Stroke: Preventing Injury in Affected Limbs

Overview

After a stroke, you may not feel temperature, touch, pain, or sharpness on one side of your body. This may lead to injuries such as:

• Cuts and scratches.

  These can happen if your nails aren't kept short and smooth. For example, if you can't feel sensations in your feet, you won't know if your toenail is cutting into your skin.

• Burns.

  If you can't feel heat on your affected side, you may be more likely to get burns.

• Shoulder problems.

  If you have poor muscle tone in an arm, you may be at risk for shoulder problems, such as a dislocated shoulder.

• Swelling.

  Swelling occurs when the affected arm or leg can't move for a long period of time. A large amount of swelling can:

  • Increase the risk of skin sores (pressure injuries).
  • Increase your chance of having the joint stiffen (contracture).
  • Cause pain and discomfort in and around the swollen tissues.

Preventing injuries

In stroke rehab, you can learn how to prevent injury on your affected side. Your stroke rehab team can suggest things that are specific for you. But here are some general tips.

• Prevent cuts and scratches.

  Keeping your nails trimmed can help.

  • If you tend to clench the fist of your affected arm, keep your fingernails short and smooth.
  • If you can't feel sensations in your feet, cut and file your toenails straight across.
  • Soaking your hands and feet may make your nails easier to cut.
• Avoid burns.
  • Bathe and do dishes in lukewarm water.
  • Test the temperature of bath water or dishwater using your unaffected side.
  • Use pot holders whenever you work near a stove.
  • Turn pot handles away from you to prevent spills.
  • Wear nonflammable clothes when you cook. And don't wear clothes with long sleeves or ruffles that could get caught in an appliance.
• Take steps to prevent a frozen shoulder.
  • Support your affected arm. For example, wear an arm sling when you sit up or walk.
  • Maintain full range of motion of the affected joints. You can do this either by moving your arm or by having someone move it for you.
  • Don't overexercise your arm. This can cause pain and make it hard to exercise.
• Prevent swelling in your affected arm or leg.
  • Prop up the affected arm or leg. If your arm hangs down at your side for long periods of time, you will have more swelling in the arm.
  • Follow your doctor's advice about what daily exercises to do. There are exercises you can do to help drain fluid from the affected arm or leg.
  • See a physical therapist. The therapist can teach you how to do special massages that can help move fluid out of your arm or leg. You also can learn what activities would be best for you.
  • Try compression stockings to keep fluid from building up in your arm or leg. Your doctor or therapist can help you know what size to buy.