- Positioning– Weak or stiff it is important to know how to position the arm. It should be supported at all times. This may be with a pillow, table or armrest. The best position may vary from person to person depending on the problem so check with the therapist.
- Exercises and stretches– To maintain and improve the arm the therapist will use controlled gentle stretches and get the muscles to work. They may be able to recommend stretches and exercises the patient and carer can do themselves. However it is important to get guidance from the therapist because if the stretches are not done correctly this can lead to damage to joints and muscle. Only use stretching techniques if you have been shown what to do by a therapist.
- Massage– this can help to reduce swelling in the hand. This can also be done by the patient or carer following instruction from the therapist.
- Slings– The therapist may provide a sling to support the arm reducing pull on the shoulder joint and aim to reduce pain. It is still important to move and stretch the arm so the therapist should give instructions on how long to wear the sling and what stretches to do when it is removed.
- Splints– These are used to keep the hand or arm in a good position, reduce pain and assist with hand care. Splints cannot improve the function or use but can help to prevent further muscle contractures or shortening of muscles caused by increased tone.They are often used in a combination of treatments including passive stretching and sometimes with injections of Botulinum Toxin or Botox. Seek advice from the therapist about how long the splint should be worn and what exercises to do.
- Electrical stimulation– Electrical or functional electrical stimulation is sometimes used to stimulate muscles to work. Small pads are applied to the skin which stimulate the nerves and muscles. For example to reach and pick up an object.
- Strapping– This is sometimes used to give additional support to the shoulder to correct its position while the muscles not working efficiently and may help to reduce pain.
3. Practical advice and tips for carers > Physical deficits
7) Care of the affected arm – how therapists can help