Muscle Atrophy after a Stroke

Use it or lose it. Muscle atrophy after a stroke is a real concern.

If you have had a stroke, you may have suffered from muscle weakness of the face, arms or legs. Usually, only one side of the body is affected. When you don't use your muscles, they can become weaker and even thinner. This loss of muscle bulk and strength is called atrophy.

Rehabilitation is an important part of stroke recovery and some patients are fortunate enough to be able to get started with physical therapy or occupational therapy shortly after a stroke.


When muscles are not used, atrophy often develops. Atrophy is the shrinking of muscle tissue. In some ways, atrophy is the opposite of physical exercise that ‘works out’ muscles, causing them to grow, bulk up and become stronger. In contrast, atrophy is the result of inactivity of muscles. The lack of activity generally causes muscles to shrink and become weaker. Once a stroke survivor feels ready to become active again, the muscle weakness of atrophy combined with the weakness from the stroke can make using those muscles a huge uphill challenge. 

Preventing atrophy

One of the ways to get physical activity started before a patient is ready to participate in therapy includes passively moving the patient’s arms and legs gently. This is often done in the hospital or at home for stroke patients who are not able to start moving on their own.

In addition to preventing atrophy, passive muscle movement helps a disabled stroke survivor in several other ways.

It can help prevent bedsores that result from prolonged pressure on one part of the body. It can help to prevent blood clots that can develop in the arms or legs due to lack of movement, (although passive movement has been somewhat controversial as a method to prevent blood clots.) And it can help to minimize some of the nerve damage and muscle stiffness that usually occur after long periods of inactivity.


Reversing atrophy

Muscle atrophyis a condition that can be reversed. Many stroke patients become depressed when they observe their own skinny bodies that appear weak and malnourished after a stroke. After a stroke, swallowing difficulties and tiredness interfere with eating, and it is common for stroke survivors to lose some weight shorty after a stroke. Even with the best attempts at providing nourishment in the hospital, people who have trouble swallowing, as many stroke patients do, tend to lose weight. Families often become very concerned about the appearance of a loved one’s thin muscles after a stroke.

But, slowly resuming nutrition and physical activity can help improve atrophy, allowing muscles to resume their size and shape. Often it takes some planning and attention to maintain a good protein intake and adequate calories. Atrophy takes some time to develop and rebuilding muscles takes time too.  Once a stroke survivor begins physical therapy and safe at home exercises, the atrophy begins to improve.  Mild or moderate activities, such as walking a few steps with assistance or even bathing may seem exhausting at first. Reasonable expectations and gradual improvement can help prevent discouragement.

Muscles that are severely impaired due to the stroke can still benefit from passive movements for the long term. This helps overall coordination and health.

Atrophy is a common consequence of lack of the use of muscles. With time, exercise, and good nutrition stroke survivors can recover from atrophy. 


Martin Samuels and David Feske, Office Practice of Neurology,  2nd Edition, Churchill Livingston, 2003

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