a muscle or tendon due to stress exerted on the muscle or spasticity (uncontrolled muscle movement). Older patients and those with limited mobility are especially prone to develop contractures. Contractures most commonly form in:
Once an individual has developed contractures, little can be done to alleviate the problem aside from aggressive orthopedic surgery. Consequently, medical facilities (hospitals and nursing homes) should provide physical and occupational therapy to people who are at risk for developing contractures and to keep the body flexible.
Once a person has developed contractures they are at a heightened risk for developing bed sores due to their bodies limited ability to move– with or without assistance and the unnatural pressure put on the body in a rigid state.
The rigidity that accompanies contractures generally means that many of the repositioning techniques commonly used to prevent bed sores may be unfeasible. As a general rule, the more immobile an individual is, the higher likelihood they have in developing bed sores.
The duty of nursing homes to prevent bed sores
Contractures simply are not part of the aging process! Recognizing the problems associated with contractions and the fact they remain widely preventable, federal law requires facilities to take action to prevent contractures. The applicable law, 42 CFR §483.25(e)(2) states:
“Based on the comprehensive assessment of a resident, the facility must ensure
that — A resident with a limited range of motion receives appropriate treatment and
services to increase range of motion and/or to prevent further decrease in range of
Caregiver’s tip for preventing contractures:
David Terry has some practical suggestions for preventing contractures in bed sore patients. Here’s are David’s suggestions.
- Insist that your loved one receive stretching exercises twice daily.
- Insist that all necessary preventive devices are used.
- Visit often and make sure that staff members are attentive to the needs of your loved one.
- Be respectful, but firm that your loved one receives the care they deserve.