Abnormal Muscle Synergies after a Stroke or Brain Injury

Abnormal muscle synergies are one of the most common “movement problems” after a stroke or brain injury.

What is an abnormal muscle synergy?

A flexor synergy is when the hip, knee, and ankle all flex at the same time (visualize drawing your knee into your chest).

An extensor synergy is when all three joints extend (picture a ballerina going up on his/her tippy toe). Um, minus the fact you and I are not trying to do ballet 😫Yeah, HUGE problem.

Are abnormal muscle synergies really a bad thing?

Now, I know I started out by calling this a “movement problem”.  However, it does not start out as a “problem”. And therein lies the REAL problem.

You see, an “abnormal muscle synergy” is one of the stages in the stages of motor recovery. Now, here in lies the problem. Many times people get “stuck” in this stage. This is when the “non-problem”…….becomes a problem.  Ugh.

Getting “stuck” in this stage of motor recovery

All that being said, this movement problem (that starts out as a non problem), becomes a problem for three main reasons:

Movement is exciting

Generally speaking, “in synergy movement” is typically the first sign of movement after a period of no movement. Therefore, in most cases, people get really excited that their body seems to be recovering. That being said, they just start moving and returning to “normal activities” thinking that this is the beginning of a “complete recovery”. Unfortunately, this is the point when you need to IMMEDIATELY start discouraging these abnormal synergy patterns.

Abnormal synergies are confusing

The second reason this becomes a problem is that “abnormal muscles synergies” can be confusing. For some people, they don’t understand why their body is doing these strange movements. And in this case, they might just stop moving and/or avoid movements.

Abnormal muscle synergies can be painful

And in some cases, these “unnatural” movements can be painful. And in this case, this might also cause someone to stop moving.

How do you successfully progress through the stages of motor recovery?

That being said, ideally, you want to move on to the next stage in the motor recovery process. The next stage is when you learn how to move “out of synergy”.

“Out of synergy” means that you can perform the desired movement at one joint without the other two joints moving. We call this “isolated” joint movement.

For example, someone is struggling with an extensor synergy. In this case, you might notice that when you want to straighten the knee, the foot points. Well, the solution to this would be to “isolate” knee movement. To do this, you would want to work on straightening the knee without letting the foot point. That is just one of many examples of how you would break up a synergy pattern.

You can learn more “isolated” joint movements in this video

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