04/12/2025
Does stretching really help with spasticity management?
It’s a question that often sparks debate and the answer isn’t simple.
With reference to up-to-date literature and national guidance, spasticity should be treated when it interferes with function, comfort, or care. Effective management must be goal-oriented, centred around the individual’s priorities, and coordinated by a multidisciplinary team.
Stretching alone isn’t enough.
Emerging evidence suggests that while stretching plays a role, it is most effective when used as part of a combined and targeted approach. It should complement other physical and medical interventions, such as:
• Splinting
• Weight-bearing activities
• Functional movement training
• Botulinum toxin A (BoNT-A)
• 24/hr postural and positioning programmes
Importantly, BoNT-A should never be used in isolation. It serves as an adjunct to broader rehabilitation goals and must be integrated with appropriate physical management strategies.
It’s also recommended to address and avoid potential triggering factors such as pain, infections, and poor seating positioning as these can exacerbate spasticity and reduce treatment effectiveness.
At NeuroPhysio, we align our spasticity management strategies with the latest evidence and recommendations, including:
• NICE Guidance (NG179)
• Splinting for the Prevention and Correction of Contractures in Adults with Neurological Dysfunction
• National Clinical Guideline for Stroke
• Manning et al. (2024) – Current Clinical Practice of Irish Physiotherapists and Occupational Therapists in the Assessment and Treatment of Spasticity in Adults
Spasticity management is multifaceted. There’s no one-size-fits-all solution it requires comprehensive assessment, clinical judgement, and a personalised, interdisciplinary approach.
We’d love to hear from others in neurorehab what’s working in your spasticity management toolkit right now?
