Gravity Matters: How to Use It (or Remove It) in Stroke Recovery
When I say “use gravity to your advantage”… what I really mean is: be strategic.
One of the biggest mistakes I see in rehab (especially home programs) is doing exercises that are technically correct—but poorly graded for where someone is in recovery.
And when that happens?
People end up doing too much. Or too little.
And progress stalls—not because they’re not trying, but because the setup isn’t right.
That’s where understanding gravity comes in.
Why Gravity Matters in Neuro Rehab
Whether you’re lifting an arm, straightening a leg, or sitting up from bed—gravity is always working.
Sometimes it helps.
Sometimes it resists.
Sometimes it makes movement almost impossible (especially early on when strength is low).
So the goal is to grade the activity—to match your ability with the right gravitational demand.
There are three key categories:
Gravity-Assisted
What it means: Gravity is helping the motion happen. You’re using its force to assist the movement.
Examples:
-
Rolling from back to side when gravity helps pull the arm across the body.
-
Shoulder flexion while leaning forward (gravity helps the arm dangle up/down).
-
Lying on your side and allowing gravity to help the arm fall into external rotation.
Why it matters:
When muscles can’t do the full job yet, using gravity to assist movement gives the brain a “win.”
It’s also great for early sensory input and retraining the brain without force.
Gravity-Eliminated
What it means: Movement happens parallel to the ground—so gravity isn’t helping or resisting. It’s neutral.
This is where we start when someone can’t move a limb against gravity yet—but you still want the brain to practice the movement.
Examples:
-
Lying on your back and sliding your arm side to side on a table (shoulder abduction).
-
Lying on your side and kicking your leg forward/backward (hip flexion/extension).
-
Using powder boards or sliding surfaces to allow arm movement without lifting.
Why it matters:
This setup removes gravity’s interference so the person can focus on motor control, not strength.
Against Gravity
What it means: Now you’re asking the muscles to work against the pull of gravity—this requires more strength and control.
Examples:
-
Lifting your arm forward while sitting upright (shoulder flexion).
-
Marching in place while standing (hip flexion against gravity).
-
Straightening your knee while sitting on a chair (knee extension).
Why it matters:
This is the progression step. Once the brain can activate the right muscles, and the body has the baseline strength, we challenge it.
But if you go here too early? You might just reinforce compensation.
Why This Shows Up in My Programs All the Time
You’ll see me reference these terms—gravity-eliminated, gravity-assisted, and against gravity—in almost every logic tree or exercise plan I build.
Why?
Because the success of any rehab plan depends on doing the right movement at the right challenge level.
And gravity is one of the simplest, most powerful ways to do that.
So if an exercise feels too hard—or too easy—it’s often not the movement itself that’s the problem. It’s the way it’s set up.
Final Takeaway: Grade Smart, Not Just Hard
Rehab isn’t just about doing more.
It’s about doing better—by matching the movement with the moment you’re in.
So the next time you see the words “gravity-eliminated” or “use gravity to assist,” don’t skip over them.
They’re not just technical terms.
They’re clues.
They help you find that sweet spot where your brain, your body, and your recovery can actually connect.
