The Parking Brake Analogy
Imagine driving your car with the parking brake partially engaged. The engine works harder, burns more fuel, and everything feels sluggish, even though you're doing the same things you always do.
That's spasticity. Your muscles are receiving too many "contract" signals from your damaged nervous system, keeping them partially tensed even when they should be relaxed. This constant low-grade contraction drains energy all day long, a hidden tax on your battery that most people (including many clinicians) underestimate.
How Spasticity Steals Energy
Direct energy cost: Contracted muscles consume glucose and oxygen even at rest. When multiple muscle groups are spastic, this baseline energy consumption can be significantly elevated, you're burning through your daily energy budget just by existing.
Movement inefficiency: Walking, reaching, and even sitting require more effort because you're working against your own muscles. Studies show people with MS spasticity use 30–50% more energy for basic mobility tasks compared to those without spasticity.
Pain burden: Spasticity often causes or worsens pain, muscle cramps, joint stress, postural pain. Pain itself is a massive energy drain (see our article on the pain-fatigue loop).
Sleep disruption: Nighttime spasms and muscle stiffness interrupt sleep, reducing restorative rest and amplifying next-day fatigue.
Types of MS Spasticity
Not all spasticity is the same, and understanding your type helps target management:
Tonic Spasticity
- Constant increased muscle tone, muscles feel perpetually stiff
- Often affects legs more than arms
- Worse after prolonged sitting or first thing in the morning
- Can actually help with standing and walking in some cases (provides a form of structural support)
Phasic Spasticity
- Involuntary muscle spasms, sudden, uncontrolled contractions
- Can be triggered by movement, position changes, or even temperature
- Often painful and startling
- More disruptive to daily activities and sleep
Clonus
- Rhythmic, involuntary muscle contractions (bouncing/shaking)
- Most common in ankles and feet
- Can be triggered by stretching or pressure on the ball of the foot
- Distracting and energy-draining
A Gentle Management System
Daily Stretching: Your Best Defense
A consistent, gentle stretching routine is the single most effective non-pharmacological intervention for spasticity. The key principles:
- Slow and sustained. Hold each stretch for 30–60 seconds. Quick bouncing stretches can trigger more spasticity.
- Warm up first. Even 2 minutes of gentle movement before stretching makes muscles more responsive.
- Target the common areas. Calves, hamstrings, hip flexors, and forearms are the most commonly affected.
- Twice daily. Morning stretching reduces the stiffness that builds overnight. Evening stretching helps prevent nighttime spasms.
- Never stretch through pain. Discomfort is okay; pain means you've gone too far.
Positioning and Posture
How you sit, stand, and lie down affects spasticity throughout the day:
- Seated: Feet flat on floor, hips and knees at 90°, support your lumbar spine. Avoid crossing legs.
- Lying down: Use a pillow between your knees when side-lying. Keep feet in a neutral position (not pointing down).
- Standing: Distribute weight evenly. Use support as needed. Avoid locking your knees.
- Change position regularly. Staying in one position too long increases stiffness. Set a timer to shift every 30–45 minutes.
Temperature Management
Temperature affects spasticity, but differently than you might expect:
- Warmth generally reduces spasticity, warm (not hot) baths, heated blankets, and warm environments can relax spastic muscles
- Cold can increase stiffness, dress warmly in cold weather, especially covering extremities
- But remember heat sensitivity, if heat worsens your other MS symptoms, find the balance point where muscles relax without triggering Uhthoff's
Medications
When lifestyle strategies aren't enough, several medications can help:
- Baclofen. The most commonly prescribed. Can be oral or delivered directly to the spinal cord via an implanted pump.
- Tizanidine. Acts on the central nervous system. Can cause drowsiness (which some people find helpful at bedtime).
- Gabapentin. Often used when spasticity accompanies nerve pain.
- Botox injections. For targeted spasticity in specific muscle groups. Effects last 3–4 months.
Important: All anti-spasticity medications can cause fatigue as a side effect. Work with your neurologist to find the dose that reduces spasticity without adding to fatigue, it's a real balancing act.
Movement Practices for Spasticity
Aquatic Therapy
Water is uniquely suited for spasticity management:
- Buoyancy reduces the effort of movement
- Warm water relaxes muscles
- Hydrostatic pressure provides gentle, even compression
- Water resistance strengthens without the impact of land-based exercise
Yoga (Adapted)
- Focus on sustained holds, not flowing sequences
- Chair yoga and reclined poses work for all ability levels
- Emphasize breath work, controlled breathing activates the parasympathetic nervous system, which can reduce muscle tone
Tai Chi
- Slow, controlled movements that challenge balance gently
- Studies show tai chi reduces spasticity scores in MS patients
- Can be practiced seated if needed
Living With Spasticity: The Emotional Side
Spasticity can feel like your body is fighting against you, because it literally is. The muscles you're asking to relax are receiving signals to contract, and no amount of willpower changes that.
This can create frustration, grief, and a sense of betrayal by your own body. These feelings are completely normal. Spasticity is not something you can push through or willpower away. It requires management, adaptation, and often medication, and seeking help for it is strength, not weakness.
Track your body symptoms each morning with Myelina Health to identify how spasticity patterns connect to your overall energy trajectory throughout the day.
